All denture patients have experienced it: that day when you realize your denture is loose. There are a number of reasons your denture may start to fit poorly. Sometimes, uneven or excessive tooth wear causes your denture to tip or rock. Certain health conditions can also affect how your denture fits, such as weight loss of more than 7 pounds, sudden or new illness, cancer treatments, and various medications. However, there is one factor affecting all denture wearers that you may not have considered – bone loss.
Due to an ongoing, irreversible process called bone resorption, the jawbone of denture wearers and other edentulous people will shrink over time, causing your mouth to eventually no longer fit your denture.
Before tooth loss
Your jawbone is maintained through two processes: nerve signals and physical stress.
A nerve runs through the root of natural teeth. These nerves signal bone-forming cells called osteoblasts which – you guessed it – build bone.
In addition, the roots of natural teeth are embedded in your jawbone. The forces created by biting or chewing will transfer through the tooth and roots into your jaw bone, stressing your jaw bone enough to maintain its mass. Even for people who have had root canals (a procedure which removes the pulp and nerve inside the tooth), simply retaining a tooth’s root helps to maintain bone density.
After tooth loss
The extraction of a tooth means that the entire tooth – including the root and nerve – is removed. Without the root and nerve, osteoblasts cannot be signaled which means that your bone in that area cannot continue to be built, repaired, and maintained. Instead, bone-removing cells called osteoclasts move in and begin to break down your jaw bone at the site of tooth loss.
In addition, when you lose teeth and replace them with a traditional denture, the bone that once supported those teeth doesn’t get stressed in the same way. Your denture will transfer chewing and biting forces to your gums, not your jawbone. This causes a lack of stress on your jawbone.
The result? Your body starts to break down (resorb) your jawbone.
This explains why you can get a new set of dentures that fit perfectly right after they’ve been made, but as time goes on they fit more and more poorly until they are ill-fitting and uncomfortable. The dentures themselves have not changed, but the shape of the bone under your gums has.
Are some patients affected more than others?
While all denture patients will contend with bone loss, patients with immediate dentures will experience rapid and significant bone loss within the first year following extractions. After that, the rate of resorption will taper off, though it will continue throughout your life.
Conversely, patients with implant-supported dentures may experience a decline or stop to bone loss. Thanks to a process called osseointegration, a structural and functional connection forms between the jawbone and titanium implants. In essence, dental implants will become fused with the jawbone. Once this bond has formed, dental implants mimic both the strength and functionality of natural teeth, leading to bone preservation.
What can I do to restore my denture’s fit?
When your denture’s fit is poor, denture function is also poor, and this affects how you eat, speak, laugh, and even smile. A properly fitting denture is essential to your quality of life!
If you notice that your denture feels loose, falls down, tips when you speak or eat, or starts causing sore spots, you should book an appointment to see your Denturist. They will examine your oral structures and your denture and provide you with recommendations for how to remedy your situation.
In some cases, a reline or rebase may be able to restore proper function. In others, a new denture may need to be constructed to accurately fit to the new contours of your gums. Some patients may also be candidates for having dental implants placed; your Denturist can provide you with information on implant-supported dentures as well as a referral to a dentist or oral surgeon specializing in this type of surgery.