Denture Complications

Question 1

cause & resolution of excessive tooth visible

Answer 1

c -increased OVD / upper anterior teeth set out too far
r - reset all teeth reducing OVD / teeth need to be reset back over the ridge

Question 2

cause & resolution of teeth looking false

Answer 2

c - no gingival contouring / teeth may all appear to have the same shape
r - rotate or stagger teeth to give more natural appearance / ask lab for more anatomical finish

Question 3

cause & resolution of upper lip being too bulky

Answer 3

c - labial flange too bulky / teeth set too far anteriorly
r - reduce bulk / reset upper anteriors

Question 4

cause & resolution of upper lip sinking in appearance

Answer 4

c - upper anterior teeth set too far palatally
r - reset teeth anteriorly / add more wax to upper labial aspect & reset teeth

Question 5

cause & resolution of over closed appearance

Answer 5

c - reduced OVD
r - remake denture / copy denture with increased OVD

Question 6

cause & resolution of whistle on ‘s’ sounds

Answer 6

c - palate could be too narrow & encroaching on tongue space / space between centrals
r - if in try in stage remove wax from palate / if at finish stage return to lab for removal of acrylic from palatal area between molars and polish

Question 7

cause & resolution of lisping on ‘s’ sounds

Answer 7

c - too much tongue space
r - at try in stage add more wax / at finish add more acrylic

Question 8

cause & resolution of muffled ‘f’ and ‘v’ sounds

Answer 8

c - incorrect positioning of upper anteriors vertically & horizontally
r - will have to go back to try in stage to reposition the teeth

Question 9

cause & resolution of instability not chewing

Answer 9

c - over or under extension of the flange / long or short post dam / xerostomia / flabby ridge
r - under extended flange will need reline / over extended flange will need adjustment on acrylic / for short post dam take new 2ndary imp to include post dam area / for long post dam ask technician to adjust / pt to use dry mouth gel / take a 2 stage 2ndary imp so ridge isn’t displaced during imp taking

Question 10

cause & resolution of instability when chewing

Answer 10

c - lack of posterior post dam seal / anterior teeth labially / flabby ridge / biting on only anterior teeth / incorrect occlusion
r - take new 2ndary imps / reset the teeth / take 2 stage 2ndary imp so ridge not displaced during imp taking / ask pt to spread bolus of food when chewing / repeat jaw reg stage

Question 11

cause & resolution of soreness on the ridge

Answer 11

c - if single area could be premature contact, inaccurate denture base, roughness on fit surface / general area of soreness could be inaccurate denture base, not achieved a balanced articulation
r - take new bite reg & mount on articulator to adjust the occlusion / take wash imp to rebase the denture or may need to go back to 2ndary imp stage / use PIP to see area of pressure & adjust

Question 12

cause & resolution of soreness under lingual flange

Answer 12

c - when RVD & OVD don’t coincide / overextended lingual flange / molars placed too far distally
r - recheck RVD / OVD, articulate casts & remove interferences / shorten overextended flange / remove last molars

Question 13

cause & resolution of loose denture

Answer 13

c - over or under extended flange / xerostomia / occlusal errors
r - adjust overextended flange / reline denture / gels for dry mouth / articulate denture & remove any interferences

Question 14

cause & resolution of tight denture

Answer 14

c - denture not relieved in undercut areas causing pain on insertion & removal / clasps or collettes too tight
r - check path of insertion & adjust denture with acrylic trimmer after using PIP / adjust collettes with acrylic bur & adjust clasps with finger pressure / adam’s

Question 15

cause & resolution of burning feeling under denture

Answer 15

c - denture not relieved in undercut areas causing pain on insertion & removal / clasps or collettes too tight / high pressure area
r - use PIP to identify & adjust

Question 16

cause & resolution of biting cheek or tongue

Answer 16

c - overclosed / posterior teeth set too lingual or buccal
r - for both denture needs to go back to try in stage to rearticulate & reset the teeth

Question 17

cause & resolution of denture making pt gag

Answer 17

c - loose denture / pt has strong gag reflex & post dam has been extended too far back into soft palate
r - construct new denture with better retention / CBT for gag reflex or trim post dam

Question 18

cause & resolution of redness over denture bearing areas or cheek

Answer 18

c - overclosed / posterior teeth set too lingual or buccal / allergic reaction (very rare)
r - need to go back to try in stage to rearticulate and reset teeth / patch test