Monkey mouth with dentures refers to when someone’s lips stick out abnormally far, resembling a monkey’s protruding mouth. This condition typically occurs when dentures are poorly fitted or do not have enough support from the gums and bone structure of the jaws. The lack of support allows the lips to stick out further than normal when wearing dentures.
What causes monkey mouth with dentures?
There are a few main causes of monkey mouth with dentures:
- Poorly fitted dentures – If the dentures are loose, do not have enough retention, or were not properly molded to the individual’s mouth, the lips can protrude excessively when wearing them.
- Resorbed jaw bone – Over time, the bone that supports the teeth naturally deteriorates after tooth extraction. This can cause a lack of foundational support for dentures, allowing the lips to protrude.
- Thin or receding gums – Thin gingival tissue provides less cushioning and support for dentures. Receding gums also contribute to less denture support.
- Missing teeth – If all teeth are extracted and multiple dentures are placed, this puts more pressure on the lips to keep the dentures in place, which can make the lips stick out more.
- Smaller jaw size – Patients with naturally smaller jaws can be more prone to monkey mouth since there is less bone to support the dentures.
Essentially, when the dentures are not adequately supported by solid gums and bone, the lips have to compensate by protruding forward to help keep the dentures in place. This gives the appearance of a monkey’s exaggerated mouth.
Risk factors
Certain factors can increase risk of developing monkey mouth when wearing dentures:
- Being elderly – Bone density decreases with age, increasing risk of resorbed jaw bone.
- Being female – Women have smaller jaw sizes on average.
- Having thin gums or gum disease – Thin or diseased gums provide less denture support.
- Osteoporosis or other bone density conditions – Decreases bony foundations for dentures.
- Being edentulous (having no natural teeth) – Puts more pressure on bone and gums.
- Wearing dentures for many years – The mouth naturally changes over time.
- Poor dental care – Lack of proper dental hygiene prior to extractions can decrease gum and bone health.
Symptoms
The main symptom of monkey mouth is protruding lips or an exaggerated pout while wearing dentures. Other signs and symptoms include:
- Lips that stick out beyond the nose or dental midline
- Inability to easily close the lips while wearing dentures
- Dentures that easily pop out of place or move around
- Difficulty pronouncing words due to loose dentures
- Mouth or facial muscles straining to keep dentures in place
- Dentures lacking retention or appearing to float around the mouth
Patients may also note discomfort, sores, or irritation from dentures rubbing on the protruding inner lips. The appearance of the protruding lips may cause social distress.
Diagnosis
Dentists diagnose monkey mouth with dentures through a physical examination of the mouth, by observing the fit of the dentures, and analyzing dental x-rays. They will check for:
- Amount of lip protrusion with dentures in and out
- Areas of skin irritation
- Loose or poorly-fitting dentures
- Gum recession or thin gingival tissue
- Status of underlying jaw bone
- Amount of bone loss through dental x-rays
Measuring the degree of monkey mouth can help determine the severity. Mild cases may have lips protruding just past the vermillion border when wearing dentures. More severe cases may have the lower lip protruding beyond the nose.
Treatment
There are several possible treatment approaches for managing monkey mouth with dentures:
Denture Adjustments
Minor adjustments like reshaping, smoothing, or relining dentures can help improve fit and retention in milder cases of monkey mouth. This provides a quick, non-invasive approach when issues are minimal.
Denture Adhesives
Special denture creams, pastes, or adhesive strips can help dentures stay firmly in place and reduce strain on the lips and mouth muscles. These provide a temporary solution in moderate cases before pursuing more advanced options.
Soft Reline
Adding a soft reline material inside existing dentures can improve comfort and retention. This also reduces pressure on gums. It offers a non-invasive, low-cost solution for temporary relief in more moderate cases if patients still have adequate bone support.
Hard Reline
Hard relining entails adding a thin layer of acrylic resin material to the tissue- contacting surfaces of the dentures. This can increase stability and support. It offers a longer-term, semi-permanent solution by essentially creating new dentures over top of old ones.
New Dentures
Constructing completely new dentures is the treatment of choice for severe monkey mouth cases with extremely poor bone and gum support. This allows dentures to be completely re-contoured and fitted to the current mouth structure.
Surgical Options
Oral surgery like gum grafts, bone grafts, or implant placement helps restore lost gum tissue and bone. This reconstructs a stronger foundation for dentures to rest on and prevents monkey mouth. These surgical treatments provide permanent solutions but involve more costs and healing time.
Prevention
Preventing monkey mouth involves proper denture care and maintenance of gum and jaw bone health:
- Have dentures adjusted by a dentist every 1-2 years or sooner if they become loose or uncomfortable.
- Practice excellent oral hygiene to maintain healthy gums before extractions.
- Get regular dental checkups to monitor bone levels and overall mouth structure.
- Eat a nutrition-rich diet with calcium and vitamin D for bone health.
- Use denture adhesives to reduce pressure on gums.
- Avoid smoking, which increases gum disease risk.
- Consider dental implants, which reduce bone loss compared to dentures.
Stopping denture-related monkey mouth early is also recommended before it progresses and requires more invasive solutions.
Outlook
With treatment, most cases of monkey mouth with dentures can be corrected for improved fit, comfort, and aesthetics. Mild cases can often be resolved with quick denture adjustments. More severe cases may require using denture adhesives or pursuing new dentures, reline procedures, or surgery for complete correction. Without treatment, monkey mouth could worsen over time as bone and gums continue deteriorating. But patients can improve their outlook with regular dental care and denture maintenance.
Conclusion
In summary, monkey mouth with dentures is characterized by overly protruding lips caused by insufficient denture support. It is often seen in elderly edentulous patients or those with gum disease and bone loss. Causes include poorly fitted dentures, resorbed jaws, thin gums, small jaws, and years of denture use. Symptoms involve lips sticking out beyond the normal limit along with loose, uncomfortable dentures. Treatments range from denture adjustments for mild cases to new dentures, relines, or surgical procedures for severe monkey mouth. With proper ongoing care and attention, denture-related monkey mouth can be corrected for a normal appearance and properly functioning dentures.