Elements of a Good Denture

I recently got a phone call from a rehab hospital. A daughter called with the concern that her mother's lower denture might need a reline. She explained to me that her mom had been in for a check-up only 6 months before. Suddenly her lower denture was very loose and uncomfortable and she was unable to talk and eat. The daughter was desperate to help her mom, and thought an emergency reline would be a quick and easy solution. In speaking to her a few more minutes, I found out the reason mom is in the hospital was due to a serious stroke. With this information, I explained to her why the reline is not the best answer for this problem.

A stroke is a blood clot lodged in the brain. This in no way changes the shape of a patient's mouth. What does change is the patient's ability to control that denture since their muscles no longer work as they used to. A reline will only change the fit of the denture, so this is a faulty solution to her problem. 

A properly fitting upper denture stays in place with suction. A lower denture, however, stays in place by having:

• a shape that balances with the muscles in all directions when the mouth is at rest,
• a shape that produces no lifting forces during talking, swallowing, or opening the mouth,
• a bite that does not rock the dentures when chewing,
• a tongue that has "learned" to stay in a relaxed position and does not push the denture up when the mouth is open.

The first three elements of a good lower denture are entirely in the skilled hands of the dentist. The fourth element is completely up to the patient. A good dentist, however, can help by teaching a patient some techniques to control his tongue.

The majority of patients who come to see me for the first time have unsuccessful dentures. While most people have one of the above denture design problems, some people just have a tongue that is not doing what it should. Most of these people survive with the help of denture adhesive but with a concerted effort, they can eliminate the problem and the need for the unpleasant glue. Others manage with the assistance of a denture stabilization implant. These are posts placed in the bone and attach with snaps to the denture. In some cases, this can be the best option. For others the surgical process is unnecessary if all that is needed is training and practice. 

My patient has since fully recovered from her stroke and regained muscle control. The reline would have ruined her denture creating the need for a new one.