New denture makes patients to be persevered. This presentation will help young dentists to solve the problems which both patients and dentists encountered.

1. Denture Complaints
• Complaint.. C/F…. Reason…. Treatment
General Dental Practice
• Complaint……C/F…. Cause… Suggestion Reason…
Decision (Pat: autonomy)… Treatment Plan/ Cost
……Definite Treatment
Dr. Kyaw Tint
B.D.S., M.D.Sc., Ph.D
Associate Professor
Department of Prosthodontics
University of Dental Medicine, Yangon. MYANMAR

2. Denture Complaints
• Patient- Pain and Discomfort
Nausea
Inability to tolerate denture
Inability to keep denture clean
• Denture- Appearance
Lack of retention and stability
• During Function
Inability to eat
Food under the denture
Clicking of the teeth
Altered speech
Biting the cheek and tongue

3. Pain (pat:)
Result from Clinical
Appearance
Reason Treatment
a.Over extension Hyeraemia Incorrect outline/
Impression
PIP ( wipe off area)- easing
In old denture- cut, reline
b.Poor fit Poor retention,
rocking, tilting ,
inability to seat
Over grinding New/ rebase
c.Insufficient
relief
Red, ulcerated
area
Under relief PIP paste - easing
d.Occlusal fault
Wrong Ant:Post
relationship
Drag the
dentures
Not fully retruded Check record,
remounting/grinding

4. Pain (pat:)
Result from Clinical Appearance Reason Treatment
Uneven pressure Heavy pressure on
crest of alveolar
ridge
Faulty setting/
tilting of record
block
Mylar strip-
Immovable in heavy
pressure area,
easily withdrawn in
opposite
Excessive Vertical
Dimension
C/F of increased
OVD
Error at registration
stage
Easing over the
white patches/
grinding the teeth/
resetting/ renew
Insufficient vertical
Dimension
C/F of decreased
OVD (TMJ pain)
Alveolar resorption Restore height/
stabilizing occlusion
Cuspal interference Dragging of During
lat & protrusive
movement
Lateral surfaces of
the ridges
Correct occlusion
Balance occlusion

5. Pain
Result from Clinical Appearance Reason Treatment
e. Teeth off the ridge
Pain confined to
To overcome arch
( upper teeth too far
upper buccal sulci&
discrepancies
buccally)
maxillary tuberosity
Remove all four last
molars/ reduce the
bulk of acrylic base/
new denture
f. Retained root or
un-erupted tooth
Localized & confined
by radiograph
Direct pressure/
preventing draining
an undetected sinus
ELA & reline/ relief by
easing
g. Narrow resorbed
ridge (sharp ridge)
esp: in lower, pain
after meal
Pressing mucosa bet:
bone and denture
Relief the denture/
alveolectomy &
reline lower denture
h. Mental foramen Gross resorption of
alveolar ridge, Pain
Localized to nerve
area
Foramen lie on the
crest of alveolar
ridge/ Pressure from
denture
Relief the denture

6. Pain
Result from Clinical Appearance Reason Treatment
i.Irregular resorption Rough & sharp
spicules of bone/
and thing mucosa
Pressure on it Relief / surgical
smoothing + reline
j. Rough contact or
fitting surface
Hyperaemia Cast with porosity/
pimple, blebs on
fitting surface of
Denture
Remove & polish
k. Swallowing and
sore throat
Slight redness or
ulceration
OE to soft palate/
excessive pressure in
hamular notch
OE in lingual pouch
Reduction of OE
l.Undercut Red and ulcerated Maximum bulge of
alveolus
Cut away fitting
surface

7. Nausea
• Cause- light or intermittent contact to soft
palate/ back of the tongue
• C/F-over
extended- contact soft palate+ denture
under extended- dorsum of tongue+ denture
thick post: border- irritation to tongue
protrusive inbalance- Dr: drop down & touch

8. Inability to tolerate denture
• Denture/ Dentist - Cramped tongue space
Altered vertical height
Altered occlusal plane
Change in shape
• Patient- Unemployed ridge

9. Inability to keep denture clean
• Lab: - inadequate lab work
- Loss of original polish
• Patient- failure of regular cleaning
- Incorrect use of denture cleansers

10. Appearance (Denture)
Until 4-6weeks, pat: can complain ( even they agree in
trial state)
(a) Facial appearance- nose and chin are more
prominent/ lips and cheek are falling in
failure to restore the correct occlusal height
(b)Dissatisfaction with teeth-color,
shape, position and general dissatisfaction
How to solve- tactful, kindness and genuine sympathy

11. Lack of retention and stability ( Denture)
(a) When opening the mouth-lower
denture lifts due to low tongue position
than dropping of upper denture
(i) Over extension- reduce
(ii) Tight lip- set lower ant; lingually
(iii) Tongue cramped- use buccolingual narrow teeth
(iv) Under extenion- tracing and reline
(v) Lack of saliva- artificial saline

12. Lack of retention and stability ( Denture)
(B) When coughing and sneezing
movement of soft palate- posterior palatal
seal broken- upper denture drop down
unusual muscular movement- lower denture
lift up
How to solve- cover the mouth with a hand

13. Inability to eat ( function)
• Especially for new denture wearer-
• Difficulty for fibrous food- due to
low cusp or zero posterior teeth,
lack of interdigitation of posterior teeth,
the use of acrylic teeth,
unbalanced occlusion of locked occlusion
• Perseverance will solve the difficulty

14. Food under the denture ( function)
• Pat: not yet learn how best to control the food
in first denture
• Occur in poor peripheral seal & severe bone
resorption
• How to solve-
Impression stage- maximum coverage
Pat: instruction- …

15. Clicking of the teeth ( function)
• Noise irritates patient
• Cause- - excessive vertical height
- distal part of denture rises
- lack of balanced occlusion
- excessive incisal guidance angle
( overjet < overlap )
- porcelain teeth

16. Altered speech ( function)
• Cause- thick palatal plate & slightly altered
positions of tongue
• How to solve- read aloud
• Phonetics– page 136 Fenn

17. Biting the cheek and tongue ( function)
(1) Cheek biting – due to
insufficient overjet,
reduce vertical height,
incorrectly positioned occlusal plane
(2)Tongue biting- due to
decrease tongue space
low occlusal plane level