Immediate denture: or how to replace hopeless teeth with a denture in the same dental visit?

Dentures are one of constant and routine dental procedures in our office. We would like to share our experience, advantages and disadvantages of the different types of dentures. Today we would like to discuss the immediate denture.

This type of denture - immediate denture can be done when a large number of hopeless teeth need to be extracted and a person cannot wait to heal for few weeks after extraction and walking without teeth. Is it possible to remove the hopeless teeth and place the denture in same appointment?

The first step of the immediate denture fabrication is the patient evaluation and planning. However, each patient’s case is different but we have developed different strategies that can be applied based on number of teeth in patient’s mouth. In the first appointment of denture fabrication the preliminary or first impression of teeth helps to make a denture design. Transitioning from natural teeth to artificial dentures is not easy and can impact person emotionally and physically. To make this transition as smooth as possible, at Dental Aid 1 we recommend removing posterior teeth first with leaving anterior teeth in position. The posterior teeth are multi rooted and the healing process after extraction takes few weeks before the final impression can be done.

Also several factors need to be considered:

1. The bone resorption following teeth extraction progress is more rapid in lower jaw compare with upper jaw.

2. The upper denture gains support from the palate.

3. The upper jaw is connected tight with the cranial when the low jaw is swinging with ligaments and more mobile. It appears that the fabrication of immediate denture in the upper jaw is more predictable procedure than making the lower denture.

Usually there are four visits before the denture is done and ready for insertion. Those dental visits can be combining with teeth treatment such as fillings, teeth cleanings or something else.

When we get the finished denture from the dental laboratory we can plan the day of teeth extraction. The dentures will be inserted into a patient mouth at same day immediately after teeth extraction. One of the cases was done in Dental Aid 1 office. Please see picture before and after at same day appointment.

The immediate denture required 24 to 48 hours follow up visit after extraction to evaluate occlusion and denture stability.

Immediate denture required more visits in the first 6 month after insertion compared with regular denture. This requirement depends on bone healing and remodeling after teeth extraction. Due to the bone healing process the denture can be unstable and can start rocking. Usually the bone healing takes place 2-3 month after denture insertion.

Sometimes the denture is not stable at the beginning when more that couple teeth were extracted. To stabilize the denture and help the denture sit well in mouth it is possible to add material to the inside part of denture. This procedure called reline. Denture reline can be done in one appointment in office visit or the denture can be send to dental laboratory. Our experience shows that fist reline may be done immediately or after couple of months of denture insertion.

An advantage of immediate dentures is that the person does not have to be without teeth during the healing period. Nowadays, the majority of our patients prefer to get immediate denture and later reline the base of the denture than remove teeth and wait couple months for bone healing, denture fabrication, and waking around without teeth.