Fixing a sore upper denture
One of the main complaints I get from patients who are wearing dentures constantly is that they feel sore or uncomfortable. I get so many concerns that I felt it a good idea to write a blog about what may be making your dentures uncomfortable and how we can go about fixing them. As upper full dentures, lower full dentures and partials are different creatures I think it’s best to dive into each type denture and describe the common problems and how we go about solving them. I will start with upper or maxillary dentures. The main problems I see with these are gagging, loss of suction, and chipping of teeth.
One of the main concerns with the upper denture is that it looks big and for some people it feels too big. The denture itself is bigger as it covers the entire upper palate or roof of the mouth. Covering the entire roof of the mouth is what allows the denture to get as much suction as possible; however, it can make the denture feel bulky and uncomfortable to some patients. I often get patients who request that I remove the entire palate, and while I have done it for some patients who cannot wear it otherwise, I’m hesitant to do that as it can make the upper denture much more difficult to wear. What I prefer to do is to adjust a bit from the back of the denture where the soft part of the roof of the mouth or soft palate feels sore or irritated. Usually a minor adjustment can make a world of difference. For patients whose dentures are not touching the soft palate but gag, they are generally new denture patients. For these patients I recommend that we treat wearing the upper denture as a marathon race in that it takes practice to go the long distance. Setting daily goals for how long you will wear the denture and putting a stop watch or alarm clock to tell you when you can take the dentures out is the goal. For example, you start out trying to wear the denture for an hour before you take it out and do this for a week or two. After an hour seems doable, press yourself to do 90 minutes and keep building stamina until the denture feels normal to you. It does take some time, but it is doable.
Another common problem is the loss of suction on the upper denture. As the upper denture is normally more stable than the lower denture because of the suction this can be worrisome for some patients. The usual reason for this is the bite or the occlusion as dentists say. Upper dentures lose suction when the front teeth bite down on them repeatedly which happens when a patient has lost the bottom back teeth. When biting down on the back teeth with an upper denture, the suction strengthens as the denture is pressed more into the roof of the mouth. To fix this problem, often a lower partial denture to replace the back teeth needs to be made. The other reason for losing suction on the upper is that the bone on the top of the mouth has changed so much that the upper denture no longer fits. This happens most often with healing or immediate dentures where the teeth are removed and a denture is given, but I do see it when a person has worn a denture for a long period of time and the bone has simply gone away. The only way to fix this problem is to remake the denture itself though denture adhesive products like Fixodent can provide a short term solution.
The final problem I see with top dentures is chipping of teeth. The most common reason for tooth chipping is an older denture that has been chewed on by natural teeth for a long period of time. Very rarely does a patient chew on a denture is a regular pattern which spreads the wear out evenly on all of the teeth. Often, a patient has a favorite part of the denture to chew on and unevenly wears on those teeth. Other times it is because those are the only natural teeth remaining on the lower jaw and therefore that it is the only part of the upper denture a patient can chew on. Unfortunately, there is no good “easy” fix for this problem. While the dentures can be made from high quality and high strength materials, the dentures are not stronger than natural teeth. While we can make them stronger, we prefer to make them weaker so that the natural teeth do not wear as it is easier to make a new denture than to repair multiple teeth. Especially with lower teeth, we want to maintain those for as long as possible to maintain good chewing function for as long as possible. The best way to address this problem is with a new denture and possibly make a lower partial denture to help even out the bite so that chewing is more even over the jaw.
The last point that I want to make is that one solution to all of these problems is with implants. While I love placing implants and then restoring them, many patients want to try alternatives to implants. I will dive into implants and dentures in a future blog post. If you do have an uncomfortable upper denture, there are options for you. I recommend that you bring it to your current dentist so that it can be evaluated. Thanks for reading!