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What To Expect From Immediate Dentures

Immediate dentures are placed in the mouth directly after the remaining teeth are extracted. This approach is utilized when a person does not want to be without any teeth for several months while extraction tooth sockets heal and a denture is fabricated.

Immediate Dentures Involve a Two-Step Denture Process

Optimally, immediate dentures are the first denture of a two-denture process and should be considered as a temporary interim prosthesis until a second refined and esthetically enhanced denture may be constructed after healing.

First Stage

• Usually, most or all of the back teeth are removed and extraction sites are allowed to heal for a minimum of six weeks or more, depending upon an individual's healing rate.
• After adequate healing, the immediate dentures unit is fabricated.
• The remaining teeth are extracted and the immediate dentures are placed in the mouth. Wearing immediate dentures right away over extractions normally is no more uncomfortable than the extractions alone.
• Discomfort is managed with proper anesthesia and pain medication. Immediate dentures act like a Band Aid bandage, holding tissues together and protecting them during healing.
• Generally, the dentist does not remove immediate dentures until the day after surgery. Surgery is checked and denture adjustments are made as necessary.
• Immediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. Provisional liners are placed in the loosening denture to help hold it in place during healing.
• Adhesives also maintain the denture in place as it becomes looser. If immediate dentures become too loose during this healing period of several months, it may be necessary to reline multiple times.

Second Stage

• After adequate healing has occurred, a second refined denture is fabricated. This denture allows the dentist to artistically position teeth in an optimal and enhanced esthetic relationship, which was not possible with immediate dentures. It also is now possible to establish better functional relationships of the jaws.
• Approximately six months after the second denture is delivered, it will most likely need to be relined to compensate for continuing jaw shrinkage. After this reline, a patient usually needs annual relines to accommodate a continually shrinking jaw.
• The frequency of relines is an individual matter unique to each patient and is best determined by a licensed dentist after a thorough periodic examination that should occur at six-month intervals.

Modified Approaches to Immediate Dentures

• It is possible to extract all the back and front teeth at one time and insert immediate dentures. However, such an approach is problematic and generally is discouraged unless the patient has no other alternatives.
• All teeth may be extracted with no interim denture while the jaws heal and a denture is fabricated. This is generally a more economical approach, but an individual would be without teeth for several months.

Advantages of Immediate Dentures

• A person is not without teeth for any extended period of time.
• Immediate dentures act as a bandage while bony tooth sockets are healing after tooth extractions.

Disadvantages of Immediate Dentures

• A second refined and esthetically enhanced denture is necessary soon after the immediate dentures.
• While the cost of immediate dentures is generally about the same as a conventional denture, the second denture needs to be fabricated soon after the immediate denture. Therefore, a person would be experiencing the additional cost of the second denture sooner.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Why Have Regular Comprehensive Denture Check-Ups?

Regular and comprehensive examinations by a dentist are critical to ensure not only the proper function of a denture, but also the maintenance of total oral health.

Two significant things happen to a denture over time:

• It loosens -- Jaw ridges (alveolar ridges) will shrink in size and become smaller due to gradual and continuing bone loss (bone resorption) that occurs in everyone to varying degrees. This results in dentures becoming increasingly loose because they were fabricated originally to fit larger alveolar ridges.
• It wears -- Denture teeth will wear from use. In addition, uneven and irregular tooth wear develops as a denture becomes loose and starts shifting.

Denture loosening combined with uneven tooth wear results in a reciprocal and cyclical reinforcing synergism between the two destructive processes.

As a denture increasingly shifts on its soft tissue and jawbone foundation, it rubs and chafes the alveolar ridge. This causes irritation, soreness, and various types of pathology, including accelerated bone loss. In turn, this will cause more uneven tooth wear, which will cause more accelerated bone loss, and so on, back and forth. This is a gradual and unrelenting process that worsens over time, frequently at the expense of excessive jawbone loss, the thinning of overlying gum tissue, and the need to prematurely replace a denture -- unless detected and corrected in a timely manner.

If these problems are detected early, as during a regular check-up, they often may be remediated by adding plastic (acrylic resin) to the inside of a denture in order to allow it to fit closely against the alveolar ridge again (called relining or rebasing). In addition, irregularly worn teeth may be adjusted, or sometimes replaced or built up. Eventually, a denture will need to be replaced, but generally this will not need to be done too soon if a person visits their licensed dentist for periodic examinations.

Some Other Check-Up Considerations

• The need to adjust a denture, as determined by regular check-ups, helps keep a proper relationship between the jaws and thus maintains esthetics. Keeping jaws in a proper functional relationship, and sometimes building out certain denture surfaces, will support the face and help prevent a premature aging appearance.
• The temporomandibular joints or TMJs (the jaw joints located in front of each ear) undergo constant change in shape throughout life by a process called bone remodeling. This process is a functional response. If improper jaw function occurs, as a result of unadjusted dentures and improper bite, it is possible for the TMJs to remodel into a pathologic relationship. This could result in numerous pathological conditions, including impaired jaw function, headache, and other head and neck pains.
• Sometimes, more importantly than finding denture problems, is the opportunity to detect serious oral pathology, such as cancer, that may be discovered in early stages rather than later when radical and sometimes devastating therapy is necessary. The maintenance of healthy oral tissues is essential for optimum comfort in long-term denture wearers.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.