Denture review

When a patient returns complaining of soreness to chew on dentures there are two broad possibilities:

-Pain in the teeth supporting or retaining the denture can occur due to tight or ill fitting dentures. You will notice that it is difficult to insert the dentures without pressure. This can cause a similar condition to traumatic occlusion to the periodontium and the patient may complain of a tight feeling in their residual teeth
-Pain to soft tissues due to denture contact: Always check the occlusion first! The patient may be contacting more firmly on one side causing uneven pressure and pain on the side they are chewing. They may also have an interference causing into lateral shift MIP. This will cause significant lateral force on the denture and will tend to cause pain on the lower denture that is on the lingual of one side and buccal of the contralateral side. Rather than adjusting the fitting surface of the denture, adjust the occlusion first til there are even bilateral contacts in mip.

A great tip is to get the patient to chew on a biscuit or some gum and observe how they chew be in more on one side than the other or some areas they avoid. Some patients will not be able to pinpoint the location of the pain or have been leaving their dentures out so there is no soft tissue ulcer to help you. In this case, pressure indicating paste or fit checker can be used. Be sure to apply firm downwards pressure to the ridges and some lateral force to get a good reading. Apply the paste to a dry denture. You can use air from your triplex to move the paste around. You want broad coverage in a thin layer so this can be very useful. You can use your strength handpice and an acryllic bur through the paste or mark the show through spot with a pencil and wash the paste off.