A Complete Guide to Denture Tooth Options

With the growth of denture tooth options available in the market, and the growing reliance on the dental technician to use clinically provided information to select teeth, it’s valuable to understand what a particular tooth brand offers, and how it fits into your laboratory business model.

In my laboratory, I offer a selection of tooth molds to provide the best option on a case-to-case basis. Knowing what to look for from each tooth manufacturer helps to narrow down the best fit. Historically, labs have taken a reactive stance when it came to denture teeth they use, being directed by prescription on the brand and mold to provide.

As clinical dentistry becomes more dependent on technical recommendations, and technicians accept the role, laboratories find themselves in a proactive position enabling them to select the manufacturer, and mold best suited for cases. To narrow my brand selection and understand each manufacturer’s strength I made a list of things that I believe are important when deciding on a brand(s) to use.

• Does the shade match the industry standard shade being requested? Although denture tooth shade guides are available, many denture case shades are selected from the same guides used to prescribe fixed prosthetics.

• Are there a variety of tooth form shapes and sizes from which to choose? Some manufacturers tend to have strength with soft, feminine molds, others with bolder, masculine molds. Some offer molds which don’t have a molded CEJ on the tooth. This provides a great deal of flexibility in controlling the length of the tooth showing and tooth emergence profile, a critical esthetic when designing smiles.

• Material composition. Some materials look great until adjusted. Once modified, translucency tends to be over exaggerated creating a shade value change. Other materials don’t lend themselves well to bonding to acrylic when heavily adjusted to fit into tight cases.

• Wear: there are many studies and lots of data on the subject. One conclusion I have reached is that without polishing to pristine condition after adjustment, unpolished, adjusted surfaces all wear at about the same rate.

• Does the brand provide a variety of occlusal schemes? Are there a variety of cusp inclinations? Many laboratories are getting away from a classic default occlusal scheme and looking to designs more case specific. Combination cases look more esthetic when there are similarly cusped denture teeth adjacent to natural ones. Options such as lingualized, monoplane, or NFP provide choices which are patient specific.  

• Working and non-working mold guides. For a laboratory to commit to a tooth brand, familiarity and confidence in their selection of molds is imperative. The last thing a lab wants to do is reset a case and return teeth because their selection off a paper chart didn’t hit the mark. Working mold guides are the actual teeth, allowing the technician to set, evaluate, and use the teeth in the guide. They tend to be expensive since they are useable denture teeth. They are replaced in the guide as they are used. Non-working guides aren’t provided by every brand, but they are identical to the actual teeth except they are composed of non-useable material. They are used to select a mold to purchase but cannot be used on the final case. This is an inexpensive option for those who aren’t ready to commit to the cost of a working guide. When I first entered the dental technology profession, I made a silicone mold of every tooth I purchased until I had a non-working guide. Once familiar with the molds, I could then rationalize purchasing a working guide.

If you are a lab that works with clinicians who still select molds, today’s market offers a variety of replicated mold shapes and strengths at considerable savings to your accounts. Many refer to them by the misnomer of cheap, but the days of inexpensive and cheap being used in the same sentence are on the decline. Remember, inexpensive is a cost definition, and cheap is a quality definition.