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When Should a Denture Be Replaced?

There is no specifically agreed-upon chronological answer by dentists to "When should a denture be replaced?" There are instances where dentures have been replaced after 1 year or less, and on the opposite side of the spectrum, there are people who have worn the same dentures for 25 or more years. These ranges obviously are extremes.

However, on average, dentists seem to be replacing dentures somewhere between four to eight years. This would seem to imply that the average denture fabricated from contemporary biomaterials will wear out and deteriorate within that time and/or the average denture patient's jaws have changed so much that a new denture must be redone.

Each individual's denture needs are different. There are some factors that a licensed dentist takes into consideration when evaluating the need to replace dentures.

Denture Longevity Considerations

Lost vertical dimension:

The proper linear distance relationship between the upper and lower jaws is called vertical dimension. This is unique for each individual.

As one's jaw changes and the ridges upon which dentures rest shrink, a denture becomes loose and vertical dimension begins to change (the vertical dimension is said to be lost by a certain linear measurement unit such as millimeters). Additional plastic (acrylic resin) is added to the inside of a loosening denture (called relining a denture) to stabilize it by reducing looseness caused from jaw shrinkage. However, relining does not restore vertical dimension in an accurate way.

The current position held by most dentists is that when vertical dimension has been lost by three millimeters or more, a new denture should be fabricated in order to restore vertical dimension and maintain functional health.

There are individuals who have worn the same denture for extended periods with considerable loss of vertical dimension over time. Since vertical dimension loss is a slow, but nevertheless progressive, process, they have gradually adapted to a continually increasing closed bite position. These individuals often have a sunken facial appearance and usually appear much older than their chronological age.

Functioning with an abnormal vertical dimension may eventually result in alterations of the temporomandibular joints (TMJ, the jaw joint located in front of the ears). This can lead to significant pain and difficulty with effective eating and even the jaw motions involved with speech. It frequently becomes quite difficult, if not impossible, to restore such individual's proper vertical dimension and chewing efficiency by relining and repairing this older denture.

Tooth wear:

Aside from impaired ability to chew effectively, excess tooth wear will adversely affect esthetics and cause other problems associated with lost vertical dimension, as described above. While porcelain denture teeth will wear at a slower rate than plastic teeth, they nevertheless will wear and are more susceptible to chipping and cracking. Multiple cracked teeth will need to be replaced.

Deterioration: While the biomaterials used by dentists to fabricate dentures today are quite durable, they still deteriorate and exhibit dimensional change over time -- no longer fitting properly, even after relining.

Aging plastic looses its natural appearance and texture, and coloration fades, making dentures look quite artificial.

Deteriorating plastic also makes it easier for dentures to become excessively contaminated with microorganisms. This contributes to mouth irritation and bad taste, and socially unacceptable odors will develop that no amount of denture cleaning will seem to eliminate.

Keeping regular dental check-ups with your dentist so that one's dentures, soft tissues, and jawbone may be checked is essential to extending the life of a denture and maintaining oral health.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Root Caries: An Epidemic of Age

People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.

With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.

Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.

Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.

Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.