Utilizing Technology To Help The Denture Community

March 9, 2025

Submitted by Dr. Joy Poskozim DDS FSCD CDP

Founder of Joyful Dental Care – House Calls, Advocate, & Presenter

Geriatric House Call Dentist for over 15 years, Dr. Joy Poskozim speaks to Long-term Care Facility Administrators, Nursing Staff, Caregivers, and loved ones on the importance of oral health care as we age. Her goal is to share as much dental information as possible, thereby making it easier to communicate to traveling dentists on what oral health problems residents may have.

Having provided oral care for the geriatric community for over fifteen years, Joy understands medical conditions – and the subsequent issues revolving around them – supersede oral care.

For over fifteen years I have been learning how I can serve my denture patients the best ways possible.

Learn best practices when dealing with dentures

With the technology we have today, I have found some denture workflows that have allowed me to have predictable results while continuing to make my patients comfortable and happy whether they can come to my practice or not.

That’s a beautiful smile, isn’t it? What if I told you she is wearing a complete upper denture?

What if I also told you she is beginning to suffer from Alzheimer’s and is now living in a memory care facility?

Over 60% of our global Alzheimer’s population are women. Yes, partially due to women in general living longer than men, but also because WE DON’T KNOW WHY.

According to the latest Centers for Disease Control and Prevention (CDC 2024) data, the United States contains 15,600 nursing homes with over 1.7 million total licensed beds.

The umbrella term of “nursing home” encompasses independent living, assisted living, memory care, skilled nursing and hospice. My at-home patients are about 70% in one of these communities, with the other 30% choosing to stay in place in their homes, with caregivers and/or family members providing care.

Adults 65 and older have lost all of their teeth

As of 2020, 13.3% of U.S. adults 65 and older have lost all of their teeth because of tooth decay or gum disease, per data from the CDC.

The challenges of growing older consist of polypharmacy, limited mobility, dementias, and limited dexterity due to arthritis, diabetic neuropathy, falls, strokes, and other medical conditions.

With limited dexterity also comes the inability to take dentures out at night and/or put dentures in. Some of my patients will leave their dentures out as they now feel too cumbersome after losing weight, losing a tooth, or teeth have worn so much over the years that they can no longer chew with them.

Most of my patients will leave their partial or complete dentures in as they can’t move them anymore and their caregivers and loved ones don’t know how to move them either.

Leaving dentures in can all sorts of problems, from bad breath to candida/thrush.

Dentures are not made to be worn at night

Furthermore, dentures are not made to be worn at night. They are created when our heads are erect, not lying down. As such, dentures can also fracture – which happens most often to men.

That being said, more and more sleep physicians want their denture-wearing patients to keep their dentures in for the sleep study and with the CPAP in order to keep a more patent airway. It’s now a question I have to ask my denture-wearing office patients.

Denture loss is a common complaint

The most common complaint I get once one of my patients has moved into one of these homes is denture loss. Most dentures get lost between the first three – nine months, and it truly doesn’t matter what type of home they move into. It all depends on who is providing their care. Most make minimum wage and are only trained on the job so if they personally have not had any dental (or denture) issues, let alone have worked with a resident with dental/denture issues, then the concept of putting dentures in the morning and taking them out at night is not part of their construct. Once again, we don’t know what we don’t know.

No one is trained on the job to know the difference between a bridge or a partial denture, let alone that dentures can be made of different materials or the difference between an upper and lower denture. Dental terminology is simply not part of any home’s training, because the trainers themselves have no dental knowledge or background for the most part.

Occasionally I meet someone who was a former dental assistant, but most are uncertified carers or caregivers (in IL).

When I learn one of my denture-wearing patients will be moving into a long-term care community, I immediately ask if I can copy or clone their current denture. I will take a digital impression, or scan the denture into my computer, where the image sits for free until the denture gets lost.

Before taking dentures from patients

Before taking dentures from patients, I make sure that the community staff know I am taking the denture, even if it is only for an hour or so; make sure the medical and financial POAs are aware, make sure that the denture fits as is, and also examine remaining teeth that are retaining or holding the partial denture in place. If these teeth are not in good shape, then making a new denture, if necessary, when and if these teeth need to be extracted is a better choice for them.

As a geriatric house-call dentist, I have put myself in a bad situation when the assumption is the medical and financial POA are one in the same. The medical POA may approve the idea, but the financial POA may rather take their chances than pay for a cloned denture. That being said, I do try to explain making a new denture is over twice the price because it takes over twice as long in time and dental appointments to make a new one. A lot of times too my patient can physically go through the steps of making a denture. All of the steps are palliative. But this same patient will graciously hand me back the shiny new denture saying it isn’t theirs and I should really give it back to its rightful owner.

Are partial dentures worth copying?

Are these partial dentures worth copying? The left one has worn acrylic on its left and the one on the right has very worn teeth.

The answer is a resounding YES! These dentures are old and well-used, but they are clean and well-kept. I copy these dentures as-is and my patient will be none the wiser that it is newly made.

When I ask one of my office patients if they wouldn’t be happier with a brand-new denture instead of their old one, I get, “Doctor, I’m so used to it the way it is, it just works. It’s been a part of me for over thirty years!”

Fortunately, the digital impression image can last forever, and my lab takes a mere 5 business days to reproduce and send me the denture once it gets lost.

Another reason to contemplate scanning dentures

This is the second reason why dentures should be scanned.

Dentures get dropped all of the time. We are human, we drop things.

Unfortunately, denture acrylic ages too, and at some point, some trauma will cause the denture to break, most often right down the middle.

These fractures can be fixed for the most part, but if I cannot get them to open their mouths to take an impression for it to be fixed and stabilized, it will be hand-repaired and can fracture again much more easily. Patients will then worry about it breaking again and choose not to wear it.

Is it life-threatening for someone to go through the rest of their life without wearing/eating with a denture? No, but there can be “failure to thrive” or weight loss once this person realizes they can no longer eat the things they want, or should.

Most have to be on a pureed diet, which is a nicer way of saying mush.

Bottom line: if you know of someone who wears a denture and has been diagnosed with one of the dementias, I encourage you to find a dentist who can scan its image and saved. You will look like the hero when it breaks or gets lost.

Questions/comments? Never hesitate to contact me!