Sometimes teeth cannot be saved and unfortunately they need to be removed or perhaps they are already missing and a fixed restorative replacement such as a tooth-supported or implant-supported bridge is simply not possible for a variety of reasons, one of which is often cost. In these cases the missing teeth can be replaced with a removable denture, either a full denture if all the teeth are missing or remaining teeth are hopeless and need to be extracted (see
extraction hopeless teeth ) or a partial denture if some of the teeth are still healthy enough to keep. With a removable denture normal function such as eating and speaking as well as cosmetic appearance can be restored with an improvement in both social confidence and self-esteem. For some, especially the elderly who may be infirmed with medical disorders which affect dexterity (e.g. osteoarthritis), the ability to remove the teeth for cleaning is an advantage which makes life easier.
Prior to making dentures certain surgical measures can be planned in advance that will optimise the fit, stability and retention of dentures. Bony lumps or undercuts or fleshy frenums which will interfere with denture fit can be removed and fibrous soft tissue lumps or flabby mobile ridges which cause loss of denture stability can be surgically corrected and ‘firmed-up’. Inadequate depth in the cheek vestibules to allow adequate extension of the denture flanges leading to poor peripheral seal and loss of retention can also be surgical corrected or dental implants can be placed in strategic positions (see
full arch removable case ) which allow connection to the denture to improve its stability.
If multiple teeth are to be extracted prior to the fitting of dentures, then bony ridges and sharp socket edges can be recontoured at the same time the teeth are extracted allowing the gums to be closed over the extraction sockets, reducing risk of post-operative bleeding, improving healing time and reducing discomfort.