Introduction
The use of removable partial dentures is often associated with problems of comfort, bacterial danger, and increased care. In some measure, the use of dentures is regarded to be harmful because of bacteriological and physiological factors. First, it is necessary to give the details of prosthetic procedures, to clarify the risks and harms, closely linked with wearing dentures. Then, the explanation of harm will be based on the knowledge of the prosthetic process and technology.
Prosthetic Technology
The technology itself is based on the esthetic, practical, and comfortable replacement of the missing teeth with dentures. The materials and the instruments, which are used for these processes are claimed to make the dental prosthetics simplified and less harmful for the health of the patient. As Gelbier (2005) describes in his work: “Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, connected by metal framework. Removable partial dentures are attached to the natural teeth with metal clasps. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on the natural teeth may improve the fit of a removable partial denture and they are usually required with attachments.” Originally, the prosthetic treatment is closely linked with the placement of the unnatural object in the mouth of the patient. Initially, the problems, which may occur, are associated with the incompatibility of natural tissues and artificial materials, used for prosthetic procedures.
Consequences of Dental Prosthetics
The fact is that the absence of teeth is dangerous for the damage of tissues in the mouth, while the placement of prosthetics is harmful to the increase of the oral cavity. It is generally explained by the fact that plaque and bacteria accumulate on the alloplastic materials and polymers, which are used for dentures. Acryl dentures are harmful for the evaporation of some chemical components, which affect the throat, tissues, and healthy teeth. Nevertheless, non-toxic materials also release small amounts of chemical components, which are then included in the oral activity.
According to Kallus (1984), it should be stated that the harmful effects may be observed in several dimensions: “The most evident is the plaque which is likely to accumulate around any RPD; direct trauma may be caused by individual components of the denture; excessive functional forces may be transmitted by an ill-designed prosthesis and from errors in the occlusion”. Surely, these problems may be avoided, in the case, if the patient can maintain optimal plaque control, and perform all the required hygiene-related procedures and cope with all the complications, associated with wearing removable partial dentures. Nevertheless, constant and comparatively frequent technical maintenance of RPDs is necessary for the optimal functioning of the oral processes, prosthetic functioning, and avoiding health problems. Some researchers regard the potential problems as the biological price for wearing RPDs, thus, it is claimed that the problems are inevitable, and the seriousness of these problems is exclusively individual. Still, Markkannen and Lappalainen (2007) emphasize the fact that the problems are sometimes rather serious and cause even more discomfort than the lack of teeth: “Functional forces are transmitted by an RPD to the tissues with which it is in contact. If a denture is supported primarily by the natural teeth, most of the forces will be transmitted to the alveolar bone through the fibers of the periodontal ligament. Bearing in mind the orientation of most of these fibers, it will be appreciated that the forces are tensile and are dissipated over a relatively large area. A very different state of affairs exists when a denture is supported only by the mucosa. Here the forces, largely compressive, are transmitted over a more restricted area.”
Indirect Problems and Harms
Along with the problems which are closely linked with wearing RPDs, there are numerous indirect problems, associated with the discomforts of wearing RPDs. Dentures are attached to the remaining teeth by grips of metal or plastic that make the RPD more firm. This plastic shields the tissue responsible for giving someone the taste of their food. This in turn makes people with dentures complain about the decrease in flavor and the level of temperature in their food. To counter this, they add more seasonings like salt to the food to make it more palatable. Heavyweight people and who take high amounts of salt have increased chances of developing high blood pressure and also have problems with the digestive system. Studies have shown that people with high blood pressure have a high risk of running heart disease. (Sandler, 1991)
Another problem is the inability to chew the food sufficiently. To cope with their chewing inability some people swallow their food almost without chewing it. This has over the years caused choking among people with dentures. (Awad, et. al., 2000)
Avoiding Problems
In the light of the fact that the problems may be avoided and the harm may be essentially decreased, it is necessary to emphasize that there are some requirements for dental prosthetics and denture care that should be strictly observed. First of all, there is a strong necessity for a clear understanding of the importance of plaque control. It is stated, that wearing of RPDs is fully compatible with strong health and absence of serious problems if a patient agrees to maintain the proper technical and bacteriological condition of the dentures. Another factor, which should be observed is solely technical. The dentures should be properly fitted to the mouth of the patient to avoid traumas and discomfort while wearing them. Azarpazhooh and Limeback (2008) state that the precision of the clinical processes is the most crucial factor in arranging dental prosthetics. Moreover, there are three factors, which are essential for the health of the patient after the RPDs have been installed. These are:
- Effective support
- Clearance of gingival margins
- Rigid connection
Conclusion
Finally, it should be stated that problems and harms may appear only in the case of negligence from the side of the technician or patient. Previous to assigning the RPDs, the patient should be appropriately motivated for wearing them, and the dentures should be designed, constructed, and then properly maintained by a professional.
Thus, the responsibility level is equal for both dentist and patient, as along with the professional care and maintenance of the construction and the materials of the dentures, the patient should be interested in avoiding harmful consequences of wearing the removable partial dentures.
References
Azarpazhooh, A & Limeback, 2008, ‘Clinical Efficacy of Casein Derivatives: A systematic Review of the Literature,’ The Journal of the American Dental Association,vol. 139, no.7,pp. 915, PMID 18594077. Web.
Awad, MA, Locke, D, Korner-Bitensky N, Feine, J 2000, ‘Measuring the effect of Implant rehabilitation on oral health-related quality of life in a randomized Controlled clinical trial,’ J Dent Res, vol. 79, no.1, pp.1659-1663.
Fisher A.A. Allergic sensitization of the skin and oral mucosa to acrylic denture materials. Journal of American Medical Association 1954.
Gelbier, S 2005, ‘125 years of Developments in Dentistry’, British Dental Journal, vol.199, no.1, pp. 470-473.
Kallus TK. Enhanced tissue response to denture base polymers in formaldehyde-sensitized guinea pigs. Journal of Prosthetic Dent 1984;52:292-299.
Markkannen, H, Lappalainen, R, Honkala, E, Tuominen, R 2007, ‘Periodontal conditions with removable complete and partial dentures in the adult population aged 30 years and over’, Journal of Oral rehabilitation, vol.14, no. 4, pp.355-360.
Sandler, PJ 1991, ‘An attractive solution to unerupted teeth, American journal of orthodontics and Dentofacial orthopedics, vol 100, no.1, pp. 437-493.