Custom Dentures

Custom dentures are for patients that want the best possible fitting denture that can be fabricated. As a prosthodontist Dr. Shannon sees and treats the most challenging denture patients. Many patients referred to Dr. Shannon come with an array of different problems. Often general dentist will refer patients they are unable to successfully fabricate dentures for. One of the most challenging situations for a denture patient is severe bone loss. Once the bone structure is lost there is less of a base for the dentures to sit on inside the mouth which greatly compromises the retention and fit of the dentures. The best solution for severe bone loss is to have a set of dentures that fits the inside of the mouth architecture as intimately as possible. The better the denture fits the tissue the better it will be retained inside the mouth. To get the best fit possible Dr. Shannon uses a functional impression technique to fabricate dentures. This technique allows the best possible impression while the denture is actually in function rather than a static impression. The technique includes all the regular denture steps plus a few more in what amounts to approximately six appointments to complete a set of dentures. Much time is spent making sure that the patients wants and needs are fully addressed during the denture process. The patient gets to choose the size teeth, the shape of the teeth, the color of the teeth and how the teeth get arranged. Some patients want perfectly white straight teeth, and some patients want darker, more natural looking teeth that mimic the natural teeth with more twists and turns. The denture is customized based on what the patient desires. The first appointment is initial impressions followed by the second appointment which is called jaw relations. At the jaw relations appointment a block of wax is used to determine where the teeth go and establishment of the bite. The third appointment is called the wax try in appointment which is where the patient gets to preview the denture inside of the mouth. The patient is given a mirror and gets to see exactly what the denture will look like inside of the mouth. If there is something not acceptable to the patient the teeth are still in wax at this point and any number of things can be changed including teeth shape, size, color and arrangement. If any changes are desired those changes are made and the teeth are tried in again to make sure the patient is happy with what they are seeing in the mirror. Once the patient is happy with the wax set up the dentures are sent for the initial processing. After this point the teeth can no longer be changed in the denture. At the next appointment, the dentures will be delivered to the patient. During this appointment, the dentures are delivered with a soft lining material that moulds exactly to inside the mouth architecture to get the best adaptation to the tissue which helps the dentures stay in the mouth as best as possible. This material stays mouldable for approximately three days, so the patient actually forms the inside of the denture while the denture is actually in function with the patient eating, talking, swallowing and yawning. The patient wears these dentures with the lining material for approximately two week or more. During this time, we are able to make sure that the patient will be comfortable in the dentures and changes can be made to the tissue surface of the dentures if necessary. It acts as trial period with the dentures to make sure they are comfortable and functioning as they should. As long as the dentures are working properly and are comfortable the next appointment will be the final reline of the denture. This requires the patient to come in one morning and the dentures are treated with a final reline material inside of the mouth to ensure the absolute best tissue adaptation possible then the dentures are taken from the patient for a day and a half. The material on the inside of the dentures that the patient moulded while actually in function is then taken out and replaced with the final hard acrylic. The patient comes back the next afternoon and the final dentures are delivered. Depending on the situation sometimes a permanent soft lining material is used inside the denture if the patient cannot tolerate the hard acrylic against the tissue surface. At this point the dentures are completed. Once the final dentures are delivered the treatment is complete. After final delivery it is common for some sore areas to develop which we will not know their identification until the patient wears the denture for a few days. This is much more common on the lower denture than on the top. Once sore areas are identified these are easily adjusted and taken care of. Depending on the inside architecture of the mouth only so much retention can be achieved. Depending on the retention requirements of the patient denture adhesive may be necessary to achieve the desired level of retention of the dentures inside the mouth. Some patients love using denture adhesive and some do not, this is an independent decision based on the patients desired level of denture retention. With this custom denture procedure described the absolute best fit is achieved. Even though the best fit is a achieved denture adhesive may still be required to keep the dentures in place based on the inside the mouth architecture. If denture adhesive is not achieving the desired level of retention for the patient the only other option will be to incorporate dental implants into the treatment plan. In most instances the same dentures can be used to incorporate implants into the treatment plan not requiring the patient to have new dentures made. The dentures can be retro-fitted to accept the implants. Patients will not always if they need implants at the outset of treatment. Unfortunately, this question cannot be answered until a proper set of well-made dentures are fabricated. The patient then has the opportunity to try the best set of dentures adapted to their tissues and then make a decision whether they may desire dental implants or not.