Adjustments – As needed

This visit can be anywhere from 2-30 minutes.  Typically there is 1-3 sore spots that just need a little adjusting and then everything is fine.  Occasionally some people do not adapt well to denture teeth and need a few adjustment visits.  There are even some people that just never get totally used to a denture and no amount of adjusting can help.  This is particularly a problem for lower full dentures and is the reason many dentists have insisted that a patient either have a partial or implant retained denture on the lower jaw.

Adjustment visit

  1. If hurts being put in or taken out then internal adjsutment
  2. If hurts after period of use then check occlusal issues
  3. Adjust sore spots (check for CR premature contact if on ridge or eccentric if just off ridge)
  4. Refine occlusion
  5. Check for over-extensions
  6. Hurt to swallow=too much lateral throat form (check by PIP paste and have swallow water)
  7. Continue to have patient return until sore spots gone.

Max
Sore spots – PIP paste or Thompson stick
Difficulty swallowing, discomfort in soft palate, speech issues, gagging = Thompson stick on border while patient does the valsalva maneuver and remove anything past line
Loose during function or opening wide – overextended so PIP paste and pull frenums – hamular notch with Thompson stick and have open wide

Mand
Ant part lifts – PIP on genioglossus area tongue tip to roof of mouth then out and side to side
Entire thing lifts from post to ant – PIP in mylohyoid and retromylohyoid areas – same as above holding denture down – reduce laterally
Swallowing issues and gagging – vertical over extension of lingual flange

Too much teeth showing, TMJ pain, muscle pain, gagging, difficulty swallowing, hypersalivation, and general feeling “denture not right” – Excessive VDO – lab remount or replace

Too little showing, TMJ pain, gagging, instable when occluding, diffculty swallowing – Insuffiucent vertical – add to vertical or remove teeth and reset

Loose – first check if underextended – green stick – common in distal flange area

Soft reline for 24 hours with Hydrocast Lynal COE comfort

Lisp “S” – thin out the rugae area of denture
Whsitle “S” – too thin in rugae area, add until better rugae or cingulum anteriors
“F” “V” indistinct – teeth too lingual
“T” “Th” indistinct – teeth too facial

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