Denture problems

Denture problems and their solutions

Denture problems plague most if not all dentists from time to time. This is a list of common issues and fixes.

Maxilla denture problems

Sore spots – Mark obvious sore spots with Thimpson stick and allow to transfer.  Add PIP paste to check as well.

Difficulty swallowing and gagging, discomfort in soft palate, and speech issues – Over-extension onto soft palate.  Check border hard and soft palate with Thompson stick and valsalva maneuverur then place denture and do same.

Loose during talking and yawning – PIP paste and have yawn and do denture movements.  Watch as may not always remove PIP.  Hamular notch needs to be checked with Thompson stick

Mandible denture problems

Denture lift

  • check genioglossus extension with PIP paste and tongue to roof mouth and out and side to side
  • anterior overextension – ask to lift lower lip to edge of teeth

Denture lift from posterior towards anterior – mylohyoid and retromylohyoid

  • PIP distal flange and tongue out and side to side
  • Adjust the horizontal, maybe vertical (Vertical causes swallowing and gagging issues – slow adjust until patient comfortable)

 

Denture vertical dimension occlusion

Excessive VDO – Show too much teeth, TMJ pain, muscle pain, hard to swallow or gag, dentures click, hypersalivation, and general feeling of too full.  Need to remake or rebase with a CR bite so don’t repeat issues.

Insufficient VDO – Show too little tooth, TMJ pain, gagging, instabilioty when not biting, and difficult to swallow.  Need to remake or rebase.

 

Loose denture

Add green stick to areas might be under-extended and see if helps – if does add to denture.  Common in distal lingual flange lower denture

Evaluation of this with hydrocast or lynal and wear the denture for 24 hours

 

Sounds with dentures

Problems with “S” sound

  • Lisping – too narrow air space on anterior palate – seen if patient has thick rugae or large anterior ridge – thin out acrylic
  • Whistle “s” – too thin acrylic in rugae or teeth too far forward

Problem with “Th” or “T”

  • Indistinct – teeth too far forward

Problems with “V” or “F”

  • Indistinct – teeth too far lingual

Denture occlusal problems

Trouble after use but not on insertion or removal – check occlusion

  • Soreness anterior hard palate and ridge
  • Unilateral pain on ridge premolar to tuberosity
  • Delayed gagging
  • Muscle fatigue
  • Hyerpsalivation
  • Discomfort chewing

Fix by doing CR bite with gothic arch tracer and Futar-D centric bite registration

Biting cheek

Increase buccal overlap.   Also ensure distal of last upper molar is distal to distal of last lower molar, this will prevent tissue wrapping around and getting bit.

 

Some great denture lab techs.

Brian Carson, Signature Dental Studio and Tim Lane at Cynosure.

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