Patient Education

Bone Resorption - Videos that tell you more!
Bone Resorption

The term resorption describes the process of shrinking that occurs in the jaw bone once the teeth have been removed. This applies to both the upper (maxilla) and lower (mandible) jaws.
After the extraction of one, several or all of your teeth, the one that once supported the teeth resorbs shrinking quite substantially. This shrinking is a process that goes on for the rest of your life. There are several factors which affect the amount of shrinkage. They include:

  • The trauma of the procedure to remove the teeth, excessive trauma or fracture of a root before or during extraction may lead to excessive bone shrinkage. Facial trauma such as an accident usually causes excessive bone loss in the area after trauma.
  • The wearing of ill fitted dentures causes excessive bone loss including dentures that have been relined or are in excess of five years old.
  • Diet and Nutrition
  • The length of time you have been without natural teeth (the longer you have worn a full denture, the more bone shrinkage you will experience).
  • For partial denture wearers, if you lost the back teeth but kept the front, on either the upper or lower arch.
Understanding Bone

Regardless of what part of the body we talk about, bone has evolved to perform a very specific task. It must function under pressure or in a “weight bearing” capacity. We lose bone mass and bone density if our bones are not allowed to function the way they were intended. Some examples include:

  • Astronauts in space or “zero gravity” lose bone mass simply by not having weight to bear upon their bones and muscles. They try to augment this problem by using techniques such as resistance training with strong rubber bands to improve strength.
  • Spinal injuries having lost the ability to walk, those confined to wheelchairs loose incredible volumes of both muscle and bone. You do not see people in wheelchairs with strong muscular legs, with healthy dense bones

We are familiar with the advice given to the more mature element of our population (especially those with osteoporosis). “You must exercise, especially weight bearing exercise” if you are forced to support your own weight as with walking the bone cells responsible for building will keep bones strong and healthy. Hip fractures in the elderly is common, especially those who are sedentary.

What does this have to do with my mouth? Simply extractions of teeth are the mouths equivalent of a wheelchair. Remember bone cells everywhere in your body require pressure to build stronger bone. Teeth, when present transmitted biting force from the cutting surface down the root of the tooth to the jawbone. The bone cells (osteoblasts) are stimulated only when there is pressure from biting on natural teeth. Dentures do nothing to stimulate this biting pressure. The force a denture experts on bone is a traumatic type. It causes the bone to shrink excessively.

My Gums Are Shrinking!

This statement is somewhat misleading. The shrinking that most people speak of is the bone. This is why the life span of a denture is much less than most would expect. A reasonable life span for a denture is approximately five to eight years. In my office the average age of a denture is fifteen to fifty years, these are not dentures that fit but are merely dentures that do not hurt. The longer we wear dentures, the more bone is lost. We lose approximately one milometer of bone height every year in the lower jaw. Unfortunately, by the time we have worn dentures for thirty years there is typically nothing for the denture to grab on to.

“My wife, husband, or friend has been wearing dentures for thirty years or longer and they have no problems.”

This is a common statement made by patients in our office, and often times it is difficult to address without being insulting. Unfortunately, the definition of chewing is different for all people. These people may eat what they want but it is unlikely they chew to the extent that they should be. Most dentures wearers alter their diet to accommodate their chewing capacity. This now forms their likes and dislikes when it comes to food choices. Denture wearers are notorious more for their ability to swallow than their ability to chew. They usually have excluded anything that requires hard chewing (raw vegetables, fresh fruit, seeds, nuts and meats) and may in fact rationalize why they do not eat them.

“I never liked raw vegetables, even as a child”
“I have always cut my apples with a knife”
“Do you know how many poisons and pesticides are present in the skin of an apple?”
This is the equivalent of complaining that the newspapers are making the print smaller every year. “Perhaps I need glasses”

Successful denture wearers are highly skilled individuals. They are people who have the ability to adapt and forget. They control a denture with their facial muscles and are capable of ignoring looseness or movement of the denture, provided it does not cause pain. They can ignore food beneath the denture or tolerate it at the very least. Unsuccessful denture wearers by contrast can’t forget the foreign object in their mouth. They are actually aware of the movement of the denture in their mouths and the food that gets under them. They find speech affected by the dentures as well as confidence and self-esteem. They are aware of the foods they avoid or consume minimally and they miss them.

In short, their standards are too high and remember, successful denture wearers have lowered their expectations to the extent that denture wearing has become “normal”. The unsuccessful denture wearer is merely saying that 10% of the biting force of natural teeth is unacceptable for them. Dental implants provide countless improvements in the ability to chew. Food choices broaden, and denture discomfort becomes a thing of the past.

Information on Denture Repairs
  • Once a denture has been repaired, it is most likely to break again.
  • Dentures break at the weakest point of the denture and also at the point where the stresses are greatest, most often down the middle of a full denture or knocking a tooth off a denture.
  • In most circumstances, merely repairing a denture is insufficient in order to stop the denture from breaking again.
  • Multiple repairs can be done on a denture, however, repairing merely treats the symptom and does not address the root cause of the problem. In some instances, fracture or breakage of the denture, adjusting the denture teeth where they meet each other or by replacing the dentures.
  • The life expectancy of a denture is 5-10 years if the denture is maintained with relining and occasional adjustments.
  • Fracture of a denture typically occurs after the denture is approximately 2 years old. The second anniversary also corresponds with the time in which the denture begins to fit poorly due to naturally occurring shrinkage of the bone (gums) in the mouth. This “looseness” of the denture may or may not be noticeable to the wearer. This is due to the fact that the changes in the gums occur over an extended period of time, very slowly.
  • The denture wearer usually adapts to the inability of the denture to perform adequately, and they come to accept this looseness as normal. This is why many people 20-30 years with the same dentures, never having relined or replaced them. They have merely come to accept this inefficiency as normal. Their definition of chewing has changed quite dramatically over the years.
How Should I Clean My Dentures?

Brushing

To keep your dentures clean, you should clean them after every meal with a soft bristle brush. They should be brushed, inside and out, using lukewarm water and mild soap or non-abrasive denture toothpaste.

An acrylic surface that has been scratched by an abrasive substance easily absorbs saliva, which carries food particles that cause stains. The result: denture maintenance is much more difficult.

Plaque is an invisible bacterial film that forms gradually, not only on natural teeth, but on dentures as well. Once it hardens, plaque turns into calculus, which is an open invitation to bacteria, irritations, gum disease, digestive problems, bacterial stomatitis, to name a few of the harmful consequences of inadequate denture hygiene.

It is also recommended that you gently brush your tongue, gums and the roof of your mouth with a moistened, soft-bristle brush. This daily one-minute massage stimulates your circulation and tones your gum tissue, while ridding your mouth of bacteria. This also helps keep your breath fresher longer. TIP: Always brush your denture over a sink full of water, or a towel. This way, if you happen to drop your denture, the impact will be considerably lessened.

Soaking

Prolonged exposure of your denture to air can discolour it and dry out the acrylic, making it more brittle. When you remove your denture for the night, keep it in a covered container, filled with water or a special soaking solution. We recommend Nova Dent, which can be purchased at our clinic. Never use bleach to clean or soak your denture. It can weaken the structure of the denture and discolour the acrylic. Bleach will not work as a whitening agent.


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