Palatal extension – gag reflex

95 percent of upper complete dentures I make extend to just in front of the vibrating line. This position is generally within 1 mm of the fovea palatini and produces the best suction. Before treatment I show the patient a denture as an example and explain it with photos in the treatment plan consent letter.

Sometimes the patient cannot tolerate this extension as it makes them heave or feel sick. This will normally occur at the registration rim stage or denture try in stage.  I explain that this normally resolves itself once the denture is finished and worn. Adaptation to the extension normally occurs. Occasionally though, this does not happen. In these cases, I bring the posterior border forward by approximately 10mm at the midline keeping the full extension around the tuberosities. A post dam is added along this border to form a posterior seal by the technician using the working cast.

The retention is often not quite as good as with a fully extended posterior border, but it generally is sufficient for the patient to manage well with the new denture. It is particularly important that the other denture parameters are correct, such as sulcus extension, tooth positions and the occlusion.

Denture Blog 32

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