Removable Partial Denture : Causes, Treatment, Side effects, Costs and Alternatives

Removable partial dentures are the components of prosthodontics which is related to the restorations and maintenance of oral function, comfort, appearance, and health by replacing the missing teeth and craniofacial tissue with the artificial substitute. The removable partial dentures consist of replacement teeth attached to a plastic base. The denture may have metal framework and clasps or the connectors may be made from fiber or plastic, which make the denture look more natural. Sometimes the atrial denture is attached to the natural teeth and is called precision attachments. The precision attachments give a better look, compared to the clasps. The removable partial denture is not fixed permanently in the patient's oral cavity and can be easily removed by the patient. It is also useful for partial edentulous individuals with an absence of alveolar bone, jaw or soft tissue. The treatment can be used for occlusal reconstruction, as a removable periodontal splint, as a surgical obturator or as food impaction device. The treatment consists of four important components, the artificial teeth, the denture base, retainers, and connectors. The artificial teeth are used to replace the actual missing teeth and restore their function. The artificial teeth are fabricated using materials like porcelain, resin, metal etc. They are fixed using the dental base. The denture base provides support and connects the artificial teeth to other parts. The base is also used to avoid fractures or deformations. The partial denture teeth are made with respect to the patient's oral condition.

Removable partial dentures treatment plan begins with gathering diagnostic information, making preliminary impressions and then, pouring diagnostic casts. The artificial teeth must be able to withstand any forces applied on it and must help the patient in cutting and chewing their food. Initially, an X-ray is taken to know the oral condition of the patient. The oral conditions of all the people would not be the same. A proper examination is done by the dentist before proceeding with the treatment. Some patients have a layer of natural tooth which would act as a base for the denture. For removable partial dentures that do not have the benefit of natural tooth support at each end of the replacement tooth, an extension base is provided which acts as residual ridge and provides the functional stability that is required by the artificial tooth. The artificial tooth or whole teeth set is made from cast alloy, resin material or porcelain. The dentist decides the best material after considering the oral health and X-ray of the patient. As the tooth support helps in controlling the prosthesis movement, the endodontic treatment must also assess the overdenture abutments before placing the removable partial dentures. The removable partial denture can also restore an incomplete dentition. Removable partial dentures are custom made and designed specifically for each and every individual according to the health condition and fit. The dentist after examining the patient, suggests the removable partial denture treatment. In this artificial tooth is made that is an exact replica of the original tooth and fits in the oral cavity. The artificial tooth or teeth is placed on a denture, which acts as a supporting base and also helps in connecting the artificial tooth to other parts. A retainer is put on the tooth or teeth to prevent dislodgement.

Connectors or clasps are placed which would act as bridge and help in connecting the denture to other parts inside the mouth. Some dentists even advise to cementing the removable restoration to the teeth, till the time the patient gets used to it.

Mostly young people do not require dentures. Even if they broke a tooth, that can be fixed using flipper, fillings, cap or cement. Around 53% percent people above the age of 44 require these partial dentures. Women above the age of 40 generally opt for the removable partial denture treatment. RPDs are fabricated for those people who miss some or all teeth on both the sides and their edentulous area has teeth remaining both posterior and anterior to it.

Patients who have diabetics, blood pressure and heart diseases must take proper precaution before opting for removable partial dentures. People below the age of 30 do not opt for this treatment. People with speech irregularities are advised not to go for the treatment. People with sensitive gums cannot undergo the treatment. Fabricating and placing a denture after oral cancer is not advisable. The patient is advised to wait for some time before opting for the treatment.

The dentures must not be worn while sleeping, else it causes bacterial infections. If the denture is not made of the correct size and if it is not fitted properly, many oral infections may occur. Sometimes the denture can lead to improper communication and speech difficulties. Dentures may also lead to the bleeding of gums and bad odor. They sometimes cause mouth sores and blisters. It also changes the taste sense of the mouth. Food debris may get stuck to the denture which creates an unpleasant taste inside the mouth.In case any patient reports any other complexity after undergoing the treatment the patient is advised to consult the doctor immediately.

In the beginning, the denture may feel bulky and getting used to it would take some time. Inserting and removing the denture would require practice. Chew the food using both the sides of the mouth to maintain even pressure on the teeth. Eat soft foods that are cut into tiny pieces. Avoid foods that are sticky and hard. Chewing gum must be avoided during the adjustment period. Clean the denture regularly using denture cleaner. Do not use toothpaste as they can be too harsh for the dentures. Never force the partial denture by biting it down. The denture must be brushed daily. The denture must be placed in a soaking solution or water, else it would lose its shape due to lack of moisture. Rinse the denture thoroughly with water before placing it in the mouth.

The treatment recovery time varies from the patient condition to condition and differs from the mode of the treatment opted for the patient. he treatment, depending upon the oral condition of the patient can be carried out in one or two sittings, with a break period of one week. After the treatment, within 4 to 7 days, the dentist would be able to figure out any changes or issues in the treatment. The patient must be able to recover within 3 to 4 weeks. After that, for the next six months, proper care must be taken of both denture and oral hygiene.

The cost of treatment and dentures depends on the dentist, clinic and the type of material used. If the denture is made for a single tooth, the cost starts from 3000. For tooth flipper, the price ranges from 7000 to 20,000. If the dentures are made of cast alloy, then their price range increases. The cast alloy dentures start from 25,000 and go up to rupees 55,000 or more. Flexible partial dentures cost around 20,000 rupees. Plastic partial dentures cost around 4000 rupees.

The treatment cannot assure hundred percent results. The success rate of the treatment depends on the oral health condition of the patient and also on how the patient uses and takes care of the dentures. If the removable partial dentures are ill-fitting or poorly occluding, they may lead to a burning sensation in cheeks, tongue, lips and in residual ridge areas. Inflammation and irritation in the mouth may also occur. Maximum benefit can be obtained by using tissue conditioning materials. Proper care must be taken by the patient to avoid further pain and illness. This would ensure less inflammatory oral conditions and a healthy denture for a longer period. But if the denture has become old, lost its shape, outer covering has tarnished, then a new artificial tooth has to fabricated.

There are a few alternatives to the removable partial dentures that provide a temporary solution to the patient. A flipper denture can be used. If a single tooth is broken or came out during an accident, fight, or knockout a flipper can be made quickly. A thin pink layer of plastic is fitted behind the broken tooth to provide support.

Another alternative is to use cemented bridges. These implants or bridges closely resemble the feel of the real teeth. The only disadvantage is that the cost is high.