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.
Problems Associated with Immediate Dentures
- 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.
- 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.
- 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
- 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
- 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
- Cold, soft foods are more soothing and help decrease future swelling. Avoid alcohol and smoking
- 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
- 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
- Remember, the cleaner you keep your wounds and dentures, the quicker you will heal
- For the first 1-2 weeks, up to 1000 mg of vitamin C a day will promote and aid in your healing
- You WILL find that a denture adhesive will be necessary to help hold the denture in place
- 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!
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 re-basing 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.
- Update medical history
- Evaluate partial fit, bite, esthetics
- Examine soft tissues for denture irritation
- Oral cancer screening
- Tooth cleaning, evaluation
- Ultrasonic clean and disinfect denture
- 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.