Blog | Finlay Sutton - Denture Education

Saliva flow and new dentures

Initially new dentures often cause the patient to produce more saliva than normal. Very occasionally the saliva flow can decrease and the patient’s mouth can feel dry with the new dentures. This gradually returns to normal over time. I make sure my patients are aware of this prior commencement of treatment.

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Post dam discussion – it may be further back in the upper complete denture

I have a discussion with the patient about the post dam position before treatment verbally and in a letter.

This is what I tell my patients’:

“The new upper denture may extend slightly further back in the mouth compared to your current denture. The extra extension is important in producing good suction (peripheral seal). I feel it is important for you to be aware of this prior to commencing treatment and most patients I find accommodate to this. If not, I will still be able to help but the denture may not have as good suction.”

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Dentures move during function

Dentures are removable mechanical substitutes for missing living tissues and as such exhibit movement when chewing food, talking and when the tongue and muscles of the mouth move. The patient needs to work with them rather than against them.

This improves with time with adaptation once the dentures do not cause soreness. This normally takes approximately 6 weeks. It can take some patients up to 6 months – particularly if they are elderly and new to denture wearing.

Fixative may be necessary.

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Newly fitted dentures will become sore

At the fitting appointment, I explain that the new dentures will become sore fairly soon and this is a completely normal occurrence, even for well-crafted dentures, made to the highest technical standards. I normally review the patient 1 week after fitting.

Occasionally, during the week the patient may find the new dentures too sore to wear. In these circumstances, I advise the patient to leave them out and revert to their previous set of dentures. I ask them to wear the new dentures for the two consecutive days before their review appointment, wearing them for the same length of time they would normally wear their dentures. This allows me to see exactly where the dentures are rubbing, thus enabling precisely accurate adjustment of the denture at the review.

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Universal Scandinavian partial denture designs

Please find my updated universal Scandinavian partial denture designs for most patterns of missing teeth. Please note there are two types of design.

1. Remaining teeth have good prognosis

2. Remaining teeth have poor prognosis - meaning the RPDs can be added to as teeth fail.

Dentures work in a similar way to a prosthetic hand

When consenting new patients and at the fitting of new dentures I emphasise to the patient that the new dentures will require considerable amount of practice and adaptation for them to be a success.

I show them a prosthetic hand and ask them to imagine how it would feel to have an artificial hand. I say “a prosthetic hand would operate in a completely different way to a natural hand and this is no different with dentures v natural teeth. Dentures chew, bite and work in a totally different way to natural teeth and as such require considerable adaption. They are essentially well- engineered blocks of plastic”

In addition, I say “The new dentures have been made to the highest possible standards using all of our skills and knowledge, giving you the best possible chance of being able to wear them comfortably. We are, however, reliant on your adaptation to the denture and it will require considerable practice and effort on your behalf to make it work. A similar analogy is learning how to use chopsticks instead of a knife and fork.”

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The magic of a heat cured soft lining for lower complete dentures

I find that patients who develop constant soreness under a lower denture benefit greatly from a heat cured soft silicone lining (such as Molloplast B or Permaliner) which is processed in the dental laboratory.

The transformation in their quality of life cannot be overestimated.

It is crucial in these circumstances that the rest of the denture is made well with optimal:

1. Extension of the denture base

2. Polished surfaces

3. Tooth positioning and occlusion

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Photographs of the patient smiling with the shaped wax rims in situ – send to the technician

Photographs of the patient smiling and at rest with the shaped wax rims in place are extremely helpful for the technician. I take the following 10 photographs with the patient smiling and at rest:

1. The right and left profile

2. The right and left three quarter view

3. Portrait view

Along with dentate photographs of the patient, if these are available, the above photographs are of great assistance for setting the teeth. Corrections to the prescribed tooth positions of the wax rim can be made by the dental technician with reference to these photographs, adding another check in the system.

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