Expert: Mark Bornfeld DDS - 9/20/2007

Question
I had my 6 remaining teeth extracted 2 1/2 weeks ago and an upper denture put in place the same day.  My back, upper teeth have been missing for several years.  My question is, where should the teeth in my upper denture line up with my remaining bottom teeth?  With my mouth in a resting position, the top teeth protrude over my natural bottom teeth a great deal.  (Approximately 1/8th to 3/16th of an inch).  I never noticed this overbite with my natural teeth and wondered how long I should give my gums to heal and shrink before a replacement set are made?  My exising upper plate feels loose although I have had some adjustments and a soft liner put in already.  Is it possible that the teeth are set too far out in the plate?  Thanks for your help.

Answer
Dear Denise,

The answer to where the upper front denture teeth should be placed depends on several different factors. In the natural dentition, the incisal edges of the upper front teeth project slightly forward and extend slightly below the incisal edges of the lower front teeth. It is NOT normal for the upper and lower front teeth to meet edge to edge, although some patients do display this type of bite. The question then becomes-- how much should the upper front teeth come out and below the lower teeth? The answer depends on what will foster the best chewing stability, phonetics, and cosmetic appearance, and this varies from patient to patient. Some dentists (and their patients) prefer a more outward, prominent positioning of the upper front teeth because it gives greater support to the upper lip contour and often eliminates the "denture look" from the wearer's face. Of course, this practice must be exercised with restraint, because too much overbite is neither functionally nor cosmetically pleasing.

I recommend that you try to wear your denture as is, and allow your mouth and your eyes a chance to become accustomed to the function and the look of the teeth. With time, you will be able to judge the tooth position with greater perspective, and your dentist will be able to modify their position based on your level of function, comfort, and satisfaction with their appearance. If it is determined that the position of the teeth is contributing to lack of denture stability (this is a possibility), then your dentist will know that he will need to re-position the upper front teeth further back to improve their functionality.

I generally allow four to six months of healing time before making a new denture after extractions. If you start taking impressions before then, the contour of your gums may still be in a state of flux, and you may need to reline your denture again after it's made.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY