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 trying to figure out what to do next and whether I can trust my dentist. – Thanks, Brad from NM
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 teeth are placed near the ridge of the jawbone beneath the denture.
Complete removable denture
When you receive a complete removable denture, the denture’s front lower teeth should be placed 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.
But measurements alone should not determine where a dentist places your denture. Aesthetics and facial appearance are important for natural-looking results. Advanced cosmetic dentists make a wax model of the denture for you to try in before the lab makes the acrylic version. The wax model lets your dentist evaluate how the 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. Your dentist may charge a fee to reset the teeth, but if you’ve already expressed satisfaction, he or she might do it without cost. If the problem persists and your dentist can’t resolve it, you can schedule a consultation with an advanced cosmetic dentist for recommendations.
Joseph Rota, DDS, a Colorado Springs cosmetic dentist, sponsors this post.