Many denture wearers avoid seeking care from a dentist when they have sore spots or their dentures feel loose. This is why there is a booming multi-million dollar denture adhesive market, with over-the-counter makeshift products that promise to solve all denture problems to no avail. In my opinion, denture wearers do not seek appropriate dental care because they assume that every dentist will insist on making a completely new set of dentures to solve their problems and fear the financial commitment for new denture therapy. Although this approach is what is recommended in dental schools and is good practice, it is not always needed or appropriate. If dentures are reasonable in fit and function and if the prosthetic teeth are in reasonable condition, the most appropriate treatment may be a simple repair, a reline, or a rebase rather than a new set of dentures.
When a denture is fractured, or if a tooth is missing from a denture, a repair may be indicated. Repairs usually work best with relatively new dentures (within the past 2 or 3 years) because the acrylic resin used to repair the fracture or to relute a tooth bonds better to newer denture base acrylic than to aged acrylic. Usually, a repair involves stabilizing the denture with a mould, enlarging the fracture with a dental handpiece, and then rebuilding the fracture site with new acrylic. Metal mesh or wires may be used for reinforcement. Repairs can sometimes be done the same day in the dental office, or they may need to be sent to an outside dental laboratory and returned on another day. If a tooth is missing or broken, a new denture tooth may be used to replace it if a similar mould of tooth and shade are available. Fees for denture repairs usually vary depending on the complexity of the fracture and difficulty of repair. Repairs can sometimes be done in conjunction with reline or rebase procedures.
A reline is simply the process of adding new denture base material to the tissue side of a denture to accommodate minor bone loss and tissue change or to remove bacteria-laden aged acrylic in an unhealthy mouth. Relines can be done with soft silicone materials or more commonly with hard acrylic, depending on the individual situation. The process of a reline usually involves an impression using the denture as the tray, and then the denture is sent to a dental laboratory for processing. The laboratory grinds a thin layer of old acrylic away from the tissue surface of the denture and then applies a layer of new acrylic in its place. The primary purpose of performing a reline is to improve the retention of a denture and to improve the health of the supporting tissues. Occasionally, chairside relines can be done in the office, but they tend to be less predictable and less durable than laboratory-processed relines. Depending on the health and condition of the supporting tissues, the average denture should be relined every 2-3 years.
When an older denture has been maintained well with relines, appropriate repairs, etc., and the prosthetic teeth are in good condition, a rebase may be an appropriate treatment recommendation. A rebase is similar to a reline except that all of the existing pink acrylic is completely replaced with new denture base acrylic while maintaining the existing teeth in their original positions. This is an excellent way to rejuvenate an old denture that has appropriate bite and function when the acrylic is all that has deteriorated with time. The purposes of a rebase are the same as those of a reline plus the added benefit of creating basically a new denture. The downside is that this procedure must be done overnight in a laboratory, and the patient may need to be without his or her dentures for several days. Rebases usually work best when the prosthetic teeth are porcelain rather than acrylic, but they can be done with both.
In all fairness, most of the time when long-time denture wearers present to the dentist with problems they are long past the point where the above less costly alternative treatments would be appropriate. Due to the bone loss that normally occurs with denture wear, the bite of a denture significantly changes over time, and the denture wears to accommodate these changes. None of the above rejuvenation options permit reconstruction of the bite. This is why it is extremely important that denture wearers maintain a regular dental examination schedule, preferably yearly but no more than every other year. Repairs, relines, and rebases are all methods of predictably rejuvenating and prolonging the life of well-maintained dentures.
Dr. Huff is a general dentist with an office in Dover, OH. We welcome the opportunity to provide you with comprehensive oral health care and invite you to schedule a visit to meet Dr. Huff and our team.