I work in eldercare, and so many clients have complained bitterly that
their dentures have never fit right, or just don't work for them
for some reason, while others seem quite content about it all.

I have a friend who is about to take this step.  I am wondering if
there is any way to pursue very high quality dentures?  Can someone
give me a rundown of the latest findings in this area?   I have even
heard that new (real) teeth can be seeded in the gums and grown, but I
imagine this would be prohibitive because of the expense.

I know that the field of orthodonture and gnathology has progressed
immensely over the past 20 years; I'm wondering if the field of
denture work (what's the term for it?)  has followed suit?


***

Hi Timespacette,

   Yes, from my research, it appears that dentures have kept up with
the times! Newer composites and techniques have made strides in
producing comfortable dentures. The very best way to find good
dentures is to ask people who have them (and are pleased with them)
where they obtained theirs. Remember that denturists make dentures,
not the dentist, and one denturist may service various dentists.

 ?As specialized professionals, Denturists are experienced in the
design, fabrication, insertion and adjustments of removable dentures,
as well as overdentures on implants, allowing you to benefit fully
from the technology. Some Denturists are qualified to provide partial
dentures,snore guards and weight loss oral appliances.

Unlike other health-care practitioners who provide dentures, most
Denturists' work is performed on the premises, by the Denturist who
sees you. Denturists are skilled in the clinical and laboratory
aspects of making dentures that are right for each individual.

When you seek the care of a Denturist you will find that as a patient
you play an active role in the discussion of what you desire for your
new dentures. Remember, you are in the hands of a professional who
specializes only in the making of removable prosthodontics. Your
Denturist will involve you in the steps necessary to ensure your
dentures fit properly and meet your full expectations.?
http://www.denturist.com/


?It's amazing how much whiter, and sometimes even bigger, new teeth
can make a huge difference in the way you look. Old dentures and their
teeth wear down. This can shorten the dimensions of your face. As a
result, you look older and more wrinkled. However, by increasing the
dimension between your upper and lower jaw with our new dentures, we
can make you look and feel years younger. It's like plastic surgery
without the scalpel!?

?Not only can you choose the shape, length and size of your new teeth,
but now you can also choose their color. The many advancements in
denture technology can now provide you with a vast array of color
options for your teeth. ?
http://www.denturewearers.com/dx/new_denture_technology.htm


?Most dentists were and continue to be taught to set denture teeth
over existing bone. This may be common sense for a patient that
recently lost their teeth, but what about a patient that?s had 2
previous sets of dentures dating back 20 years!

Do you think they have lost bone? Of course they have. People lose
about 4 mm of bone in the first year after having teeth removed and
may lose up to 60% more bone over the course of the next 5-7 years.

So it?s axiomatic that putting teeth over the bone will continue to
drive teeth further and further backwards in someone?s face over a
period of years if this criterion for tooth placement is followed.?
Please see this site for more complete information.
http://www.dental--health.com/bargain_dentures_prosthodontics.html


?There are four primary types of dentures:
?	complete
This type of denture replaces all of the teeth and their adjacent tissues.
?	partial
Partial dentures act as dental bridges as they "bridge" the gap
between a missing tooth or teeth.
?	conventional
Conventional dentures allow a recovery time (usually 4 to 8 weeks)
after all of the teeth are extracted before the dentures are placed in
the mouth.
?	immediate
This type of denture does not allow a healing period after all of the
teeth are removed. The denture is immediately fit into the mouth after
all teeth are removed. Additional adjustments in the fitting of this
type of denture procedure may be necessary as healing occurs.
http://www.umm.edu/oralhealth/denture.htm



?Immediate dentures
Immediate dentures are those that are inserted the same day you have
your teeth removed. Your dentist will see you for a series of
appointments before your teeth are removed in order to make molds of
your jaws. Your teeth are then removed and your denture is inserted.
Since your gums and your jawbone will shrink after your teeth are
removed, your denture will need to be adjusted or replaced later.
You might consider an immediate denture if you're having the front
teeth in your upper jaw removed. Having a denture right away can
reduce some of the embarrassment you might feel about not having front
teeth.
An immediate denture might not be possible if your diseased teeth
can't withstand the process of making a mold (impression) of your
teeth. In this case you'd need a conventional denture.?
http://www.mayoclinic.com/health/dentures/HA00057


?There are various types of complete dentures. A conventional full
denture is made and placed in the patient?s mouth after the remaining
teeth are removed and tissues have healed which may take several
months. An immediate complete denture is inserted as soon as the
remaining teeth are removed. The dentist takes measurements and makes
models of the patient?s jaws during a preliminary visit. With
immediate dentures, the denture wearer does not have to be without
teeth during the healing period.

Even if you wear full dentures, you still must take good care of your
mouth. Brush your gums, tongue and palate every morning with a
soft-bristled brush before you insert your dentures to stimulate
circulation in your tissues and help remove plaque.?
http://www.ada.org/public/topics/dentures.asp


Neuromuscular dentures
?Once the initial diagnosis is made and the decision to proceed with
dentures is made, the dentist will make any necessary extractions of
compromised teeth. Once the gums are healed and healthy, the dentist
can proceed. First, an impression of the mouth is taken and a wax -up
is made to determine the most optimal position of the jaw as well as
the dimensions (size, shape, length, width) of the teeth.
The wax up is sent to a dental laboratory to construct a "try-in;" an
initial set of dentures. The "try-in" is placed in the mouth to assure
comfort, fit, bite position and appearance. Once the "try-in" is
approved, the lab creates the final dentures. The dentist will place
the final dentures and make any necessary adjustments.

Neuromuscular dentures, also known as precision fit dentures, are
preferred by patients because of their exceptional comfort and natural
appearance. Trips to the dental office for adjustments are nearly
eliminated, and no longer will you keep your dentures in your pocket
except for eating; truly a cosmetic improvement!?

?Cost: 
Dentures made by traditional means typically cost from $800 - $1,500
per plate (upper denture or lower denture). Neuromuscularly fitted
dentures are more expensive, often $5,000 to $7,500 for a full set.
However, the fit and comfort far outweighs the cost for the patients.?
http://www.locateadoc.com/articles.cfm/1097/1172


   ?Over time, dentures will need to be relined, rebased, or remade
due to normal wear. To reline or rebase a denture, the dentist uses
the existing denture teeth and refits the denture base or makes a new
denture base. Dentures may need to be replaced if they become loose
and the teeth show signs of significant wear. Dentures become loose
because a mouth naturally changes with age. Bone and gum ridges can
recede or shrink, causing jaws to align differently. Shrinking ridges
can cause dentures to fit less securely. Loose dentures can cause
health problems, including sores and infections. A loose denture also
makes chewing more difficult and may change your facial features. It's
important to replace worn or poorly-fitting dentures before they cause
problems.?
http://www.ada.org/public/topics/dentures_faq.asp#11


   ?If only a few roots can be saved, an Overdenture, which is a
denture which attaches to a couple of roots anchored in the jaw can be
constructed.
For patients wanting to maintain some teeth while a denture is
constructed an Immediate Denture can be constructed. Implants may be
placed in the jaw to anchor a denture when a patient is unable to wear
a denture successfully.
http://www.qualitydentistry.com/dental/denture/fdenture.html


??Dentures are fragile and can break if dropped. It is a good idea to
clean your dentures over a sink filled with a few inches of water, or
a folded towel laid over the counter top.
?Dentures may warp if they dry out. When your denture is not in your
mouth, be sure to store it in a denture bath filled with denture
cleaner or water.
?Denture adhesive may be used to assist the retention of your denture,
but should not be used with a poorly fitting denture. Poorly fitting
dentures should be relined or replaced.
http://www.cda.org/articles/dentures.htm


?New to dentures?
You're not alone. About 49 million Americans (one in five adults) wear
either full or partial dentures. And while it may seem a bit
overwhelming at first, with a little patience and practice, you?ll
soon be enjoying a newfound sense of confidence and security.

You do not want to have to be conscious of your dentures while you are
eating, talking, smiling or laughing when you are with your family,
friends or work colleagues. A thoroughly clean, well fitting denture
will give you the confidence you want. The following information will
help you to adjust to wearing new dentures and to continue to have a
confident experience with wearing dentures.

What can I expect when I start wearing dentures?
It's perfectly normal to experience any of the following sensations: 
?	Your dentures may feel large in your mouth 
?	Your lips may feel like they're being pushed forward 
?	You may experience a gag reaction, particularly in the back of your mouth 
?	You may experience an increased amount of saliva 
?	The denture may feel loose while your mouth muscles adapt to holding it in place.

Don't worry - your mouth will soon become accustomed to your dentures,
and wearing them will seem like second nature. Your mouth needs a few
weeks to adjust to holding the denture.

Will dentures affect my speech?
You may have a bit of difficulty with your speech at first, especially
pronouncing "s" and "f" sounds. The following tips can help:
?	Practice speaking aloud while wearing your dentures 
?	Read aloud from a book or magazine in front of a mirror 
?	Prior to speaking, bite down and swallow to "set" your dentures in place 
?	If your dentures "click" while you're talking, speak more slowly
With a little practice, your speech pattern will return to normal in no time!?
http://www.mydenturecare.com/newwearer.aspx


   ?Problems with dentures include the fact that patients are not used
to having something in their mouth that is not food. The brain senses
this appliance as "food" and sends messages to the salivary glands to
produce more saliva and to secrete it at a higher rate. New dentures
will also be the inevitable cause of sore spots as they rub and press
on the mucosa. A few denture adjustments for the weeks following
insertion of the dentures can take care of this issue. Gagging is
another problem encountered by some patients. At times, this may be
due to a denture that is too loose fitting, too thick or not extended
far enough posteriorly onto the soft palate. At times, gagging may
also be attributed to psychological denial of the denture.
(Psychological gagging is the most difficult to treat since it is out
of the dentist's control. In such cases, an implant supported
palateless denture may have to be constructed or a hypnotist may need
to be consulted).

Another problem with dentures is keeping them in place. There are
three rules governing the existence of removable oral appliances:
support, stability and retention.? Please visit this link for more
information.
http://en.wikipedia.org/wiki/Dentures


   ?Most artificial teeth are made from high quality acrylic resins,
which make them stronger and more attractive than was once possible.
The acrylic resins are relatively wear-resistant, and teeth made from
these materials are expected to last between five and eight years.
Porcelain is also used as a tooth material because it looks more like
natural tooth enamel. Porcelain is used particularly for upper front
teeth, which are the most visible. However, the pressure of biting and
chewing with porcelain teeth can wear away and damage natural teeth.
Therefore, porcelain teeth should not be used in partial dentures
where they will contact natural teeth during chewing.?

?Good quality control is critical to ensure the denture fits and looks
natural in the patient's mouth. No two dentures will be alike; even
two sets of dentures made for the same person will not be exactly
alike because they are manufactured in custom molds that must be
broken in order to extract the denture. After the molding process is
completed, the fine details of the denture are added by hand. This
step is necessary to ensure the teeth look natural and fit properly.
The quality of the denture's fit can be controlled in two ways.
Relining is a process by which the sides of the denture that contacts
the gums are resurfaced. Such adjustments are necessary because the
dental impressions used to make dentures cause the gums to move. As a
result new dentures may not fit properly. Also, over time bone and gum
tissues can shift, altering the fit of the denture. Rebasing is used
to refit a denture by replacing or adding to the base material of the
saddle. This process is required when the denture base degenerates or
no longer extends into the proper gum areas. Most patients require
relining or rebasing approximately five to eight years after initial
placement of the dentures.?
http://www.madehow.com/Volume-3/Denture.html


New device to secure dentures:
Biomedics NZ reports that Ultra Suction? system comprises a tiny
unidirectional device that is imbedded into a denture plate. As the
denture wearer bites firmly, the air trapped between the gum and the
denture is expelled through the device, via two air passages. The
lower pressure obtained beneath the denture tends to exert a pull and
helps secure the denture against the gum. Properly fitted dentures can
increase wearing comfort, the ability to chew and therefore impact on
the overall health of the patient.

Complete dentures are the most common prescription offered to the
millions of edentulous patients worldwide. One of the main problems
with complete dentures arises in securing them to the gum, often
resulting in ill-fitting dentures, which in turn can affect eating and
the overall health of the patient. The problem is much more common
with lower dentures.?
http://www.medicalnewstoday.com/medicalnews.php?newsid=24545



Dental Implants
===============
  Implants are apparently more comfortable, and natural feeling, but
the cost is significantly higher.

?What are dental implants?
An alternative to dentures, dental implants (small dental appliances
that are inserted into the upper and lower jaws) help to restore the
mouth that has little or no non-restorable teeth. Dental implants are
slowly replacing dentures used by some people, as they provide many
advantages of traditional dentures.
Advantages of implants over dentures:
For some people, particularly persons with loose or poor fitting
dentures due to flat ridges, or persons with multiple missing teeth
who need support for crowns and bridges, implants may be considered a
more appropriate alternative to fix the appearance of missing teeth
than dentures.?
http://www.umm.edu/oralhealth/implants.htm


   ?The implants, typically made from titanium, work like roots for
the replacement teeth. That means greater ease with talking and
chewing and less discomfort.
The surgical procedure usually is performed in an outpatient setting
under local anesthesia. The number of implants varies. As few as two
implants in the lower jaw may retain a removable lower denture
adequately. If you want teeth permanently fixed in place, you'll need
more.?
http://www.healthcentral.com/drdean/408/60869.html


   ?More recently, there has been a move to increase denture stability
with implants. When pressure is applied to alveolar bone bereft of
teeth (alveolar bone is the bone in which teeth normally reside), the
bone reacts to this pressure by resorbing. After many years of denture
wearing, the ridges upon which the dentures rest deteriorate and can
easily all but disappear. The insertion of implants into the bone
below the dentures can help to seriously combat this unfortunate
occurrence. The implants are strategically placed to bear the brunt of
the pressure when the denture is used for chewing, keeping the bone
from melting away. When implants are integrated into treatment, the
denture is now referred to as being an implant supported overdenture
and the implants are referred to as overdenture abutments.?
http://en.wikipedia.org/wiki/Dentures


   ?Although implants are usually place for stability of lower
dentures, implants can also be place to add to the stability of upper
dentures.
As with everything in life, there are always some disadvantages of
implant treatment.
?	They are costly
?	They require meticulous oral hygiene to prevent infection and loss
?	Placement of implants is a surgical procedure
Any surgical procedure has risks. Infection, reactions to the
medications and anesthetics are a couple of complications that can
happen.
The success rates of properly cared for implants is approximately 95%. 
http://www.qualitydentistry.com/dental/denture/implant.html


   ?Under normal conditions, dental surgeons want you to let your
implants heal approximately 3-4 months before they put them into
function under your denture. This allows the titanium material and
surface of the implant to integrate with your bone and gives the
implants the best chance of lasting you a lifetime. There are many
dental surgeons that feel that implants under certain styles of
dentures can be put into immediate function and load. This means that
the minute your implants and dentures are finished you can go out and
eat a meal, smile, and speak with confidence. You should discuss this
option with your dental surgeon if you are interested.?
http://www.denturewearers.com/dx/implants.htm


   ?A dental implant is used in prosthetic dentistry. There are
several types. The most widely accepted and successful is the
osseointegrated implant, based on the discovery by Professor Brånemark
that titanium could be successfully incorporated into bone when
osteoblasts grow on and into the rough surface of the implanted
titanium. This forms a structural and functional connection between
the living bone and the implant.

A typical implant consists of a titanium screw, with a roughened
surface. This surface is treated either by plasma spraying, etching or
sandblasting to increase the integration potential of the implant. At
jaw sites where no prior tooth has existed for many months, a pilot
hole is bored into the recipient bone, taking care to avoid vital
structures (in particular the inferior alveolar nerve within the
mandible). This pilot hole is then expanded by using progressively
wider drills. Care is taken not to damage the osteoblast cells by
overheating. A cooling saline spray keeps the temperature of the bone
to below 47 degrees Celsius. The implant screw is usually self-tapping
and is screwed into place at a precise torque so as not to overload
the surrounding bone. Once in the bone, a cover screw is placed and
the operation site is allowed to heal for a few months for integration
to occur.?
http://www.answers.com/topic/dental-implant

  
   ?For dental implants to be successful, the jawbone must have enough
bone to support them. You may not have enough bone because of tooth
loss from periodontal (gum) disease, injury or trauma, or a
developmental defect. If your jaw is too short (up and down), too
narrow (side to side), or both, you will need a procedure to add bone
to your jaw before implants can be placed.
Bone augmentation is a term that is used to describe a variety of
procedures that are used to "build" bone so that dental implants can
be placed. These procedures typically involve grafting (adding) bone
or bonelike materials to the jaw, and waiting for the grafted material
to fuse with the existing bone over several months.

There are several different procedures that can be used for bone
augmentation. Your dentist will select a procedure depending on the
type, location and number of implants to be used. If you need a bone
graft, it is important that you and your dentist discuss all of the
options available to you.
After a bone-augmentation procedure, dentists usually wait 6 to 12
months before placing implants, although some dentists may place them
sooner.?


Scroll down to Implants to learn more about different types of implants:
http://www.wboc.com/Global/category.asp?C=61700


   I?ve never heard of real teeth being implanted, especially where
they grow (!!) nor did I find information this. Depending on the
condition of the tooth and socket, a dentist can at times, re-implant
a tooth that has been knocked out from a trauma.
http://www.emedicinehealth.com/broken_or_knocked-out_teeth/article_em.htm

http://www.mayoclinic.com/health/first-aid-tooth-loss/FA00015


   I hope this is the information you were seeking! Please request an
Answer Clarification, and allow me to respond, before rating if you
have further questions.

Sincerely, Crabcakes


Search Terms
=============
latest + dentures + comfort
latest + denture + technology
dentures + good fit
Natural looking dentures
Denture composition
Dental implants

thanks a bunch!