Losing teeth is not necessarily a part of the aging process. Taking good care and guarding one's teeth against periodontal or gum disease can make them last a lifetime. However, if removing a tooth becomes imperative, a dentist tries to save even a portion of the natural tooth (roots) as it helps to act as a stable support for bridges (fixed replacement for missing teeth), over dentures (semi-fixed replacement of missing teeth), or partial dentures. This helps to retain the shape of the jawbone.

There is no specific age for replacing a tooth. It is important to try and replace an extracted tooth as soon as possible. Ignore this and it could lead to other posterior teeth moving from their position, leading to slow mobility and loss of teeth. A tooth can be replaced with either a removable or a fixed prosthesis. The removable prosthesis is known as a denture.

Dentures are broadly classified into the following:

(1) Partial Dentures: These fill up the missing space created by the removal of few teeth.

• Fixed Partial Dentures: Popularly known as bridge, it is the fixed replacement of missing teeth, made of acrylic resin.


• Removable Partial Dentures: Popularly known as RPD, it is a removable type of replacement. The cost of RPD (made of acrylic resin) depends on the number of teeth replaced. Price of the base ranges from Rs 400 to Rs 700 for one tooth and Rs 100 to Rs 175 for every additional tooth.


• Cast Partial Dentures: Made from a combination of acrylic resin and chrome cobalt or nickel titanium, it is also a removable type of replacement of missing teeth. There are two types of Cast Partial Dentures - Unilateral and Bilateral. The Unilateral range costs between Rs 3,000 and Rs 8,000 and the Bilateral range costs between Rs 6,000 and Rs 14,000.

(2) Complete Dentures: Complete replacement of all the missing teeth. This is the most popular replacement.
The cost ranges from Rs 2,500 to Rs 18,000.

(3) Over Dentures: These are semi-fixed replacement of missing teeth. Normally supported by roots of canine teeth, they work on a ball and socket type of mechanism. However, the preserved roots should meet certain standards of tooth health. The procedure could cost between Rs 3,000 and Rs 6,000. The cost of the denture is additional - Rs 3,000 to Rs 18,000.

(4) Implant Supported Dentures: Implants (screws made of titanium or a combination of titanium with hydroxylapatite) are surgically embedded in the bony jaw for better support and fixation of dentures. This procedure is expensive and needs good surgical skills and high level of precision. They can also be removed at times (under the supervision of a dentist) for cleaning.
Cost of these dentures is on the higher side, ranging from Rs 7,000 to Rs 20,000. Every implant costs Rs 14,000 to Rs 22,000.

Initially, new dentures may feel uncomfortable. It takes few weeks to get accustomed to them. Minor irritation, denture soreness or increase saliva flow is normal. One may also experience change in facial appearance, difficulty in chewing or speaking.

Cleaning Dentures
Dentures must be cleaned daily in order to prevent plaque, tartar or calculus deposition. They can be cleaned with a toothbrush or scrubber using any soap or washing detergent. Denture cleansing tablets and solutions are also available in the market. The most effective way of cleaning dentures is to soak overnight in water and clean them next morning.

Dentures not cleaned regularly or properly may lead to:

• Mouth ulcers.
• Irritation of tissues under the surface of the dentures.
• Oral infection.

Maintaining Dentures
The dentist provides denture boxes with dentures. They should be stored in these boxes during the night when not in use. Adding some water in the denture boxes avoids distortion of dentures and also helps to clean them.

Precautions

• Don't hold the denture too tightly while cleaning as the pressure could break it.
• Avoid soaking the denture in hot water as it may distort the fit and make wearing uncomfortable.
• Never use a hard brush to clean the denture as this could scratch it.
• Keep the denture in normal water when not in use to maintain a proper fit.
• Always store the denture in a denture box.
• Keep the denture away from kids.
• Avoid dropping the denture as it may break.
• Show the denture to your dentist at least once a year.
• Go for six monthly dental check-ups even if you don't have any pain or problems.

Dr Jignesh Mehta, BDS (Bachelor of Dental Surgery) has done extensive work in Smile Design, Implants, Prosthodontics, Periodontics and Oral Surgery. Besides his private practice in Vile Parle (West), he is available at the BKJ Polyclinic in Bandra (West) in Mumbai.