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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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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