Dental prosthetics: removable and fixed dentures

A missing tooth is more than a cosmetic problem. Neighbouring teeth gradually tilt into the gap, the opposing tooth drifts out of its socket towards the gap, chewing shifts to one side and the load on the jaw joints and gums becomes uneven. Prosthodontics restores a complete dental arch, so you can eat what you like, speak clearly and smile with confidence. At UKRMED Dentistry, the restoration is planned for your particular case, from a single crown to a full denture.

Photo: Tiia Monto, Wikimedia Commons, CC BY 4.0

What prosthodontics covers

Prosthodontics is the branch of dentistry that restores damaged and missing teeth with artificial replacements. The prosthodontist plans treatment, chooses the material, takes an impression or a digital scan and works with the dental technician to make a restoration that copies the shape of natural teeth and spreads the chewing load correctly.

There are two main types:

• fixed dental prosthetics - crowns and bridges cemented onto teeth or implants; the patient does not take them out;
• removable dentures - taken out for cleaning and at night; they are held by the gums, clasps (small hooks) or implants.

At UKRMED this area is led by dentist Mariia Sieraia, who specialises in aesthetic prosthetics and full bite rehabilitation (restoring all teeth and the way the jaws meet) with removable and fixed restorations.

Fixed restorations

Fixed dental prosthetics suit a badly damaged tooth or one or several missing teeth when there are reliable teeth next to the gap.

A crown is a cap that covers the whole tooth and restores its shape and colour. Crowns are made from acrylic (temporary), metal-ceramic (a metal framework covered with porcelain) and metal-free ceramic. Types and indications are described on the dental crowns page. For front teeth with healthy tissue, thin veneers are sometimes enough.

A bridge replaces one or several missing teeth. It consists of crowns on the neighbouring teeth and artificial teeth between them. The supporting teeth have to be reshaped, so the dentist always weighs up whether it is worth loading healthy teeth. If the neighbours are intact, dental implants may be an alternative: the implant replaces the root and the neighbouring teeth stay untouched.

The cost of a bridge is calculated per unit: each crown and each artificial tooth. The dentist gives the exact amount after an examination and, if needed, X-rays.

Removable dentures

Removable dentures help when many teeth are missing, when there are no reliable supports for a bridge or when implants are not possible at the moment.

A partial denture is used when some natural teeth remain. It has a gum-coloured acrylic base (the part resting on the gums) with artificial teeth and is held by clasps on the remaining teeth.

A complete denture is made when there are no teeth left in the jaw. It is held by close contact with the gums and palate, so an accurate custom tray (a plastic tray made for your jaw to take a precise impression) and impression are essential.

A cast-frame (clasp) denture has a thin metal framework with a bar (a metal strip along the palate or behind the lower teeth) that spreads the load between teeth and gums. It is more compact than an acrylic denture and usually more comfortable to wear.

A nylon denture is made of flexible material. It is light and has no metal clasps, so it is less visible. Nylon works for a partial denture replacing 1-2 teeth or as a complete denture.

Research shows that with a partial denture people find it easier to chew and speak and feel more confident around others.

How treatment works

1. Consultation and diagnostics. The dentist examines your teeth, gums and bite and, if needed, takes an X-ray or 3D CT scan (a three-dimensional image of the jaw).
2. Preparation. A restoration is placed only on a healthy base, so decay and root canals are treated first at the general dentistry department, followed by a professional cleaning and, if the gums are inflamed, periodontal treatment.
3. Impressions or a digital scan. For removable dentures, a custom tray and wax bite rims are also made to set the bite height.
4. Try-in. You check the shape and colour of the teeth, and the dentist checks the bite.
5. Fitting of the fixed restoration or delivery of the denture with instructions on how to use it.

Getting used to a removable denture takes a few weeks: you may notice more saliva or sore spots. Adjustments during this time are a normal part of treatment.

Care and lifespan

• clean the denture daily with a separate brush and rinse it after meals;
• take a removable denture out at night and keep it in a container;
• do not bend clasps or grind the base yourself;
• have a check-up at least once a year.

Over the years the gums and bone under a denture change and it starts to move. The denture is then relined: its fitting surface is adjusted to the new shape of the gums. A crack or broken tooth is fixed by a repair, and a tooth or clasp can be added to the denture.

Prosthodontics prices at UKRMED

The total cost depends on the number of missing teeth, the chosen restoration and the preparation needed. The dentist gives a full estimate at the consultation.

Sources

1. Choong E. K. M., Shu X., Leung K. C. M., Lo E. C. M. Oral health-related quality of life after rehabilitation with removable partial dentures: a systematic review and meta-analysis. J Dent, 2022. https://doi.org/10.1016/j.jdent.2022.104351
2. NHS. Dentures (false teeth). https://www.nhs.uk/tests-and-treatments/dentures/
3. American Dental Association (MouthHealthy). Dentures. https://www.mouthhealthy.org/all-topics-a-z/dentures