What is the difference between upper and lower dentures?

I belong to several online dentist groups where dentists discuss cases and treatment plans together to try and further their education.  Last week, one of the dentists posted this title, “Dentures without implants are for smiling, not chewing,” and it really resonated with me.  

In the beginning of my career, I would happily complete a lower denture on anyone who wanted and/or needed one.  I had learned the best techniques and was taught that in cases with hopeless teeth, dentures were standard of care.  Over the years, I began to realize that my denture patients and specifically my patients with conventional lower dentures, were my “problem” patients.  They were the patients who were never happy.  They often just couldn’t function with the lower denture.  So, I took a denture course.  I thought surely it was something I was doing wrong.  And, thanks to an amazing dental school (Go Gators!), I didn’t learn any new techniques.  I was taught, and was doing the best techniques for completing dentures that were available.  

My next plan of action was to create a new policy for myself.  And, this is the policy I have stuck with for many years now.  I just don’t do lower dentures without implants anymore.  I hate when patients are unhappy or disappointed.  I want to know that when I finish my work, I will have a happy, healthy, functioning patient.  I couldn’t guarantee that with lower dentures without implants.  Don’t get me wrong, there are some patients who are completely happy with anything.  You literally put a denture in their mouth and they happily start chewing and functioning with it and never look back.  But, those patients are few and far between.  The rest of the time, patients who get conventional lower dentures are sorely disappointed.  They can’t eat and often can’t speak properly.  Most of the time, they end up putting the dentures in a drawer and only using them for special occasions.  

So, what is the difference between upper and lower dentures?  People think, well I have 2 jaws, so they must be the same.  This couldn’t be further from the truth.  As I would tell my patients, most people can tolerate an upper denture.  While it is not the most fun experience, and it is definitely not like having your own teeth, most people can learn to function with an upper denture.  Lower dentures are a whole different ballgame.  Let’s talk about the difference between your upper and lower jaws.  Feel the roof of your mouth with your tongue.  It is mostly hard, and where the hard part meets the soft part, back by your throat, this is what helps the denture suction to the roof of your mouth.  Now feel your lower jaw.  Most of it is covered by your tongue and it is soft moveable tissue in the middle of your teeth.  Your jaws are completely different.  Therefore, the dentures have to be completely different.  An upper denture covers the entire roof of your mouth.  It has a lot of surface area to help it suction and have retention.  

A lower denture on the other hand is horseshoe shaped.  It follows the horseshoe area where your teeth would be, but the entire middle is left open so that your tongue has space to move.  But it doesn’t stop there.  Not only is a lower denture missing all that area that creates suction, but in addition, there is nowhere for the lower denture to suction.  Your tongue is attached to the floor of your mouth in the middle of your lower jaw.  Every time you speak or chew, your tongue moves and it moves all of that soft tissue around it.  Most of the time, this displaces a lower denture.  This is what makes lower dentures intolerable for most people.  Unless you have the patience to retrain your mouth to use your tongue and cheek muscles to hold the lower denture in place, then it will be a miserable experience.

Now you can see why the above quote resonated with me.  I have been trying to find a succinct way to explain my policy on dentures to my patients for years…and there it was.  Often people don’t realize how big of a difference just two implants underneath a lower denture can make.  It turns a vanity item into a useful appliance.  Throughout the years, my patients that have gone from a conventional lower denture to an implant supported denture are always my happiest patients.  I can’t even tell you how many of them have told me that it changed their life.  They can go back to chewing and eating foods that they haven’t had for years.  They can socialize without fear of their denture moving around during conversation.  And for many it even changes their intimate life as well.  They feel so much less self conscious.  It is always amazing to me how two little snaps can truly change a person’s life.  I could honestly go on speaking about it for hours!   I won’t bore you with the details, but if you or someone you know is suffering, or just “getting by” with a lower denture, I implore you to look into getting two implants on the bottom.  With payment plans, it is more affordable now than ever and it will change your life.  Let’s get you back to smiling and chewing again!

Dr. Ariana Clayton
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