Immediate
dentures (sometimes
called temporary dentures) are actually made BEFORE the front natural
teeth are extracted. When we remove your front teeth you walk out with
false teeth. Generally, most patients do not complain of much pain after
their teeth are extracted and the immediate denture is inserted. The
denture acts like a band aid and reduces pain. For the first week or
so, the denture remains stable and reasonably retained. It will need to be relined in the
future.
Making your Immediate Denture
Appointment
1- Full exam of
mouth done including teeth, gums, jaws, soft tissues, bite, etc.. If any teeth
are found to have decay or periodontal needs these problems are addressed at
this appointment as well. It is important to address the foundation teeth prior
to making the denture, just as you would want a strong foundation for your
house. A prior approval is sent to your insurance company, usually taking
3-5 weeks to come back.
Appointment 2- We remove any back teeth that need to be extracted, since those
take longer to heal. All teeth that
will be saved should be restored to provide the most accurate fit. Extraction sites in the back of the mouth
must be allowed to heal prior to denture impressions.
Appointment 3- An accurate impression is made of the
teeth and supporting gum tissues.
Appointment 4- Bite records are taken. Sometimes we
will have the teeth set in wax at this point to make sure the bite is correct
and the tooth color selected is right for you.
Appointment 5- The teeth are extracted, and a prefabricated
denture is inserted directly over the previous tooth sites. Your denture
is tried in and adjusted to fit. You may return in 24 - 48 hours to adjust any
sore areas that develop or as needed until the partial is comfortable.
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After Denture Placement Before Extraction
Problems Associated with Immediate Dentures.
1.
If the patient has more than one or two remaining front top teeth, it is
usually impossible to do a “try in”, because the other teeth are
present. The denture teeth are placed in about the same position as the
natural teeth before extraction. Even though the denture teeth will be
straight, and clean, their position may not be ideal because there is no way to
preview them as we do with a standard denture. For this reason, not everyone
will be happy with the final appearance of their immediate denture, and may
wish to invest in a new one at the end of about a year when most of the healing
has taken place.
2.
After the natural teeth are extracted and the immediate denture is inserted,
there is a relatively fast loss of the bone that used to hold the natural teeth
in place. By the end of three weeks, enough bone has been lost that there
is a LOT of space between parts of the denture and the healing gums. This
leads to rapidly increasing looseness and sore spots which must be removed
frequently. If needed, we can do a temporary "soft" reline at
about one month after the extraction/insertion date. This is a simple way
to tighten the denture against the gums, and since the material is a bit
rubbery, and frequently medicated, it makes the denture much more comfortable
until enough healing has taken place to do a permanent "hard" reline.
3.
At the end of 6 months, the immediate denture must be relined with the same
acrylic that the denture base was made from originally. Again, we will
send your insurance company a pre-approval.
The longer you wait, the longer you can expect the denture to remain
tight before another reline is needed. The hard reline is a separate
procedure and the cost is NOT included in the original price of the immediate
denture. Thus the immediate denture ends up costing a bit more than the
standard denture when the cost of the reline is taken into account. The hard
reline marks the official transition of the immediate denture into a standard
denture.
Post Extraction and Delivery Instructions
1.
Do
not remove your denture for 48 hours.
Your gums will swell under the denture, and you will not be able to get
them back in once removed. The dentures
act as a Band-Aid for your healing sockets.
2.
While
you are still numb, take 600 mg of Ibuprofen, Tylenol, or prescribed pain
medication to help reduce swelling and increase comfort after your extractions.
3.
Cold,
soft foods are more soothing and help decrease future swelling. Avoid alcohol and smoking.
4.
Some swelling is to be expected after extractions. To help
reduce swelling and stop the bleeding, hold an ICE PACK next to where teeth
have been extracted. 15 minutes on, and 15 minutes off.
5.
Several times a day (after 48 hours), until healed, place a teaspoon
of salt into one cup of warm (not hot) water, remove denture and rinse mouth
gently for five minutes.
6.
Remember, the cleaner you keep your wounds and dentures, the quicker
you will heal.
7.
For the first 1-2 weeks, up to 1000 mg of vitamin C a day will promote
and aid in your healing.
8.
You WILL find that a denture adhesive will be necessary to help
hold the denture in place.
9.
If you develop any sore spots, call the office so that we may take
care of them.
Caring
For Your Immediate Denture:
·
Take your denture
out when you sleep and place it in water with a splash of Listerine. This lets
your gums and teeth rest from the pressure of the denture. Placing it in water
keeps it from drying out and changing shape.
Clean BEFORE storing.
·
Do not soak
in hot water as they may distort. Also
remember they are made of brittle acrylic, so be careful not to drop or bend
them.
·
Remove your
denture to clean it using a denture brush and toothpaste or dish detergent after each meal, or at least before bed. This
removes loose food debris, plaque and some stains. Do this over a sink filled with water or a towel to prevent
breakage in case you drop the denture.
·
Brush and
floss any remaining teeth with the partial out of your mouth to help
prevent future cavities. A fluoride
varnish may be recommended if you have problems with dry mouth.
·
Occasionally
soak your partial in a commercial brand soak designed specifically for denture
to help disinfect them and remove stains.
·
Maintain
your recall visits so we can check your denture and supporting teeth for any
problems. Also call us for an appointment if you develop any problem with your
denture due to soreness or looseness.
It will take you some time to get used to
your new denture. Eating and speaking will seem awkward at first but with time
you will learn how to use your denture. Each person is different in how fast
they adapt, but eventually adaptation will occur. To get used to them, you must WEAR them! Give them 2 weeks and we know you’ll make
friends with them!
Follow
Up Care
The
Future: Your jaw
bones and gums shrink up to 1/32 of an inch per year when your teeth are
missing and much more immediately after extractions. This is one of the main
disadvantages of dentures. Because of this shrinkage, you should plan to have
your dentures and oral tissues evaluated by us every six months. We
will inform you when relining or rebasing of the dentures is necessary. Wearing
ill-fitting dentures for too long without refitting can cause severe bone loss
and very serious oral disease. Even dentures that “fit” comfortably need to be
checked along with your tissue.
Six Month Appointment:
o
Update
medical history
o
Evaluate partial
fit, bite, esthetics
o
Examine
soft tissues for denture irritation
o
Tooth
cleaning, evaluation
o
Ultrasonic
clean and disinfect denture
o
Reline of
denture once extraction sites have healed.
Yearly Follow-Up: Same as Six Month Appointment. We may decide to see you more
often depending on your case. Many patients like to come in more than once a
year for peace of mind and a nice clean denture.