Dentures in America, Then and Now: From Hippopotamus Ivory to Digital Dentures

Every complete denture patient arrives with a comparison in mind: a parent's denture, a set that never stayed put, a friend's implants. Now there is a new question: milled or printed? The answer depends on evidence still coming in.

This is part 4 of our Then and Now series. Part 1 tracked what dental care cost, part 2 who paid for it and part 3 how crowns were made. This one follows the complete denture from George Washington's hippopotamus ivory to the digital dentures of 2026.

Quick Answer

American dentures went from carved ivory holding human and animal teeth in Washington's day, to porcelain teeth (France around 1774, Philadelphia by the 1840s), to vulcanite bases that made dentures affordable from the 1860s, and to acrylic (PMMA) from the late 1930s. The base is still mostly acrylic, but it can now be processed conventionally, milled from a pre-cured block or 3D printed. Milled dentures have the strongest evidence; printed dentures still trail on retention.

What Were George Washington's Dentures Really Made Of?

Not wood. Mount Vernon calls that one of the most enduring Washington myths; stained dentures may have looked wooden. Over his life he wore dentures made of human teeth; cow, donkey or horse teeth; hippopotamus, walrus and possibly elephant ivory; lead, tin, copper and silver alloys; and gold.

By his inauguration in 1789, Washington had one tooth left. John Greenwood, a New York dentist, made him a set carved from hippopotamus ivory, with gold wire springs and brass screws holding human teeth, and a hole for the last natural tooth. All of Washington's dentures caused him pain. In 1797 he complained that a set caused "both upper, and under lip to bulge out, as if swelled," and the teeth gradually worked loose.

Some human teeth have an uncomfortable history. Washington's records for May 1784 show payments to enslaved people at Mount Vernon for nine teeth, on account of his French dentist, Jean-Pierre Le Mayeur. Mount Vernon notes it is not known whether they were forced or pressured to sell.

When Did Porcelain Teeth Replace Ivory?

Around 1774, a Parisian apothecary, Alexis Duchâteau, and a Parisian dentist, Nicolas Dubois de Chémant, made the first successful porcelain dentures, replacing Duchâteau's own stained and malodorous ivory set. Dubois de Chémant refined his "mineral paste," won a French patent in 1791 and, after the Revolution forced him to England, a 14-year British patent. By 1804 he claimed to have made more than 12,000 sets. In 1808, Giuseppangelo Fonzi in Paris introduced individual porcelain teeth with embedded platinum pins.

In the mid-1840s, Philadelphia dentist Samuel Stockton White began making porcelain teeth from feldspar, and his company became the world's largest manufacturer of dental instruments.

How Did Vulcanite Put Dentures Within Reach?

Until the mid-1800s, gold was the only satisfactory denture base. American dentist Thomas Evans claimed he was the first to use rubber for one, in 1848. In 1865, S.S. White published the vulcanizing process for dentistry, and soon many thousands of American dentists were making vulcanite dentures. The savings were huge: for the first time, the middle classes could afford dentures. Part 3 of this series covers the patent war over vulcanite.

Acrylic (PMMA) replaced vulcanite from the late 1930s, and war sped the change: Japan's conquest of the Dutch East Indies in 1942 cut off 90% of the world's rubber sources. PMMA is still the most used denture base material.

What Did the McGill Consensus Change?

Implants changed the standard for the lower jaw. In 2002, an expert panel at McGill University in Montreal concluded that a conventional denture was no longer the most appropriate first choice for the edentulous mandible, and that a two-implant overdenture should become the first choice. In 2009, the York consensus statement noted that uptake had been slow and went further: a two-implant mandibular overdenture should be the minimum offered as a first choice.

Cost is still the barrier: a 2021 NIH report says implants remain out of reach of most older adults. For fixed options, see our comparison of full-arch zirconia, PMMA and hybrid prostheses.

How Many Americans Have No Teeth Today?

In federal survey data for 2015 to 2018, 12.9% of adults aged 65 and over had lost all their natural teeth: 8.9% at ages 65 to 69, 10.6% at 70 to 74 and 17.8% at 75 and over.

Projections differ because they count different things. In 2002, Douglass and colleagues projected that adults needing one or two complete dentures would grow from 33.6 million in 1991 to 37.9 million in 2020, as population aging outweighed a 10% per decade decline in edentulism rates. In 2014, Slade and colleagues, counting only people with no teeth at all, projected a fall from 12.2 million in 2010 to 8.6 million in 2050. Either way, a sizable minority of patients will keep needing complete dentures.

What Are Digital Dentures, and Do They Work?

A digital denture is designed in CAD software, then milled or printed. The first published report on computer-aided complete dentures appeared in 1994. A 2013 systematic review found no clinical trials yet, but two US manufacturers making CAD/CAM complete dentures in two clinical appointments.

Milled dentures

A milled base is cut from a preformed acrylic block polymerized under high heat and pressure, which gives a dense, low-porosity material. A 2021 review of 73 studies found milled dentures had higher flexural strength than conventional and printed dentures, and CAD-CAM dentures overall showed better retention than conventional ones. A 2025 network meta-analysis of 63 in vitro studies ranked milling first or second across mechanical outcomes, with printed bases last.

3D-printed dentures

FDA has cleared resins for printing denture bases through 510(k) since at least 2015 (K143033), including one in June 2026 (K260569). The summary for a printable denture system cleared in 2023 (K231578) states that no human clinical data were included: clearance is not long-term clinical evidence.

For printed dentures, bench accuracy has not yet become retention. The 2021 review found them more accurate (true) than conventional dentures, but with weaker esthetics and color stability. Meta-analyses in 2024 (16 studies) and 2026 (12 studies) found conventional dentures more retentive than printed ones, with no other significant differences in the 2026 review. A 2025 meta-analysis of four studies found no significant difference between printed and milled dentures in retention or satisfaction.

Appointments, cost and satisfaction

A 2015 study compared a two-appointment digital process with the conventional five-appointment process in 15 patients, who preferred the digital dentures. But a 2026 meta-analysis of five studies (184 patients) found about 1.5 fewer sessions with digital workflows, not statistically significant, and no significant difference in lab or total costs; operator experience mattered. In a 2024 review, milled dentures needed fewer post-insertion adjustments than conventional ones; printed dentures did not differ.

A digital denture also leaves a design record, which the 2021 review called a great advantage for older adults with limited access to care.

Denture Timeline, 1774 to 2026

Then vs Now: What Changed for the Patient?

Dentures and Removables at Elegant Dental Laboratory

We are a full-service dental lab at 2308 McDonald Ave in Brooklyn, founded in 2007 by Gary Fingerman. More than 35 technicians make every case in our 7,000 sq. ft. facility, with no outsourcing.

• What we make: dentures and removables, and implant restorations, including full-arch.
• Getting cases to us: our own drivers pick up cases in the New York area (call to confirm availability), and we provide UPS shipping labels for practices anywhere. Send a case or call 877-335-5221.

More From the Then and Now Series

• Part 5: The American Dental Lab, Then and Now: From Back Rooms to Digital Workflows

FAQ

Were George Washington's dentures made of wood?

No. Mount Vernon lists human and animal teeth, hippopotamus, walrus and possibly elephant ivory, metal alloys and gold. Stained dentures may have looked wooden.

When were porcelain denture teeth invented?

The first successful porcelain dentures were made in France around 1774. Porcelain teeth were manufactured in Philadelphia from the mid-1840s.

Are milled or 3D-printed dentures better?

Milled bases test stronger and were at least as retentive as conventional dentures in reviews. Printed dentures were less retentive than conventional ones in two meta-analyses, but a 2025 meta-analysis comparing printed and milled dentures found no significant difference.

What is the McGill consensus statement?

A 2002 expert statement that a two-implant overdenture, not a conventional denture, should become the first choice for the edentulous mandible.

How many Americans have no natural teeth?

12.9% of adults aged 65 and over in 2015 to 2018, and 17.8% of those 75 and over. One projection puts the total at 8.6 million people in 2050, down from 12.2 million in 2010.

Then and Now series by Elegant Dental Laboratory, Brooklyn, New York. Reviewed by Gary Fingerman, founder and CEO. Last reviewed: September 28, 2026.