‘My upper denture is ok but my lower denture is loose and sore and I have never been able to get on with it, what can I do?’
Loose dentures are often due to a lack of fit of the lower denture or imbalance in the biting pattern between the two dentures. As an upper denture is often the more stable of the two, it is the lower that gives way first and moves off the gum. This can cause soreness and ulcers under the denture and make eating and socialising a pain rather than the pleasure they should be. A loose denture can cause embarrassing moments and lead to a loss of self-confidence.
I would always look closely at the fit and function of your existing dentures to see if they can be improved, but the problem is more often solved by making a well fitting and balanced set of dentures using the BPS system (see blog on this).
In some cases even a well fitting lower denture may move in function, particularly if the teeth were lost long ago to leave a low ridge that limits retention of the denture. A lower denture relies to an extent on the wearer learning to use it and to control it with the tip and sides of the tongue. For many this is a struggle initially but can be overcome, but for some this is a difficult skill to master.
In the case of John who was about to lose his last few remaining lower teeth we could see that he was going to struggle to cope with a lower denture. He was happily wearing an upper denture and though worn it was comfortable and stable. His lower lip muscles were very strong and he had given up wearing the part lower denture made previously because he disliked the feel of it and its looseness, so he was dreading the thought of a full lower denture.
Our first step was to make a new well fitting and balanced set of dentures ready to be fitted on the day that we removed Johns’ last remaining lower teeth. This avoided any time without teeth and allowed us to see if John could cope, but as expected he struggled to tolerate them.
After two months waiting for the gums to heal we saw John again for a single surgical visit of an hour or so to place two dental implants approximately where his lower canine teeth used to be. Healing covers were placed on the implants which just showed above the gum and the lower denture was eased to fit comfortably over these.
After another two month wait for the implants to take to the bone we were able to make a copy of John’s new lower denture with Locator inserts in the denture directly over the implants. The healing covers were swapped for Locators onto which the denture now positively clicks into place.
This technique can also be used to improve the fit of troublesome upper dentures.
