Patients often find that the most cumbersome and unsatisfying part of a denture is the palate. A traditional maxillary (upper) denture covers the entire palate or “roof” of the mouth. The reason this is done is to create suction between the palate and the denture, which helps hold it in place.

However, this adds a lot of extra bulk to the maxillary denture. It also prevents patients from being able to taste some foods. By removing the palate, individuals are more comfortable and can enjoy eating again.

Palateless or horseshoe dentures are given that name because of their shape. Mandibular appliances are always U-shaped, but that’s not always the case with the maxillary denture.

Process of getting horseshoe dentures

Full lower dentures above the gums

Picture by Authority Dental under CC 2.0 license

The process of getting a horseshoe denture is the same as it is for a traditional appliance. It can vary somewhat depending on if you have teeth that need to be extracted and if you already have a current denture. During your initial consultation, your dental provider will map out your treatment.

Extract teeth

If there are remaining teeth in the arch, extracting them is the first step. Prior to their removal, your dental provider may take impressions so that an immediate denture can be placed after the extractions.

Wax try-in

If you are not getting an immediate denture, the first step following the initial impressions is to do a wax try-in. Your dentist will place a wax rim on the arch and make adjustments to the wax. This allows the dental lab to modify the rims before they process them for final fabrication.

Sometimes, there is a second wax try-in with the teeth in place. Your dentist will check the fit again, and make any adjustments to your bite before sending the wax-up back to the lab for processing.

Denture delivery

When you get your new denture, you may need adjustments for any spots that feel sharp or tight. After that, you may need to return several times to have further adjustments made. Wearing dentures does take some getting used to, so multiple adjustment appointments are common.

Pros and cons of a roofless dentures

There are several pros and cons to palateless dentures. You should consult with a dental provider or prosthodontist before making this decision, as your bone level has a lot to do with how well roofless dentures will work for you.

An upper denture without palatewill be more comfortable and feel like your natural teeth. They can also increase your ability to taste, which allows you to enjoy food. Patients who have a sensitive gag reflex may not do well with a traditional denture, but can often tolerate a roofless denture.

The biggest con of a maxillary horseshoe denture is the decreased level of security and stability. Unless you use implants to help retain the denture, you will likely need to use denture adhesive to get them to stay in place. Even with adhesive, they can be dislodged during eating.

  • More comfortable

  • Increased taste ability

  • Better for sensitive gag reflexes

  • Unstable

  • Easily dislodged

  • Must use adhesive

FAQ

What are alternatives to palateless dentures?

A traditional maxillary denture that covers the palate is one alternative to palateless dentures. Single or multiple dental implants are another option and can be used in conjunction with a palateless denture.

Do roofless dentures require the use of dental implants?

You can request a roofless denture without also having dental implants, but they are much less stable and will require denture adhesive.

Are horseshoe dentures more expensive than traditional ones?

Horseshoe dentures are the same price as traditional ones unless you are utilizing dental implants.

References

  1. Palateless dentures: Help for the gagging patient - The JPD
  2. Palateless complete denture for restoring good tastes: a case report - KoreaMed