The Lower Denture Nightmare

Hello, this is Dr. Daniel Vinograd, biological dentist in San Diego, California. Today, I’d like to speak about something that’s dear to my heart. I’ve been practicing dentistry for over 30 years and there are a lot of pains in my work that give me great satisfaction. I’m very blessed that I can say that I really, truly love what I do.

But one of the things that brings the most satisfaction to me is to help people who have dentures – lower dentures in particular.

I believe that a lot of people don’t really understand how challenging a lower denture is. When people sometimes get tired of having a lot of cavities, gum disease, sometimes they just want to “get rid of the problem”, get the teeth out and get some dentures on.

Of course, today, that’s becoming less and less of a problem, but we still have a large number of people out there with dentures that are struggling with them.

Now, why lower dentures? There was actually a dentist that used to say, “I usually charge only for my upper dentures and I give my lower dentures for free because inevitably, patients come back with great problems with their lower dentures.”

And so why is it that lower dentures are so much more challenging than upper dentures? Well, a properly executed impression and a properly done upper denture can achieve in most cases a good seal especially if the flanges on the back and the post stem on the denture is well-secured.

Once we get that suction in that upper denture, if you really think about it, the upper denture really is going to be suctioned up to a non-movable arch. The arch is really part of our skull and our skull is not really moving at all. Actually, when we chew, when you think about it, it’s really the jaws, the mandible that is actually doing all the movement and all the work.

So having said that, we can easily understand that the part that’s constantly moving is the lower jaw. In addition to that, we have the tongue, which actually tends to move the floor of our mandible up and displaces the denture.

So between the jaw moving and the tongue moving and having less surface for that denture to create suction on, plus the great re-absorption of the bone, we really have a very, very challenging situation.

The latest statistics that I’ve read is that 90% of the people that have lower dentures are very dissatisfied. That is not the case for upper dentures at all. For most of other dental work, not even close.

So I would say this is probably the most challenging piece of dentistry that a patient can actually use that will cause patient dissatisfaction.

What is the answer? Today, we can actually place implants. Implants can actually change the quality of a person’s life.

Two challenges with the implants, two problems that we have with the implants, one is the cost because in order to place fixed restoration with the lowers, we need at least four large implants (if not more) and a soft structure and then the bridge.

So we’re talking usually tens of thousands of dollars to get this done if not more depending on the circumstances and where it’s done.

The other challenge is that often enough, there’s not a lot of bone in the mandible area. And so that creates a challenge to place the implants. So that leaves us with sometimes very little to work with.
In the recent past, smaller implants, smaller diameter implants have actually been used for actually securing a lower denture. By actually using the denture and creating a situation where we can actually snap the denture into a fixed position, we can actually not necessarily get rid of the denture, but make it so that the denture is no longer challenging.

I have to say that this is one of the most satisfying things that I have done for patients where patients come and they are so exasperated, so frustrated with their lower dentures, unable to have really a decent quality of life. Once we secure that lower denture, the look on people’s faces, their ability to function again, their ability to chew is just heart-warming.

So once again, if you have a lower denture, you are challenged by the denture and the quality of your life is not great, think about going to your dentist and asking about the possibility of having an over-denture made for you.

Obviously, you can always explore the quality of your bone and the quantity of your bone to see if actually fixed prosthesis can be placed. But if the finances or the bone are problematic, you no longer have to just sit and suffer.

I hope that was helpful. All the best to you from San Diego, California, Dr. Daniel Vinograd.