Dentures and Facial Features

Dentures and Facial Features

By: The Denture Pro.

Copyrighted Material

<thedenturepro@aol.com>

　

With regard to the way a dental appliance affects the patients facial features depends on a number of things. If the dental appliance is created in a manner that makes the appliance much thicker than necessary, the results cannot only create appearance distortions, but can also have a great affect on the patients ability to speak clearly.

Two areas that seem to be more routinely complained about by patients is the feeling and seeming appearance that the lips are overly full or puffy. The other area is the feeling that there is not enough room for the tongue, it feels crowded.

Overly full or puffy lips in association with what is called an "Immediate" denture is not unusual. When the natural teeth are extracted and the denture "Immediately" placed in the mouth, the denture base material fits over gum tissues that will change in size and shape as healing takes place. Since the tissues have not changed the denture base must fit over the tissue to provide as much fit as possible. Following the healing period gum tissues will have shrunk and changed shape. These changes will it necessary for the denture to be refitted by "Relining", (rebuilding the inside of the denture). When the reline has been accomplished the walls of the denture will be thicker and provide the ability to thin the walls by grinding off some of the outer layer of the base material....This is especially beneficial for the base material that fits over the front of the gums and behind the lips. As for the tongue, it is quiet possible that the lower dentures tongue side walls could be made to thick as well as to long. Either of those two things can create speech problems as well as sore spots at the base of the tongue.....The denture base material can be ground very thin in most areas without making it weak and subject to breakage. The one place that could be a problem however is under the nose...Almost every Upper denture has a "slot" in the denture base that corresponds with the muscle or ligament (Frenium) that attaches the center of the Upper lip to the gums, between the two front Central teeth. If this area is to thin it provides a possible area for breakage, especially, during the healing period following extraction's.

There are two major requirements that must be met for a denture to provide the patient with proper fit, function and appearance. Those two requirements are (1) the thickness of the denture base material and (2) the proper opening alignment of the jaws. There are of course other creative issues that affect the overall success of the denture and you could say that of the some 20 different steps required to create a denture, any one of those is the most important. While that's true, the two listed above most affects the appearance.

In so far as the lips are concerned, the thickness of the denture base does, as stated, have a major impact on the appearance, however another issue is called "Over-extension". This term relates to how far the sides or borders of a denture extends into the oral tissues.

Over extension can be the result of an error by designing technician or it can be the result of the Impression not taken in a manner that correctly defines the landmarks and borders of the oral tissues. An over extended impression results in the model of the mouth, that is created from it, being distorted and falsely creating a shape and size that does not correctly duplicate the oral tissues.

Now.....let me state here that experience over the years has taught me that while a great deal can be accomplished with a dental appliance to enhance the patients appearance, no dental appliance can perform the miracle of accomplishing the equivalent of a face lift. Note I said "dental appliance" not "dental implant"....because patients tend to relate to jaws as dental appendages, implant augmentations such as those associated with the chin or cheeks are not "dental appliances". I have had a number of patients that so desperately wanted to change their facial appearance with a dental appliance that they opted to sacrifice fit and function quality for the appearance that could be achieved by either making a denture extremely thick or on rare occasion very thin.

Finally, lets talk about the relationship of the jaws. Dental appliances should never cause the jaws to be overly open or overly closed. Either of those positions seriously subjects the jaw joint to possible damage. A competent dental professional can properly establish the proper jaw relationship.

As dentures age the tooth surfaces wear down, especially those with plastic denture teeth (which is best for your jaw bones) and the jaw bone itself tends to shrink. As a rule neither of these create pain for most patients. The jaws slowly close down, corners of the mouth fold in, the lips get thin and a deep wrinkle line forms on either side of the nose. This change is so slow and painless patients fail to readily recognize that their appearance is changing. In the end the patient can smile or laugh and little to no teeth can be seen and this is not normal appearance for properly supported facial features....Many patients get so accustomed to the collapsed face tissues that they think it’s their proper appearance and when new dental appliances are created that restores them to a more natural appearance they have difficulty accepting it...The problem as already stated is the collapse of the facial tissues is slow and painless where as the resupporting of the facial tissues is almost instantaneous when the new dental appliance is placed in the mouth. Not all of the facial tissues reacts immediately, some reconstruction shaping takes time as the tissues are subjected to better support that creates, if you will, stimulation to the tissues similar to an exercise program. The tissue reacts to the stimulation and to some degree tends to firm up and become more healthy in both function and appearance.

To protect your appearance and extend the life of the facial features a dental appliance wearer should have their appliances examined and evaluated a minimum of once a year.....If you have a question regarding any of the above information contact The Denture Pro at <thedenturepro@aol.com>  or respond on this site. Reproduction of this copyrighted material is prohibited without the written consent of The Denture Pro.

There are three major issues that concern every denture wearer, (1) Appearance,(2) Fit , (3) Function. The order in which I listed them in no way indicates their importance, one over the other. The most important issue to the patient is decided by which of the three issues seems not to be working at any given time.