Loose dentures are often due to a lack of fit of the lower denture or imbalance in the biting pattern between the two dentures. As an upper denture is often the more stable of the two, it is the lower that gives way first and moves off the gum. This can cause soreness and ulcers under the denture and make eating and socialising a pain rather than the pleasure they should be. A loose denture can cause embarrassing moments and lead to a loss of self-confidence.

I would always look closely at the fit and function of your existing dentures to see if they can be improved, but the problem is more often solved by making a well fitting and balanced set of dentures using the BPS system (see blog on this).

In some cases even a well fitting lower denture may move in function, particularly if the teeth were lost long ago to leave a low ridge that limits retention of the denture. A lower denture relies to an extent on the wearer learning to use it and to control it with the tip and sides of the tongue. For many this is a struggle initially but can be overcome, but for some this is a difficult skill to master.

In the case of John who was about to lose his last few remaining lower teeth we could see that he was going to struggle to cope with a lower denture. He was happily wearing an upper denture and though worn it was comfortable and stable. His lower lip muscles were very strong and he had given up wearing the part lower denture made previously because he disliked the feel of it and its looseness, so he was dreading the thought of a full lower denture.

Our first step was to make a new well fitting and balanced set of dentures ready to be fitted on the day that we removed Johns’ last remaining lower teeth. This avoided any time without teeth and allowed us to see if John could cope, but as expected he struggled to tolerate them.

After two months waiting for the gums to heal we saw John again for a single surgical visit of an hour or so to place two dental implants approximately where his lower canine teeth used to be. Healing covers were placed on the implants which just showed above the gum and the lower denture was eased to fit comfortably over these.

After another two month wait for the implants to take to the bone we were able to make a copy of John’s new lower denture with Locator inserts in the denture directly over the implants. The healing covers were swapped for Locators onto which the denture now positively clicks into place.

This technique can also be used to improve the fit of troublesome upper dentures.

CEREC stands for Chairside Economical Restoration of Esthetic Ceramics, and is a state of the art digital system which enables the dentist to provide porcelain crowns, partial crowns, inlays, onlays, veneers and anterior bridges at a single visit.

It is the most used CAD/CAM system worldwide with over 28 million restorations placed since it was first developed in 1984. Cerec has been through a number of developments, which have widened its applications and made the restorations more lifelike. Studies have shown a longterm success rate of 95%.

How are they made?

The teeth are prepared in the usual way before the Cerec acquisition unit, a sophisticated 3D camera, is used to take a number of pictures of the prepared tooth and its neighbours. You can now sit back and relax while your dentist designs the restoration on the computer. The design is then transmitted to a milling machine which cuts the new restoration out of a solid block of ceramic. It is then finished, polished, stained and glazed. As little as 45 minutes later the restoration can be ready to be cemented in place.

What are they like?

Cerec restorations are entirely ceramic which means that they are metal free, avoiding the risk of visible dark lines around the edges of crowns as gums recede. The ceramic also allows a greater transmission of light through the restoration making it look more natural. The strength of the ceramic allows it to be used in thin section allowing the dentist to be more conservative, removing less tooth tissue.

Are all teeth suitable?

Most teeth are suitable, but there are certain situations where it is not the ideal option such as where there is insufficient space for the camera, the edges of the tooth cannot be accurately scanned or all ceramic is not ideal.

What are the advantages?

Natural, lifelike restorations are achieved at a single visit. They remove the need for messy impressions, plastic temporary crowns/veneers/bridges and a return visit for fitting.