DentureTroubleShootingGuide

Comfort
Discomfort
Sorespotinvestibule
upperorlowerdenture
Sorespotinupperpost
dam.
(posteriorlimitofupper)

1.
2.
1.
2.
3.

Causes
Overextendedborders
Roughspotinbase
Postdamtoodeep
Sharpedgesontheposteriorseal
Overextension

Singlesorespotsonthe
crestoftheridge

1.
2.
3.
4.

Prematureocclusion
Inaccuratedenturebase
Voidsorporosityinacrylic
Nodulesunderbase

Generaloverallsorenesson
ridge

1. Verticalopentoomuch
2. Totallyinaccuratedenturebase
3. Malocclusionorimproperinterdigitation

Soreunderlowerlingual
flange

1. Centricoff,masticationdriveslowerforward
2. Lingualflangeoverextended
3. Posteriorstoofardistal

Soreunderlowerlabial
flange

1. Toomuchoverbite
2. Overextendedlabialflange
3. Whenmasticatingpatientthrowslowerforward

Solutions
1. Shortenbordersandpolish.
2. Refinishborders.
1. Reducebasecarefullyandgraduallytoavoidlossoftheborder
seal.
2. Sameasabove,makesurepostdamisonsofttissue.
3. Sameasabove.
1. Newcentricregistrationoraccuratebite.Remountdentureson
articulatorandadjust.
2. Takewashimpressionandrebaseaftertissuetreatment.
3. Sameasabove.
4. Removenodules.
1. Remake1ofthedenturestocorrectvertical,ifplaneof
occlusioniscorrect.
2. Tryawashimpressionandrebase,orremakedentureafter
tissuetreatment.
3. Seesolutions1a,1b,1cfromsolutionswhenoccludingin
centric.
1. Recheckverticalandcentric.Rearticulateandremovethe
interferingcuspsorchangetononinterferingteeth.
2. Shortenandpolishflange.
3. Removesecondmolars.
1. Rearticulateandchangetoothposition.
2. Shortenflangeandrepolish.
3. Recheckverticalandcentric.Checklingualflanges,shorten.

BurningSensation*
Discomfort
Burningfeelingonhardpalateareaoronlower
anteriorridge
Burningfeelinginbicuspidareatotuberosities
Burningfeelingonupperanteriorridge

Causes
Highpressureareaintheacrylicbase*

Solutions
Locatethehigharea,removeandpolish.

Highpressureareaintheacrylicbase*
Pressureonpapillaandrugaearea*

Sameasabove,grindfirstbicuspidoutofocclusion.
Relieve.

*Burningsensationsareusuallycausedbypressureonanerveasitleavesnasopalatineorbyundercuredbases.Diabeticsexperienceburningoccasionally.


BitingCheeksandTongue
Discomfort
Keepsbitingcheeksand/ortongue

Causes
1. Posteriorteethsetendtoend
2. Overclosed
3. Posteriorteethsettoofartothe
lingualorbuccal

Solutions
1. Rearticulateandresetposteriors(waxtryinhighly
recommended).
2. Rearticulateandresetallteethopeningbite.
3. Rearticulateandresetposteriorteeth.

RednessofTissue
Discomfort
Tissuegettingredindenturebearingarea

Alltissuesbecomingfieryredincludingcheeks
andtongue

Causes
1. Illfittingdenturebase
2. Impropercureofdenturebase
3. Aviaminosis
Denturebaseallergy(extremelyrare)

Solutions
1. Takeawashimpressionandrebasedenture.Checkfor
prematuritiesintheocclusion.
2. Rebase(heatcureacrylic).
3. Prescribevitamins.
Changebasematerialbyhavinglabjumpavinylbasematerial.
Removeallacrylicteethandreplace.Apatchtestshouldbe
taken.

PaininMandibularJoint
Discomfort
PaininMandibularjoint

1.
2.
3.
4.

Causes
Verticaloverclosed
Centricrelationoff
Arthritis
Trauma

1.
2.
3.
4.

Solutions
Rearticulateandresetallteethtoopenbite.
Takeintraoraltracingandreset.Retrialadvised.
Consultpatientsdoctor
Difficulttocorrect.


Instability
Instability
Whennotoccluding

1.
2.
3.

4.
5.

Causes
Overextensionofbordersandposteriorlimits
Underextendedborders
Lossofpostdamseal
a. Postdamonhardpalate
b. Postdamnotoverhamularnotches
c. Insufficientpostdam
Dehydrationoftissueduetoalcoholismormedication.
Flabbytissuesdisplacedwhentakingimpressiondueto
impropertray.

Lossofpostdamseal
Anteriorteethtoofarlabially
Flabbyanteriortissue
Improperincisinghabits
Lowerposteriorssetoffridge

Whenchewingfood

1.
2.
3.
4.
5.

Whenoccludingincentric

1. Malocclusion
a. Prematureindividualteethhitting
b. Highocclusionononesideofarch
c. Bicuspidareaprematurecontact
2. Upperdentureridingonhardpalatesurface
3. Flabbytissuesoverridge
4. Teethsettoofarbucally
5. Centricocclusionnotinharmonywithcentricrelationship

Solutions
Inallcasesanewimpressionisnecessary.Besttogrindout
thetissuesideandtakeawashimpression,usingcompound
wherenecessarytoextendimpressiontoincludepostdam
area.Rebaseentiredenture.

1. Sameasabove.
2. Remountandresetbringinganteriorsbacklingually.
3. Surgerytoremovepoordenturefoundationand
rebase.
4. Patienteducationistheanswer.
5. Resetandcorrectposterioralignment.
1. a.Remountgrind,andmillinselectiveteeth.
b.Remountandreset.
c.Trychairsidemillinorremountandset.
2. Relievepressurearea
3. Removeflabbytissuewithsurgeryandrebase.
4. Remountandresetlingual.
5. Remakeonedenture.


Interference
Interference
Whenswallowing

Causes

Solutions

1. Upper
a. Overextensionintheposteriorbuccalflanges
b. Toothickinlingualposteriorflanges
2. Lower
a. Overextensioninthelingual
b. Toothickinposterior
3. Overclosedvertical
4. Toomuchvertical
5. Posteriorstoofarlingual,crowdingtongue

1. Upper
a. Carefullyreducedistalbuccalflange.
b. Adjustbythinningdenturesfromtheoutside,not
thetissueside.
2. Lower
a. Carefullyreduceflange
b. Reducefromoutsidedonotgrindtissueside.
3. Remountandreset,correctingvertical.
4. Sameasabove.
5. Remountandresetopeningarchtoallowmore
tongueroom.

Gagging
Gagging
Immediateoninsertion

Causes
1. Upper:Overextensiontoothickposteriorborder
2. Lower:distallingualflangetoothick

Delayedgagging:2weeks
to2monthsafterdelivery

1. Faultypostdamallowingsalivaunderdenture
2. Malocclusionallowingdenturetoloosencausessaliva
seepage

Solutions
1. Denturemustbedoublepostdammedandcutback
toanteriorpostdam.
2. Carefullyreducefromtheoutside.Donotgrindtissue
side.
1. Grindoutpostdamareaandtakewashimpression
forlabrebase.
2. Remountandmillin,sometimesnecessarytoreset
theteeth.

Esthetics
Esthetic
Toobulkyundernose
Sinkinginundernose

Upperlipsinksintoofar

1.
2.
1.
2.

Causes
Labialflangeofuppertolongortoothick
Upperanteriorteethsettoofarout
Upperlabialflangeneedsmorebulk
Upperlabialflangeneedsmorelength

Upperanteriorteethsettoofarlingual

Showstoomuchteeth

1.
2.
3.
4.

Verticaltoogreat.
Occlusalplanetoolow
Cuspidsandlateralssettooprominent
Upperanteriorteethsetouttoofar

Justlookstoofalse

1. Settooregular;techniquetypesetup
2. Allteethappeartobethesameshade
3. Nogingivalcontouringorstaggeringofgingival
depth.

Solutions
1. Reducebulkand/orlengthandrepolish.
2. Resetanteriorslingually.
1. Addwaxtobuilduptopropercontourandhavelabbuild
outbase.
2. Grindouttissuesideoflabialflange,addcompound
borderandtakewashimpression.
3. Resetanteriorsforlipsupport.
Addwaxonteethtopropercontourandhavelabsetteethmore
labialforlipsupport.
1. Havelabresetallteethclosingvertical.Maintainesthetics
bydeterminingtoraiseorlowerupperorlowerteeth.
2. Havelabresetallteethraisingocclusalplane.
3. Replacecuspidsandlateralswithsmallerteethandrotate
themin.
4. Resetteethbacktoridge.
1. Trysculpturinganteriorincisalstogiveabraded
appearance.Rotateandstaggerteethinsetup.
2. Changetocharacterizedanteriorteeth.
3. Havelabprocessnewbasewithanatomicalfinishand
characterizedbase.

Phonetics*
PhoneticSound
WhistleonSsound

LispingonSsound
ThandTsoundsindistinct

FandVsoundindistinct

Causes
1. Notenoughroomfortonguebetweenupper
bicuspids
2. Spacebetweencentral
Toomuchspacefortonguebetweenupperbicuspids
1. Notenoughroomindenturesfortongue
2. IfThandTsoundaliketheanteriorsaretoo
farlingual
Improperpositionofupperanterioreitherverticallyor
horizontally.

Solutions
1. Removeandmovebicuspidstothebuccalorifroom
grindoutmoreareaforthetongue.
2. Closespace.
Narrowpalatespacebetweenupperbicuspidsbyaddingledgeof
acrylic.
1. Thinoutdenturesfromlingualsidesdontgrindtissue
side.
2. Remountandmoveanteriorsouttothebuccal.
Difficultadjustmentmustdecodeandtrytocorrect.

*Phoneticsoundsdonotreacttoaregulartrialbaseplatethesameasthefinaldenture.Aunibaseonyourtryinwillduplicatefinaldenturephonetics.