Dentures are false teeth made to replace teeth you have lost. They can be complete or partial. Complete dentures cover your entire upper or lower jaw. Partials replace one or a few teeth.

Dentures may feel strange at first. Speaking and eating may feel different. Be careful when wearing dentures because they may make it harder for you to feel hot foods and liquids. Also, you may not notice biting on a bone from your food.

In the beginning, your dentist may want to see you often to make sure the dentures fit. Over time, your mouth will change and you may need to have your dentures adjusted or replaced. Be sure to let your dentist handle these adjustments.

If your dentures move too much in your mouth, denture adhesive may help. In some cases, your dentist may suggest that you switch to dental implants. They are permanent, and they replace both the roots and teeth.

Keep your dentures clean and free from food that can cause stains, bad breath, or swollen gums. Brush them every day with a denture care product. Take your dentures out of your mouth at night, and put them in water or a denture-cleansing liquid.

A partial denture attached to prepared natural teeth, roots, or implants by cementation.

A commonly used prosthesis that results in a strong, permanent restoration. It consists of an electrolytically etched cast-metal retainer that is cemented (bonded), using resins, to adjacent teeth whose enamel was previously acid-treated (acid-etched). This type of bridgework is sometimes referred to as a Maryland bridge.

Implant

What is it?

• A dental implant is made of 2 main parts – a titanium screw that fuses with the jaw bone, and a ceramic tooth that fits over the screw.

What does it do?

• Replaces a missing tooth or teeth, without damaging neighbouring teeth.

How is it done?

• The area of the missing tooth needs to be studied to make sure it is suitable for an implant. This includes looking at the gum and bone health, amount of space, your bite, and your general health.
• The titanium screw is placed into the jaw bone.
• It can take up to 6 months for the bone to fuse strongly to the screw. A temporary, removable tooth may be provided for you to wear in the meantime.
• When the bone is ready, a mould (impression) of the screw’s position in your jaw is taken and sent to a lab for the ceramic tooth to be custom-made.
• The tooth is attached to the screw.

What are the risks?

• The ceramic can chip or break, and need replacing.
• The bone may not fuse to the implant, and the implant will need to be removed. People who smoke, have diabetes or immune compromised are at greater risk.
• It is more difficult to clean around an implant. Gum disease around an implant can be very difficult to treat. If severe, the implant will need to be removed. This area may no longer be suitable for future implants.
• Depending on your anatomy, there may be some risk of damage to nearby structures like nerves or sinuses.

By 2060, according to the US Census, the number of US adults aged 65 years or older is expected to reach 98 million, 24% of the overall population. Older Americans with the poorest oral health tend to be those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized (e.g., seniors who live in nursing homes) also increases the risk of poor oral health. Adults 50 years and older who smoke are also less likely to get dental care than people who do not smoke. Many older Americans do not have dental insurance because they lost their benefits upon retirement and the federal Medicare program does not cover routine dental care.

Oral health problems in older adults include the following:

• Untreated tooth decay. Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.
• Gum disease. A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.
• Tooth loss. Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%).Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
• Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.
• Chronic disease. People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions. Also, most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.

Background

Denture adhesives are pastes, powders or adhesive pads that may be placed in/on dentures to help them stay in place. Sometimes denture adhesives contain zinc to enhance adhesion.

In most cases, properly fitted and maintained dentures should not require the use of denture adhesives. Over time, shrinkage in the bone structure in the mouth causes dentures to gradually become loose. When this occurs, the dentures should be relined or new dentures made that fit the mouth properly. Denture adhesives fill gaps caused by shrinking bone and give temporary relief from loosening dentures.

Zinc and Potential Risk

Zinc is a mineral that is an essential ingredient for good health. It is found in protein-rich foods such as shellfish, beef, chicken and nuts, as well as in some dietary supplements.

However, an excess of zinc in the body can lead to health problems such as nerve damage, especially in the hands and feet. This damage appears slowly, over an extended period of time.

Overuse of zinc-containing denture adhesives, especially when combined with dietary supplements that contain zinc and other sources of zinc, can contribute to an excess of zinc in your body.

Reports of Problems

The FDA is aware of case reports in the medical literature linking negative reactions such as nerve damage, numbness or tingling sensations from denture adhesives that contain zinc to chronic overuse of the products. The subjects of these case reports used at least two tubes of zinc-containing denture adhesive each week. Some product instructions indicate that one tube should last seven to eight weeks.

The FDA has also received reports of adverse events linked to use of denture adhesives. However, the FDA’s adverse event reporting system is not designed to establish injury rates and individual reports vary in the amount and reliability of data included.

Neither published data nor FDA adverse event surveillance data are adequate to associate injuries with specific device types or brands.

The FDA has not found conclusive evidence that these problems result from using zinc-containing denture adhesive as instructed in the product labeling.

To help address the potential risk that overuse of zinc-containing denture adhesives may pose, the FDA asked makers of zinc-containing denture adhesives to consider:

• Including directions that will prevent overuse if zinc is an ingredient. (Some companies include graphics of the amount of adhesive to use or the amount of time that a tube should last under correct usage.)
• Modifying the labeling to specify that the product contains zinc as an ingredient, if appropriate and consider replacing zinc with an ingredient that presents less health risks in situations of overuse.

Manufacturers, importers and distributors of denture adhesives are required by the FDA to register their facilities, list their products and report adverse events. In addition, they are required to adhere to other general regulatory controls such as good manufacturing practice and adequate directions for use or a clear definition of an unsafe dosage or methods or duration of application.

Advice for Denture Wearers

Denture wearers may have difficulty determining the proper amount of denture adhesive to use if the instructions are not clear. If a denture wearer is uncertain about how much to use, he or she should contact a dental health professional to help determine the correct amount.

Denture wearers should know that a large amount of denture adhesive will not necessarily address problems with ill-fitting dentures, and prolonged use of ill-fitting dentures may lead to an increase in bone loss.

The FDA recommends that consumers of denture adhesive products:

• Follow the instructions provided with the denture adhesive. If the product does not come with instructions or the instructions are unclear, consult with a dental professional.
• Do not use more adhesive than recommended.
• Understand that some denture adhesives contain zinc, and that although they are safe to use in moderation as directed, if overused, they could contribute to harmful effects if over-used.
• Know that manufacturers may not always list their product ingredients.
• Know that there are zinc-free denture adhesives products.
• Stop using the denture adhesive and consult your physician if you experience symptoms such as numbness or tingling sensations in the extremities.
• Start with a small amount of adhesive - if the adhesive oozes off the denture into your mouth, you are likely using too much adhesive.
• Know that a 2.4-ounce tube of denture adhesive used by a consumer with upper and lower dentures should last seven to eight weeks.
• Track how much denture adhesive you use by marking on a calendar when you started a new tube, and when the tube is empty.
• Consider speaking to your dentist to see that your dentures fit properly. Dentures can become ill-fitting as a person's gums change over time.

Reporting Problems to the FDA

Prompt reporting of adverse events can help the FDA identify and better understand the risks associated with medical products. If you suspect problems associated with the use of denture adhesives, we encourage you to file a voluntary report through MedWatch, the FDA Safety Information and Adverse Event Reporting program.

It is important to clean your mouth and denture daily so your mouth will stay healthy. Soaking dentures in water or a denture cleaner is not enough. They must be brushed with a soft toothbrush or with a toothbrush made especially for dentures.

Be sure to brush and massage your gums daily with a soft toothbrush, and brush any remaining natural teeth you may have.

• Do not clean dentures with boiling water.
• Clean all denture surfaces, both inside and outside, with a denture brush and denture cleaner that you can buy at a drug store. Do not use an abrasive cleaning powder like Ajax™ or Comet™.
• When cleaning dentures, hold over a bowl of water between your thumb and forefinger. If the denture slips out of your hand, it will land in the water and not break.
• If a denture smells, it can be soaked in a solution of 1 teaspoon of bleach (such as Clorox™) in 1 cup of water. Soak the denture for 30 minutes. Rinse well before putting it back in your mouth.
• Take your denture out of your mouth for at least eight hours every day. When out of your mouth, keep the denture in a bowl of water or diluted mouthwash.
• Do not try to adjust a denture with sandpaper or files. This will ruin the denture.
• Do not use denture liners or denture adhesives.

Go to the dentist for the following:

• Your regular fitting appointments after you get a denture
• When you have mouth sores that last for more than one week
• When your dentures become loose in your mouth
• One time a year to check the health of your mouth and the fit of your denture