Total dentures are used and recommended when the patient has lost all dental units due to bone atrophy or extensive carious processes leading to rapid tooth decay.
It is made of an acrylic portion, which rests on the alveolar ridge, i.e. the buccal mucosa.
The buccal mucosa receives the forces transmitted by the full dentures. Over time, if these forces are not calibrated and adjusted according to the condition of the mucosa, lesions or other types of irritation will occur.
The response to irritative factors may be in the sense of keratin deposition and consequent thickening of the mucosa or in the sense of ulcerative lesions.
Potentially irritating factors
The following factors may be involved in modulating the response to irritants:
General nutritional diseases – diabetes – occurs due to improper functioning of the pancreas. It is a slow-onset disease that affects the whole body, producing changes in blood microcirculation, vision and causing the patient to swallow increased amounts of fluids without stopping the thirst. In the mucous membranes, diabetes causes dryness-like changes. The mucous membranes will be dull, pale and may even ulcerate because of the opening. The gums will be enlarged and lose their firm consistency.
Blood diseases or hepatopathies – representative in this respect are leukemia but also thrombocytopathies. In both cases, bleeding spots and bubbles will appear on the oral mucosa, consisting of lesions that bleed extremely easily at the slightest touch or even spontaneously. In the treatment of bleeding lesions, one should always start with determining the general cause and instituting treatment of the disease, followed by improvement of oral health.
Decreased immunity – a decrease in the body’s reactivity to oral pathogens can make it easier for infections to set in. Irritant factors, grafted onto a patient’s already bacterial-infested terrain, can worsen symptoms which can be complicated by over-infection of lesions.
Avitaminosis – lack of certain vitamins in the body consistently leads to damage to oral structures. Vitamin A deficiency leads in many cases to a change in the appearance of the gums, which become paler.
Vitamin A deficiency also leads to delayed healing of mucosal sores. Deficiency of certain nutrients can also affect structures of the oral cavity other than the mucosa. For example, vitamin B1 deficiency leads to dentine hypersensitivity, while vitamin D deficiency causes bone demineralization.
More than half of denture wearers have changes in the underlying mucosa, detectable by histopathological examination. These changes lead over time to a decreased ability of the mucosa to respond to surrounding aggression.
Most patients experience a degree of discomfort, especially in the first few days after total denture fitting. It is advisable to have a dental check-up less than a week after the application of dentures. In this way, mucosal changes can be detected early and complications can be prevented.
Lack of adjustment of full dentures leads to speech, eating and even aesthetic disorders, with the patient being unable to eat properly or, due to the aesthetic deficit, isolating themselves from others.
