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.
- If hurts being put in or taken out then internal adjsutment
- If hurts after period of use then check occlusal issues
- Adjust sore spots (check for CR premature contact if on ridge or eccentric if just off ridge)
- Refine occlusion
- Check for over-extensions
- Hurt to swallow=too much lateral throat form (check by PIP paste and have swallow water)
- Continue to have patient return until sore spots gone.
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
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
More issues and solutions can be found on the denture problem blog.
How to make PIP
Crisco and zinc oxide powder 50/50 with a little vanilla extract for taste. This is water based instead of commercial PIP which is oil based. The water based is easier to remove.
Hydent spray is faster