Your treatment plan includes placement of a full or partial denture with extractions. This information is to explain the advantages and disadvantages of placing dentures when the mouth is changing due to tooth removal.

     There are two distinct advantages to having the denture placed the day of extractions. The obvious one is that you do not have to go without teeth, but the second is that the denture will act somewhat like a bandage over the gums, helping to control bleeding and swelling, and providing a "mold" for the gums to adapt to as they heal. In spite of these advantages, there are several disadvantages, which we will review.

    In the past, it was common to extract teeth, wait 6 to 8 weeks for initial healing, and then take impressions of the mouth to make partials or full dentures. Today, people rarely have the option of going without teeth for a few months while their mouth heals. Even though this method greatly improves the initial fit, and allows for a wax try-in in the mouth to check appearance, the bone that was supporting the teeth (called alveolar bone) will still change over a long period of time. Following the extraction, most of this remodeling occurs the first 3 to 6 months, but will change for up to a year. For some individuals, this change only slows but never actually stops, and these people must have relines or new dentures periodically for the rest of their lives. Unfortunately, there is no way to know who may be in this category.

    A few lucky people have very quick initial healing and bone remodeling, and have very little change in their mouths after that, maintaining good ridge form for many years. These are the people that dentists rarely see but that everybody has heard about. These individuals have the denture or partial placed the day the teeth are extracted and never have to have anything done to the denture after that. Unfortunately, dentists know that these people are the minority.

    The longer you wait before the hard acrylic reline is done or new dentures made, the better "final fit" you will have, but most people find that they need to have something done in the first 3 months, when the mouth is changing the most.

    Most often, the denture "settles in" the first 2 to 3 days, but then begins to feel very loose as the gums shrink. You will need to increase the amount of adhesive you use as the gums heal, perhaps eventually using a pad-type liner such as Sea-Bond, Cushion Grip, or Secure. The edge of the denture will feel as though it is "sticking out", but that is actually the original position of your gum.

    Immediate dentures usually require more visits for sore spot adjustment or to remove bone chips. Some of the worst sore spot areas are actually where the denture is applying the most pressure to help with bone remodeling. There is a nominal charge for these appointments to help offset sterilization costs. Some people find that an immediate denture becomes very loose very quickly. If this occurs, we can place temporary soft liners to help improve the fit of the denture while the mouth is changing (see Reduced Fee policy sheet for applicable fees). Full lower immediate dentures are especially difficult to master. If your treatment plan includes this, you may expect to need adhesive on the lower perhaps even after final relining is complete.

    Another limitation of the immediate denture is that our laboratory technician may not have the space he would like to position the teeth where he would prefer because the gums and overall ridge are very full at the time of extraction. We estimate where the ridge shape will be by removing teeth on the stone model of your mouth, and quite often there is very little space for the denture teeth. In addition, we are unable to try the dentures in the mouth before the are finished. Since immediate dentures have to be processed in acrylic to place in the mouth at the time of extraction, we are unable to change the appearance of the denture once it is made.

    Although there are limitations to an immediate denture, the final outcome is usually positive. The most important factor is your attitude toward mastering the denture or partial, and the realization that the process is gradual. Your mouth will be changing daily, but your denture does not. Please be patient during this healing stage. Your final "fit" will not occur until the majority of the changes in your mouth are complete and the dentures are relined or new ones made.