Denture fittings

TashaB86

Hi,

My mother recently had her teeth out and had two fittings(impressions) for full dentures.

On her most recent visit and the final visit before collection(next friday) the top denture just fell down every time my mother opened her mouth.

The dentist said that the mold is soft and the actual denture should be harder. The dentist also requested that my mother go to a pharmacy and bring in dental adhesive for putting in the denture at collection.

Does this seem normal. From research the dentures should fit snugly and adhesive should only be required if the dentures rock slightly in your mouth, not fall down. Also if adhesive was commonly required with dentures, wouldn't the dentist not have some to assist clients with their fittings.

Any advise welcome.

Thanks.

There are a few important reasons why the dentures did not fit securely in position at at appointment, hopefully I can explain this without getting too technical.

When you have teeth removed, the tissues swell in the immediate aftermath, and then the bone and gum shrink as they heal. This shrinkage slows as time goes on, but usually continues for 3-4 months after the extractions. Of course it would be better to wait until the tissues stabilise, but people usually will not wait for up to 4 months before having replacement teeth made, especially if they are front teeth. So, the dentist is making new dentures to fit tissues which are still changing shape. That can cause dentures to loosen, and the time the dentures are made, is the very time that most tissue changes occur, ie soon after the extractions. Sometimes the dentures have to be relined (a new fitting surface) after the bone/gum has fully healed, you should be aware that the dentist cannot control tiissue healing/shrinkage, so if it is necessary the cost will be borne by the patient.

At the try in stage, the dentures are made out of wax, it is soft and it distorts in the mouth, so it is not unusual for it to move around easily.. the finished denture will be a rigid acrylic and will be tighter/grip better against the tissues.

At final processing in the lab, either the dentist or the lab will place a thin raised area along the back border of the denture. This helps a seal to form and stops air/food getting under back of denture. This helps form the suction which holds the denture in.

Dentures can be over extended at try in stage, but when they are worn, these areas become noticeable and are then adjusted. An over extended area can cause the denture to move when lips/tongue move. A few adjustments are always needed.

The dentures are made to fit on the jaws, if there isn’t much bone there to support and retain them, doesn’t matter what the dentist does, the dentures won’t stay firmly in position. There is nothing to hold them.

This applies to full dentures where you have no upper teeth, if there is upper teeth and the dentures are being made to fit around them, dentures of this type are actually too tight when they are fitted and need adjustment to allow them to fit in.

From what you posted, the biggest issue you may have is the tissue changes which occur after extractions, if the patient wants a denture made quickly to replace them. You may need to use and adhesive in this case.

Strumms

It’s a bit of a head scratcher as to why your dentist would request that you bring your own adhesive. They should have tubes of the stuff, that just stinks of being a tight fûcker beyond belief...

Anyone who I’ve known that has worn dentures has used adhesive, I’d imagine eating would be seriously difficult without it. You don’t want dentures too tight or else they will damage and wear away the gum..

Strumms

Strumms wrote: »

It’s a bit of a head scratcher as to why your dentist would request that you bring your own adhesive. They should have tubes of the stuff, that just stinks of being a tight fûcker beyond belief...

Anyone who I’ve known that has worn dentures has used adhesive, I’d imagine eating would be seriously difficult without it. You don’t want dentures too tight or else they will damage and wear away the gum..

This is why non dentists should not give advice, you don’t use adhesive on a wax try in. It sticks to the wax and transfers to the master plaster model when the denture is transferred back onto it for processing. It also gives a false reading on the accuracy of fit as the adhesive stops the try in fitting up against the tissues when the dentist is checking it.

The adhesive may need to be worn after the final dentures are fitted to compensate for tissue shrinkage and/or lack of bone support.

From a cross infection point of view, I don’t keep tubes of it because it is rarely needed in the surgery and it goes off after a while.

Dentures that are too tight do not damage or wear away your gum, they hurt, you can’t wear them, so they are adjusted in the days after fit.

TashaB86

Thanks Strumms and Dav010

@Dav010, the first fitting and teeth extraction was 3/4 weeks ago, final fitting was Friday just gone and collection is a week later being next Friday. Understanding your very informative information, that the bone etc. will further shrink when things settle, but it wouldn't be a good sign to be using adhesive to hold denture in place?

As we wouldn't have much experience of this, we wouldn't know what to normally expect but gut instinct doesn't seem right and my mothers confidence would be low enough (and this dentist hasn't been nice but her father in the same practice is absolutely lovely).

Thanks

TashaB86

TashaB86 wrote: »

Thanks Strumms and Dav010

@Dav010, the first fitting and teeth extraction was 3/4 weeks ago, final fitting was Friday just gone and collection is a week later being next Friday. Understanding your very informative information, that the bone etc. will further shrink when things settle, but it wouldn't be a good sign to be using adhesive to hold denture in place?

As we wouldn't have much experience of this, we wouldn't know what to normally expect but gut instinct doesn't seem right and my mothers confidence would be low enough (and this dentist hasn't been nice but her father in the same practice is absolutely lovely).

Thanks

Unfortunately your mums tissues will have changed since the teeth were extracted and first impressions taken 3-4 weeks ago. How much they have changed is not definable as these changes occur under the gum. Anyone who has had a tooth extracted will confirm that the extraction site changes from having a big hole with sharp edges after extraction, too a smooth rounded surface a few months later. The dentist cannot control this, the only way to avoid the effect it has on the denture is to wait until March next year before having replacement teeth made, and that often is not practical.

There is no doubt that the tissues will shrink further, that is how the body heals. Think of a cast put on a broken arm the day it is broken, by the time it is taken off 8 weeks later you can get your fingers under it.

A lot of people who have dentures made after extractions need adhesive, it is less often necessary for dentures made to fit stable tissues which are not changing as much.

I understand your concern, but there is a reason why houses require solid foundations, in dental terms, your jaw bone is the foundation for dentures.

btkm8unsl0w5r4

Usually the denture at the fitting is just on a temporary wax base and has no real retention at all, the final base is made of hard plastic cut with a special bead line at the back that is much better, however sometimes the mouth is not shaped great for a denture and adhesive is needed.

Everything Davo10 says is also true.

Denture prosthetic needs a lot of patients by dentist and patient, it can be at time very rewarding and at time the most frustrating thing in the world. Hold tight and await the finish product, and even then have patience and instill a sense of patience in your mother, her adaptability has as much to do with, if not more, with successful wear of the denture than the denture itself.