False teeth (removable dentures): who are they for, and how long does it take to get used to them?

A removable denture, as dentists call it, is made up of artificial teeth set in a gum-coloured base. The base sits directly on the gum. Unlike a bridge or teeth on implants, it is not fixed in place; it comes out for cleaning and at night. If all the teeth are missing, a full denture is made (in everyday speech often called a plate); if you still have some teeth, a partial denture is made.

What holds a full denture in place is not a screw or a clasp. The better the denture fits the ridge of gum over the jawbone, the better it stays in; the thin layer of saliva in between and, in the upper jaw, the suction created under the palate complete this hold. This is why a full upper denture usually stays in better than a lower one: in the lower jaw there is no broad palate to rest against, and the tongue and cheek move the denture all the time.

A partial denture, on the other hand, holds on to the remaining teeth. An acrylic denture with clasps is quick to make and teeth are easy to add later, but it is thicker, so it is often used as a transitional denture. A denture with a metal framework is built on a thin metal base; it is lighter and less bulky, but it needs healthy teeth to hold on to. A flexible denture is made from a plastic that bends, holds on by wrapping around the remaining teeth and often does not cover the palate.

Then there is the immediate denture. If teeth need to be taken out, the impression is taken before the extraction and the denture is fitted on the day of the extraction, so there is no period without teeth. However, because the gum and the bone underneath change shape quickly in the months after an extraction, this denture soon becomes loose. That is why relining or replacing an immediate denture within the first year is usually part of the plan from the start.

A well-made removable denture that is looked after regularly brings back much of your smile, the support for your lips, your speech and your chewing; many people wear one comfortably for years. Knowing its limits from the outset makes getting used to it easier. Chewing force does not reach that of natural teeth, and very hard or sticky foods can be difficult. An upper denture that covers the palate can reduce your sense of taste and temperature somewhat. Nor does a denture stop the bone underneath slowly shrinking over the years, which is why adjustments and relining become necessary in time.

There is no age limit for a removable denture. The answer to the question 'at what age do you get a denture?' is not an age but how many teeth have been lost, and which ones. A partial denture can also be made for a young adult who has lost teeth through an accident or illness; in older age, general health and the ability to put the denture in and take it out become part of the decision.

The decision is made not on age but on your remaining teeth, your jawbone, your general health and what you expect. The second list does not mean a removable denture cannot be made; it shows situations that need more careful planning.

The sequence below applies to a conventional full denture; with a partial denture, preparing the remaining teeth and trying in the metal framework come in between. The number of appointments and the total time depend on whether extractions are needed, and usually spread over a few weeks.

1. 1

   Examination and X-rays

   Your remaining teeth, the health of your gums, the height of the bony ridge and any sores in your mouth are assessed. Teeth that need to be taken out or treated are identified at this stage; if a partial denture is to be made, the teeth it will hold on to need to be healthy.

2. 2

   Impressions

   First, an initial impression is taken with a ready-made tray. From it, a tray made specially for your mouth is prepared, and a second, more precise impression that sets how far the edges will reach is taken with it. How well the denture stays in depends largely on this impression.

3. 3

   The bite and choosing the teeth

   The position of the upper and lower jaws in relation to each other and the height of the lower part of your face are recorded. The shape, size and shade of the teeth are chosen to suit your face; old photos in which your natural teeth can be seen are useful at this stage.

4. 4

   Try-in

   The teeth are first set in a wax base and tried in your mouth. The appearance, lip support, speech and bite are checked. This is the easiest time to ask for changes; once the denture is finished, changing the arrangement of the teeth is much harder.

5. 5

   Fitting

   The finished denture is fitted, and any spots that press too hard and the way the teeth meet are checked. You are shown how to put the denture in and take it out, how to clean it and what to watch for in the first few days.

6. 6

   The first check-ups

   Check-ups are planned within the first few days and at the end of the first week. It is normal for a few spots on a new denture to need slight adjustment; these appointments should not be skipped.

The options below are not rivals to a removable denture. Each suits a different mouth; the decision is shaped by your remaining teeth, the state of the bone, your general health and your priorities.

We write these down not to run removable dentures down, but because most of them can be solved easily when they are noticed early.

Timescales vary from person to person. Someone wearing their first denture and someone who has worn dentures for years and is getting used to a new one do not adapt at the same speed; a lower denture also usually takes longer than an upper one.

1. The first few days

   Your mouth feels full, you produce more saliva and some sounds, especially s, sh and z, come out differently. Start with soft food, take small bites and chew on both sides at once. Reading aloud helps your speech recover quickly.

2. The first week

   Tenderness or small sores may appear in a few spots. These are not a sign of getting used to the denture but of spots that need adjusting; tell your dentist without waiting for your check-up. If the pain allows, put the denture in a few hours before your appointment so that the spot that rubs can be seen.

3. Weeks two to four

   Saliva returns to normal, and for most people speech improves noticeably. Over time you learn to hold a lower denture in place with the muscles of your tongue and cheeks. Widen the range of foods you eat gradually; leave very hard and sticky foods until last.

4. The first few months and beyond

   With an immediate denture, gaps open up as the gum shrinks, and relining may be needed within the first year. After that, the fit is monitored at regular check-ups. Dentures usually need replacing after five to eight years.

There are no figures on this page. A removable denture is not a one-size-fits-all product; its scope is determined by the items below:

Full or partial

A full denture in one jaw or both, and a partial denture that holds on to the remaining teeth, involve different stages and different laboratory work.

The type of denture

Acrylic, metal-framework, flexible and precision-attachment dentures differ from one another both in the stages of making them and in how durable they are.

Preparing the mouth

Extractions, fillings, gum treatment and preparing the remaining teeth for a partial denture are part of the plan.

The transitional period

If you start with an immediate denture, you should know from the outset that relining or a new denture may be needed within the first year.