I RECALL that while studying dentistry in Brazil in the late 1980s, many of my patients remarked as they sat in the dental chair, “Doc, do anything but don’t extract any of my teeth.” I often wondered if their request had something to do with the knowledge that I was from Guyana. Its is clear that the abnormal frequency with which we Guyanese seek to have our teeth extracted for clinically frivolous reasons must have, as a concomitant factor, a nation with almost every adult  missing teeth.
From the era in which George Washington, a former president of the United States, wore dentures made entirely of wood, the dental discipline has come a long way. But as anyone who has worn them can attest, dentures can cause discomfort. This may range from the initial ‘adjustment’ phase, when dentures are new, and after several years of wearing when they stop fitting properly.
Most persons become accustomed to their new dentures within a short time. However, at first, you may have difficulty in talking and eating. You may find that the dentures tend to ‘slip’ or develop sore spots in your mouth. Sometimes you may tend to blame your dentist for this, but often the problem lies with the physical state of your ridge, and the position of your remaining teeth, if present. Even people who have had dentures for years sometimes develop problems with them. Usually, in these cases, the problem relates to the way the denture fits.
When the teeth are extracted, the dentures sit on the bony ridge that is left. Without the teeth, the stimulation to the bone is gone and, over the years, the bone is reabsorbed by the body. This absorption can be delayed if dentures are fitted at least three weeks after the extraction. Whether a denture fits ‘tight’ or ‘slack’ depends on the height of the bony ridge left after the extraction.
Poor fit is probably the most common cause of denture discomfort. As the bony ridge shrinks, the dentures can slip, move around, and cause sore areas. In addition, they can ‘fall’ when you talk, and food can get under easily as you eat. I have no doubt that it is quite frustrating for a patient to pay dearly for a new denture, only to have it not fitting properly.
While dentures will never be as comfortable as your natural teeth, there are many things that you can do to prevent and resolve denture discomfort. Perhaps the most important thing to do in order to avoid denture discomfort is to have them fitted at least three weeks after the final extraction.
Maintain a clean mouth after extraction, since the presence of excess bacteria will prolong the healing process. Avoid chewing hard food for a few weeks after you get your new dentures, as they may traumatize the gums and bone of the jaws.
During the initial break-in of your dentures, your mouth is likely to feel sore and your denture slack. If a sore area develops, remove the denture for an hour or so, then continue to use it. Sometimes the discomfort disappears by itself. New dentures often feel ‘tighter’ with the passage of time. If the pain persists for a week, see your dentist, as he may have to make some adjustments to it if necessary.
Finally, it is important to remember that your dentist can only fabricate your denture and eliminate the factors that may cause pain, a poor fit and discomfort, within the realms of possibility. The adaptation is entirely up to you.
More importantly, maintain your natural teeth healthily so you would not have to lose them through extraction. No government in the world could afford to repair all the decayed teeth of its population, so your own oral hygiene is the key.