Should permanent dentures (all on four) be placed with the anterior teeth 2 to 3 mm from the gum line, or should they follow the gum line? Is this a standard procedure or the dentist’s choice? I have bulky lips from a denture that protrudes. I’m doing some research and figuring out what to do next and whether I can trust my dentist. – Thanks, Demetrius from NJ

Demetrius,

Before we answer your question, we want to define the gumline. As shown in the picture to the right, the gumline is the edge where the gum meets a tooth. Consider some examples:

• If a tooth is extracted, there is no longer a gumline.
• If a tooth is replaced with a dental implant, the gumline is the edge that meets the dental crown.
• If all your teeth are missing and you receive a complete denture, the gumline is the edge of the pink, gum-colored acrylic that meets the false tooth.

We defined the gumline because it is impossible to place a dental implant at that location.

You’re probably referring to where a dentist places teeth near the jawbone ridge beneath the denture.

Complete removable denture

When you receive a complete removable denture, your dentist should place the denture’s front lower teeth directly over the bony ridge. If the denture is too far forward, it will tilt back when you bite anything with your front teeth.

All-on-4 dental implants

An implant-retained denture, such as All-on-4, is secure and won’t tilt when you bite. The placement of denture teeth 2-3 millimeters from the ridge, as you described, is close enough within range for a removable denture or an implant denture.

Aesthetics and facial appearance are essential for natural-looking results. But measurements alone should not determine where a dentist places your denture. Advanced cosmetic dentists make a wax model of the denture for you to try in before the lab completes the acrylic version. The wax model lets your dentist evaluate how the implant denture affects your facial features, lip, speech, and the overall function of your mouth.

Adjusting your denture to soften the appearance of your lips

If you already have your implant denture, your dentist can remove it and reset the teeth. If the problem persists and your dentist can’t resolve it, you can schedule a consultation with an advanced cosmetic dentist for recommendations. Your dentist may charge a fee to reset the teeth, but if you’ve already expressed satisfaction, they might do it without cost.

 

Dr. Steven Brooker, a Baton Rouge Fellow of implant dentistry, sponsors this post. Dr. Brooksher is accredited by the International Congress of Oral Implantologists.