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Dr. George: New Dentures Demand Patience and Nutritional Care (part 1 of 2)
Published in Ojai Valley News, August 21, 1992.
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Dear Dr. Meinig:
This isn’t a nutritional question but I hope you will answer it as men can be such problem patients. You see, my husband is going to have all his teeth out and immediate dentures inserted. Would you write about the problems he will have so I can be supportive of him during this time? –E.G.
Dear E.G.:
No matter what kind of difficulties new denture wearers experience, the most important is a nutritional one. Not only do patients become so involved in learning how to get along that they forget the main reason for replacing teeth is their need to masticate food.
Your husband is fortunate to have a wife who so much wants to ease his burden that she takes it upon herself to write for professional advice.
Patients with new full upper and lower dentures inserted at the time of the last tooth extractions have numbers of special requirements, most of which are not difficult to bear when there is a little understanding of what is to take place. Most of the following information also applies to those who are having old dentures replaced with new ones or those having partial dentures.
People generally realize that a soft diet is necessary in the beginning, but surprisingly, some do expect to go right out and chew a big steak. A few are able to do so but actually no matter how expertly constructed, new teeth are quite a mouthful. The tendency is for the tongue, lips and cheeks to want to push them out. It is only our mental acceptance of the problem that enables our brains to instruct facial muscles and tissues to learn how to hold and control the new dentures.
Light, soft, nourishing small meals are called for such as soft-boiled eggs, eggnogs, baked potatoes mashed up with butter, steamed vegetables, soup, whole grain cooked cereals, fish, poultry, rare hamburger, banana and other bland fruits. Make the knife and fork do most of the work by using them to cut and mash the food.
Avoid drinking fruit juices and eating citrus fruits, as their acidity and high sugar content often cause sores and eruptions in the mouth that will be blamed on the new dentures. Remember, protein is necessary for healing and repair of tissues, so don’t avoid poultry, meat, fish or eggs. If cooked rare, meat, fish and poultry are easy to cut into small pieces and will readily be tolerated and digested. Do avoid more than one alcoholic drink, for the incidence of post-operative pain is much greater in those who try to drown their sorrows. Some patients find baby foods are particularly helpful at this time.
A good multiple vitamin-mineral supplement, plus calcium and vitamin C are suggested throughout life. You can see from all the foregoing that your question about new teeth is really one of nutrition.
Dentures that are inserted immediately after the teeth are removed create a certain amount of fear in patients. While worry about all the other things that will take place is common, the one most troublesome thought is, how in the world can these things work without causing a lot of discomfort to the newly extracted teeth areas?
The fact is the mouth heals better, faster and with less discomfort because the dentures act as a bandage over the wounds. Many dentists place medications in the denture base to encourage healing and reduce discomfort. I always used a vitamin E cream in them as it proved more effective than anything else I had used to hasten healing.
The only discomfort that can come from the denture base is usually not over the extraction but at the border extensions of the dentures. These can be readily corrected by adjustment to the area involved.
Patients are instructed to leave their new immediate dentures in for one to two days. Inasmuch as some swelling often occurs because of the surgery, it is difficult for people to get the teeth back in their mouth right after they have been inserted for the first time. On their return postoperative visit, the dentist removes the dentures, sprays the mouth with water and/or disinfectant, and cleans the dentures.
Any sore spots are adjusted and the patient is then instructed as to how best to take the dentures out and put them back in. I personally advise patients to leave the new teeth in 24 hours a day–to take them out only to clean them. Rinsing the mouth with warm salt water is soothing (¼ to ½ teaspoon salt to a glass of warm water).
After the first 30 days some dentists suggest leaving dentures out during sleep, in order to give the mouth tissues some rest. Except for people who grind their teeth in their sleep, I do not find nighttime use a problem, so I leave the decision up to the patient.
Naturally, when first inserted, new teeth are quite a mouthful. They feel bulky, awkward, too loose, and at the same time, too tight. Because artificial teeth are the best of all replacements of lost body parts and in most cases look so natural, patients do at times become overly fearful that any beginning difficulties are abnormal. They remember a friend or relative who has had dentures for many years, who swears he ate everything right away, and had no sore spots or adjustments. With time, most people do forget the problems that occurred. I can’t tell you how many patients, after years of using dentures, have told me how great a job I did, and how they never needed adjusting, until I showed them their old treatment record that listed four or more adjustments.
There are a number of other important considerations, such as how to avoid discouragement, the saliva increase problem, speaking irregularities, chewing with new teeth, gum shrinkage and keeping it to a minimum, the use of denture adhesives, home cleaning problems, etc.
These will be covered next week in part II, in order for you and your husband to be fully acquainted with the data that will help to ease his way and make this experience a pleasant one.