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Immediate Dentures
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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Immediate Dentures

I had a set of immediate dentures (full upper-lower) inserted on Wednesday. This set replaces one (full upper-partial lower)that I have had in. The previous dentures were a very good fit, a no problem until my remaining natural teeth moved and caused a partial loss of occlusion. (Compensated with a lot of Fixodent paste). After one of the teeth broke two three weeks ago, I decided to have them removed.  
   I had two appointments with the denturist prior to extraction. One for impressions, the other for biting blocks. After the surgery, the new set was put in - alas - the choppers were badly misaligned. Contact only at the back of the mouth and the lower denture sunk in with a gap of 3/8 in between the front teeth. The bite is approx 3/4 in higher compared to the old denture which was a comfortable fit with no sign of over-closing.
    I am shocked and dismayed at the total lack of fuctionality of the new set. Simply put, I cannot eat anything requiring mastication. I can only insert minimum amount of soft food into my mouth(tip of teaspoon). Anything else is a torture. I have not had two hours of uninterrupted sleep since the surgery.  
    My denturist tells me that this is ok and will be fixed next Monday. I called the day after the extraction asking him to do something to relieve the discomfort of the the high bite and to get at least some function back. He insisted on the schedule.  
    What is the normal procedure if a large misalignment  occurs ? Should I get someone else look at this?
Thanks for your help.  















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Avatar_dr_m_tn
This doesn't sound correct and you should be seen asap. If you do not get any satisfaction then I would suggest you see another dentist.
7 Comments
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Avatar_m_tn
i would have never sent you home with such a large malalignment. at the very least, i would have you back the next day to make you comfortable until you healed and a new set can be made. it is indeed a bit tricky to make immediate dentures align perfectly-- there is a bit of estimation involved--- but they are adjustable chairside if the bite/alignment is close. sounds like something went wrong in your case with the bite registration or the labwork....
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Avatar_n_tn
Thanks JB.

to mike1105: thanks.
You say it's a bit tricky to get the "intermediates" right. Since posting I located an old friend out of town(who is a D.D. but no longer practicing) and he told me over the phone several things: 1) he never heard of "intermediates" for the type of denture replacement I described. I had a functioning set of dentures which were there to be used for control prior to the surgery - they were not. 2) he said that the front 6 teeth in the old mandibular should have been filled in right away after the surgery and the dentures swapped if the new pair did not appear viable. 3) he said that the reasons for, and consequences of, changing the vertical dimension should have been explained to me before proceeding 4) he said there were great risks of choking associated with the lack of occlusion I described, and that I was not under any circumstances eat anything that needed grinding down (I had not been warned by the denturist) 5) he was skeptical of the chances to get the bite down to a comfortable level with the existing pair, given the the apparent difference in tooth size. 6) he urged me to see a "neutral" denturist - i.e. pay someone to evaluate the work done, ensuring objectivity by making clear that if the opinion is negative he/she will not be getting the job.

Would you agree with these assessments ?





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Avatar_m_tn
sadko, it's hard for anyone, including your no longer practicing friend, to evaluate your case without seeing you. your old dentures perhaps could have or perhaps could not have been used as "transitional" dentures until you healed from the extractions and new ones could be made. It could be that they were too worn to add teeth to, or it could be that your vertical dimension was collapsed because of the wear and tear on yopur old set. yes, you should have been told that your vertical dimension would be changed. I would definitely take this new set of dentures (along with your old ones) to another office for an opinion, preferably a prosthodontsist who specializes in dentures and bite reconstruction/realignment-- or else someone referred to you by a friend or family member.. I would not decide beforehand that you will not let him or her redo/remake or continue with your case. you may like him or her. either way, you probably have a correctable problem.
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Avatar_n_tn
I have new immediate dentures following total upper teeth extraction about two weeks.  I understand that I should expect to wear these for approximately six months. The piece covering my palate feels cumbersome, I'm constantly aware of it because of the bulk and I have trouble speaking without slurring my words.  I was told my dentures would be exactly like the ones I had before extraction, they are not.  I now have excessive denture gum over my front teeth that gives me a very unattractive "gummy" smile. I also have sores at the top of the gum line.  Needless to say I'm extremely self conscious about the "gummy" smile and my speech impediment that these dentures cause. My dentist made some adjustments two days after the extractions but did not remedy the problems. these dentures are a dissapointment to say the least.  Is this normal?  What do you suggest I do?
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Avatar_n_tn
I wrote the previous question.  I should have made my comments to "everyone". I would appreciate responses from anyone who's experienced what I have and/or feels they have pertinent advice.
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Avatar_m_tn
A related discussion, gummy dentures was started.
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Avatar_m_tn
A related discussion, Immediate dentures was started.
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