What is an Immediate Denture - Dr Muzzafar Zaman
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An immediate denture is fitted during the same visit as tooth extraction, preventing gaps and allowing for immediate cosmetic restoration. While this option offers benefits like avoiding a period without teeth, it has disadvantages including no try-in stage and potential fit issues due to gum shrinkage post-extraction. Aftercare involves careful monitoring and adjustments over time, as the denture may become ill-fitting due to ongoing gum changes.
What is an Immediate Denture - Dr Muzzafar Zaman
- 1. What is an Immediate Denture? An immediate denture is a denture which is fitted in the mouth at the same time one or more teeth are extracted at the same visit. If you have a tooth or teeth that need to come out but you don’t want to walk around with a gap whilst a new denture is being made then that’s usually the time when your dentist will recommend an immediate denture. Normally, when you have a conventional denture made, the teeth are taken out first but then there is a period of two to three months where the gums are allowed to heal or harden. After a tooth extraction, the area is sore for the first few days as the socket tries to close up. However, even after the socket has closed up, there is a period of a few months where the gum continues to shrink back. This is the reason why it is best to make a permanent denture after this healing phase. If the denture is made before all the gum shrinkage has taken place, then the denture will become ill fitting as further gum shrinkage takes place. The problem with this approach is that you may not want to be without a denture for a few months whilst waiting for the gums to heal up fully. This is particular the case at the front of the mouth for obvious cosmetic reasons. It can also be an issue where several teeth are taken out at the back of the mouth and it is difficult to chew without any teeth.
- 2. Reasons for making an immediate denture. An immediate denture means that you won’t have to have a gap once your teeth have been extracted because an immediate denture will fill this gap at the same visit. How an immediate denture is made? An immediate denture has basically the same steps in construction as a normal conventional denture. Like all dentures, impressions are taken of your mouth. The bite is measured and recorded. A denture try-in is also possible but it won’t include the tooth/teeth yet to be taken out. Finally, on the last visit, the tooth or teeth are taken out and the denture is fitted straight away in that same visit. Advantages An immediate denture has distinct advantages. The main reason being is that a tooth can be taken out and at the same dental visit, the denture is fitted as well. Therefore the patient is not left to go home with a big unsightly gap. Before the days of immediate dentures, if a patient had to have a tooth out at the front of the mouth, it was first extracted and then the patient had to wait for about two to three months for the healing to be complete. The patient had to then return for further appointments to have impressions taken followed by the try-in, the bite and finally the fit visit. The whole process could take nearly six months. Of course, if multiple teeth were extracted or even a full mouth clearance, the patient could be left without any teeth whatsoever for a few months. Dentists at the same told the patient that the “gums needed to harden up.” This was more common in the 60s and 70s but patients also had far less expectations and were prepared to be without any teeth for a several months.
- 3. Disadvantages There are however a few disadvantages of an immediate denture that all patients need to be aware about before proceeding. Let’s look at these in turn: 1. No try in. With a conventional denture, the try-in stage of a denture allows both the dentist and the patient to see what the final denture will look like before the actual final denture is made. If any adjustments are required these can be made at this visit because the denture teeth are held in a wax base which can be altered. At this try-in stage, alterations to the shape, size and positioning of the denture teeth, can be made. Even, if the shade or colour of the denture is not quite right, the try-in can be sent back to the denture technician for another try-in. The bite can also be corrected if it is not quite right at this stage also. However, with an immediate denture, no try-in is possible with the tooth or the teeth that are to be extracted right at the final visit. However an experienced dentist will have a very good idea of how the final denture should be and even at the final visit, minor adjustments to the denture are still possible. The big drawback of an immediate denture is when the final denture does not fit properly. The only solution is to remake the denture from scratch again. This will cost in terms of time and money. 2. One of the skills of making an immediate denture is it estimate how the denture tooth will fit once the patient’s own tooth or teeth have been extracted. It is an estimate so problems can occur hear resulting in a shorter tooth causing a gap near the gum line or the tooth can be too long creating rubbing along the gum line. The latter can be adjusted but the former will require a reline or a new denture later on. 3. As I said above, whenever a tooth or teeth are taken out, the patient’s gum will continue to alter and shrink back for up to 6 months although
- 4. most of it will happen in the first 2–3 months. This is called bone resorption and will result in the denture not fitting as good as originally when it was made. During this time, the denture usually becomes progressively loose and the patient will require the use of denture adhesives to get through this phase. This is a main disadvantage of an immediate denture and it can cause lots of difficulties for a patient. 4. Once a period of two to three months has elapsed from when the tooth or teeth were extracted and the immediate denture fitted, it will be necessary to recall the patient back to discuss either a reline or a new definitive denture. Most of the time, a full remake will be necessary and the patient must be warned from the outset as this has implications in terms of time and cost. An immediate denture is therefore disadvantageous because the patient has to buy a new denture and also further visits ate needed. Aftercare An immediate denture requires the same elements of aftercare as a normal conventional denture but there are some additional factors also which are very important. The aftercare can be divided into short term and medium term aftercare. Short Term Aftercare After the tooth or teeth have been taken out and the denture fitted, it is very important that you do not take out the denture that same evening for cleaning. In fact, it should be left in for 3 days in total. This is for reasons to do with how a tooth extraction socket heals up. After a tooth has been taken out, the area will swell up which is just the normal healing process. If you attempt to take out the immediate denture during this time, the denture may not want to go back in again due to the
- 5. swelling. This is the reason why the denture should not be taken out for the first 3 days until most of the initial swelling has subsided. Medium Term Aftercare. The medium term aftercare of an immediate denture relates to the subsequent gum shrinkage and therefore the denture becomes ill fitting. The ill fitting becomes apparent because the denture gets loose or a gap appears underneath it for food to collect. It is important that the full healing process is allowed to take place before making the definitive final permanent denture. During the time when the immediate denture has become ill fitting, the best solution is to use denture adhesive. Click into the section on which is the best denture adhesive. After a period of 2–6 months, the dentist will start to make a new denture which will fit much better. During the time the immediate denture is being used, it is normal to come back several times for denture adjustments such as if they are rubbing in a particular spot. REFERENCES Journal of Prosthetic Dentistry Controlled immediate dentures by Earl Pound September 1970 Volume 24, Issue 3, Pages 243–252 Journal of Prosthetic Dentistry Digital immediate denture: A clinical report Jing-Huan Fang Affiliations
- 6. Postgraduate student, Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea Xueyin An Affiliations Postgraduate student, Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea Seung-Mi Jeong Affiliations Professor, Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea Byung-Ho Choi Tagged in Dentistry, Immediate Denture, Denture, Teeth Care, Mouth Maintenance By Dr Muzzafar Zaman on May 4, 2018. Canonical link Exported from Medium on May 11, 2018.