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