Hello Dr. Hall,
I had all upper teeth extracted several years ago and got a denture, and now I need a new denture. So I picked a dentist who said he could get me a good-fitting denture.
Anyway, he did the impression was done followed by a wax bite and then two wax try-ins. When I had the second wax try-in I informed the dentist that it wasn’t staying in. He said the wax try-in is just about the teeth. But then, when I got my new denture, there was no suction at all and it wouldn’t stay in. The dentist said I have to give my gums time to adjust to the new denture and come back in a week to be evaluated. I returned in a week with NO change. I told him I love it WHEN it stays in, which isn’t very often!
He thought that maybe the problem was that my bite was off, so he took my denture and ground on it, maybe four times, each time checking my bite again! Then he put Fixodent on it, put it in my mouth and said to use the Fixodent and come back in (another) week to give my gums time to adjust to the denture. Let me also add that he ground down 3 molars on each side of the inner side of the denture to practically nothing.
I overheard him say to an assistant about maybe doing a reline. ???????
My question is: Why would he think a reline will work when the original impression (done only a month earlier) didn’t work???? My suspicion is the original impression wasn’t right and he wants to just do a “reline” to save HIM money instead of re-doing my new $1225.00 denture AND owning that he, the lab or somebody in his office screwed up.
Am I on the right track here or am I missing something? My next appointment is next Wednesday after having to do the Fixodent for a week. This isn’t what I signed up for.
– Carol from California
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Carol,
While your dentist isn’t innocent of all dental transgressions here, a reline should be the appropriate remedy for your problem of the denture not staying in.
I going to try reading between the lines about the procedure your dentist went through in order to give you some insight into what is going on. If you have indeed told me everything that went on with your getting this denture made, your dentist skipped a couple of steps that he was taught in dental school. But this is a common practice. There is a lot of price competition in the denture market, and the way a dentist trims the cost of a denture is by skipping some steps. Most of the time the end product is a perfectly adequate denture. In your case, it sounds like the denture is okay except for the fit, and a reline should take care of that problem. Something didn’t turn out right in the impression process, and a reline basically re-does that impression.
The best, most accurate impression is done with a two-step impression. I actually used to use a three-step impression. I would take a preliminary impression with alginate, from which I would make a preliminary model of the jaw and my assistant would use that model to make a custom tray specific for the patient. Other dentists will use a special moldable stock tray which many dentists say are as good as a custom tray. But the important part of the impression is the next steps. A heavier impression material is used to register what will become the borders of the denture. The process is called border molding. It’s the border of the denture that is responsible for the suction of an upper denture. To create suction, you want the border to press into the tissue a little, which is why the dentist will use a heavy-body impression material. This will be followed by what is called a wash—a light-body material that fills up the interior of the impression that registers all the tiny details of the soft tissue. When this impression is shortened to one step, a medium-body material is used. As I said, the result will usually be an adequate denture, but the dentist will save chair time which saves on the cost, which is usually, but not always, passed on to the patient.
With your denture reline, your dentist will most likely use the denture he made for you as a custom tray and should get a more accurate impression than he got the first time. If he hasn’t done that impression yet, I would ask him to use a two-step impression, if he didn’t do that in the first place.
This that he told you that the gums needed to adjust to the new denture sounds to me like a stalling tactic. Gums don’t adjust to a new denture. As far as the fit of the wax try-in, he was correct that the base used for the wax try-in is made to be an approximate fit. If it is made to an exact fit it will abrade the model on which it is made and thus compromise the final fit of the denture. The wax try-in is done just to check the positions of the teeth and to make sure you like their appearance.
I hope this is helpful.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Thank you Dr Hall for you response!
I have been back to this dentist since my email to you and I will try to keep this short and simple. 🙂
He did advise he wants to do a reline which doesn’t make me happy on my brand new denture. I don’t know if he did a border mold at the time of the original denture impression. I do believe the impression was done with a stock tray because she (assistant ?) tried a couple of them for fit and she said she used the smallest tray (I know I have a small mouth but a dentist has been the only one that’s ever accused me of that……humor but true).
I ask the dentist why he thought a reline would work when the original impression didn’t. He replied with “It could be a number of reasons. Maybe the impression, maybe at the lab, there is no way of really knowing”. I may be wrong but I’m just not convinced he doesn’t know where it went wrong. I now think, is that what he tells patients when a crown doesn’t fit and seal like it should or does he remake the crown?
I verified with him if the reline will make my NEW denture thicker and sit lower and he said “yes” (not good in my book). I already feel like my denture sits on my tongue after he ground all around the inside of my denture because I told him the denture was slightly hitting a front bottom tooth. I can tell where he grounded because the denture feels dirty. It took the glaze off! I understand adjustments but all that for it hitting a bottom tooth? My email to you didn’t mention anything about my bite being off BUT maybe that’s why he did all that grinding. “I” only complained about it hitting a bottom tooth and (still) no suction!
Honestly? I feel like he has ruined my new denture. Why that much grinding on a new denture if there was nothing wrong with the original impressions? Maybe he got carried away with the grinding and tried to compensate for it? Maybe he was trying to cut corners and costs? I will probably never know but I feel he does……just my gut.
In a nut shell: I told him if I wasn’t happy with the reline I wanted him to remake my denture at his expense. He agreed but wants me to (here it comes), give it a week. I agreed. My appointment for the reline is Monday. I’m hoping for the best.
I want to thank you sooooo much for your input and letting me rant, it means a lot!!!! You may be glad I’m not your patient…lol
Thank you, Thank you, Thank you!!!
Thank you for the thorough explanation. I learned something new about the benefit of a denture reline and how it works. This is helpful as we figure out what to do for my mother.
I paid in full my amount due for top and bottom partials, the top fit fine, but they kept trying to do the impression for the bottom. I repeated over again that it was too tight the claps was in my gums, and I had a time in pain trying to take them out. I go back this week and I can’t wear the bottom partial. My teeth have shifted now waiting so long for an appointment.
It sounds incredibly frustrating to deal with a denture that won’t stay in place despite multiple adjustments. It’s concerning that the issues persisted after the initial impressions and adjustments. If the new denture isn’t fitting well, a reline might help, but it shouldn’t be needed if the original denture was properly made. Communicating your concerns with your dentist and seeking a second opinion could be valuable in resolving this issue.
I have the same issue with my new denture except this this was way off not even close to fitting