The ups and downs of dentures

By Carol Waldman February 26, 2010

Over five-million Canadians wear dentures. For some of them, ‘false teeth’ are a lifesaver, for others a constant source of frustration. This is natural, experts say, and education about what to expect and how to cope is an important step in the process

Ellen Ashton-Haiste
Published on Dec 01, 2009

When my mother’s teeth started breaking on things like tuna sandwiches, the writing was on the wall.

And when the dentist pointed out that no number of pins and no amount of filling was going to rebuild a tooth with virtually no original enamel left to hold it in ‘ and virtually all her top molars were in that shape ‘ her fate was confirmed.

Denture time.

‘Don’t worry. It will be so much better in the long run,’ said my friend Dale, who knew my mom had been babying her teeth for years, eating only the tenderest meats (certainly no steak!) and soft foods verging on purees.

Dale spoke from experience. She’d had an upper denture for years and declared it was the best move she’d ever made, as she now enthusiastically crunches apples, chomps corn on the cob and chows down on T-bones.

So, at age 84, Mom bit the bullet and entered the world of what was once known as ‘false teeth.’ The dentist extracted what was left of the broken molars, took imprints, made molds and, on the final day, pulled five remaining front teeth and inserted an upper denture. There was also a partial lower, with four teeth ‘ three on one side, one on the other ‘ joined by a thin wire running behind Mom’s own bottom teeth.

We were realistic. We expected a period of adjustment, some discomfort. But, with Dale’s words ringing in my ears, I optimistically predicted a steak dinner for Mom’s June birthday, six months away.

The new teeth were beautiful. Mom’s smile fairly gleamed. Everyone commented how nice and how natural they looked. But appearances were, unfortunately, all that improved from Mom’s point of view. That and the fact that she could now chew her beloved cashews.

Otherwise the dentures have been a constant source of frustration. After so long with few teeth, her mouth felt too full, like there was not even room for the food. There were times when the plate along the top of her palate made her feel like gagging. And the food ‘ except for the cashews ‘ didn’t seem easier to chew. Sometimes the denture would wiggle around and even pop out ‘ once at a restaurant. Mom didn’t like the goopy adhesive creams. (Dale, luckily, had never had to use those.)

The birthday came and went with the steak dinner still a distant dream.

So whose experience is typical ‘ Dale, who has embraced her denture and never looked back, or Mom, who’s sure she will never eat the same way again’

It is an individual experience, say the experts, but there are extenuating circumstances and factors.

Age is one, says North York dentist Dr. Carol Waldman, cosmetic dentist. ‘For older people, it’s harder,’ she says, adding that the longer they have coped without teeth or with fewer teeth, the longer it takes to adjust to dentures. Dale got her dentures at about age 50, when Waldman says the learning is easier than at 84.

But regardless of age, education is a major factor, says Donna Hennyey, a registered dietitian working in the University of Toronto’s Faculty of Dentistry. It’s a fact, she maintains, that many people getting dentures have misconceptions and unrealistic expectations.

Says Hennyey: ‘Dentures don’t function like real teeth. Eating with them is only about 25 per cent as efficient as eating with real teeth. So you have to work at developing new skills for how you eat. People haven’t been educated to that.’

The front teeth, for example, are primarily for appearance and not built for biting or tearing food. The more people use those front teeth to bite into food, the more likely they are to loosen the dentures and put stress on the gums and bones, Hennyey says.

‘Cutting food into pieces, putting it into your mouth and chewing with your back teeth ‘ that’s really what dentures are for.’

When my mom seemed unable to adjust to her dentures, I took her to my own dentist, Dr. John Tupper in London, Ont., for a second opinion. He examined her new teeth and pronounced them a good fit and one that he would be unable to improve upon.

But he told her, as Waldman and Hennyey say, that everyone is different and there is definitely a learning curve. Among the advice tips he offered was to try to chew on both sides of the mouth at the same time and to chew up and down, rather than sideways.

‘The actual mechanics of how we chew our food with dentures is different from how we chew with our regular teeth,’ Hennyey says. ‘These are really strong habits to break and that’s why it takes so much time.’

Waldman prepares her patients for dentures by giving them an acronym: ‘It’s a SNAP.’ The letters stand for ‘soak,’ ‘new routine,’ ‘adhesives,’ and ‘patience.’

Soaking, she says, is important for hygiene. She advises overnight. Dale never left her teeth out overnight, at 50 not wanting her husband to see her toothless. While overnight soaking gives the tissues a chance to relax, Waldman agrees there are younger wearers who, like Dale, are unwilling to do that and there are products that allow the option of a15-minute soak to cleanse the teeth, which can even be done while showering.

Something else to be aware of, says Hennyey, is that a plate covering the top palate in the mouth decreases certain sensations, like hot and cold, which can affect how food is tasted.

‘Because heat and cold are not conducted well by denture surfaces, this may alter the taste experience. Experiment with herbs and condiments for added flavour ‘ pepper, garlic and onion powder, oregano, dried dill weed, basil and rosemary are only a few you could try to make up for this change in taste perception.’