DentureTroubleShootingGuide

Comfort
Discomfort
Sorespotinvestibule
upperorlowerdenture
Sorespotinupperpost
dam.
(posteriorlimitofupper)
Singlesorespotsonthe
crestoftheridge
Generaloverallsorenesson
ridge
Soreunderlowerlingual
flange
Soreunderlowerlabial
flange
Causes Solutions
1. Overextendedborders 1. Shortenbordersandpolish.
2. Roughspotinbase 2. Refinishborders.
1. Postdamtoodeep 1. Reducebasecarefullyandgraduallytoavoidlossoftheborder
2. Sharpedgesontheposteriorseal seal.
3. Overextension 2. Sameasabove,makesurepostdamisonsofttissue.
3. Sameasabove.
1. Prematureocclusion 1. Newcentricregistrationoraccuratebite.Remountdentureson
2. Inaccuratedenturebase articulatorandadjust.
3. Voidsorporosityinacrylic 2. Takewashimpressionandrebaseaftertissuetreatment.
4. Nodulesunderbase 3. Sameasabove.
4. Removenodules.
1. Verticalopentoomuch 1. Remake1ofthedenturestocorrectvertical,ifplaneof
2. Totallyinaccuratedenturebase occlusioniscorrect.
3. Malocclusionorimproperinterdigitation 2. Tryawashimpressionandrebase,orremakedentureafter
tissuetreatment.
3. Seesolutions1a,1b,1cfromsolutionswhenoccludingin
centric.
1. Centricoff,masticationdriveslowerforward 1. Recheckverticalandcentric.Rearticulateandremovethe
2. Lingualflangeoverextended interferingcuspsorchangetononinterferingteeth.
3. Posteriorstoofardistal 2. Shortenandpolishflange.
3. Removesecondmolars.
1. Toomuchoverbite 1. Rearticulateandchangetoothposition.
2. Overextendedlabialflange 2. Shortenflangeandrepolish.
3. Whenmasticatingpatientthrowslowerforward 3. Recheckverticalandcentric.Checklingualflanges,shorten.

BurningSensation*
Discomfort Causes Solutions
Burningfeelingonhardpalateareaoronlower Highpressureareaintheacrylicbase* Locatethehigharea,removeandpolish.
anteriorridge
Burningfeelinginbicuspidareatotuberosities Highpressureareaintheacrylicbase* Sameasabove,grindfirstbicuspidoutofocclusion.
Burningfeelingonupperanteriorridge Pressureonpapillaandrugaearea* Relieve.
*Burningsensationsareusuallycausedbypressureonanerveasitleavesnasopalatineorbyundercuredbases.Diabeticsexperienceburningoccasionally.


BitingCheeksandTongue
Discomfort Causes
Keepsbitingcheeksand/ortongue 1. Posteriorteethsetendtoend
2. Overclosed
3. Posteriorteethsettoofartothe
lingualorbuccal
Solutions
1. Rearticulateandresetposteriors(waxtryinhighly
recommended).
2. Rearticulateandresetallteethopeningbite.
3. Rearticulateandresetposteriorteeth.

Discomfort
Tissuegettingredindenturebearingarea
Alltissuesbecomingfieryredincludingcheeks
andtongue
RednessofTissue
Causes Solutions
1. Illfittingdenturebase 1. Takeawashimpressionandrebasedenture.Checkfor
2. Impropercureofdenturebase prematuritiesintheocclusion.
3. Aviaminosis 2. Rebase(heatcureacrylic).
3. Prescribevitamins.
Denturebaseallergy(extremelyrare) Changebasematerialbyhavinglabjumpavinylbasematerial.
Removeallacrylicteethandreplace.Apatchtestshouldbe
taken.

PaininMandibularJoint
Discomfort Causes Solutions
PaininMandibularjoint 1. Verticaloverclosed 1. Rearticulateandresetallteethtoopenbite.
2. Centricrelationoff 2. Takeintraoraltracingandreset.Retrialadvised.
3. Arthritis 3. Consultpatientsdoctor
4. Trauma 4. Difficulttocorrect.



Instability
Instability Causes Solutions
Whennotoccluding 1. Overextensionofbordersandposteriorlimits Inallcasesanewimpressionisnecessary.Besttogrindout
2. Underextendedborders thetissuesideandtakeawashimpression,usingcompound
3. Lossofpostdamseal wherenecessarytoextendimpressiontoincludepostdam
a. Postdamonhardpalate area.Rebaseentiredenture.
b. Postdamnotoverhamularnotches
c. Insufficientpostdam
4. Dehydrationoftissueduetoalcoholismormedication.
5. Flabbytissuesdisplacedwhentakingimpressiondueto
impropertray.

Whenchewingfood 1. Lossofpostdamseal 1. Sameasabove.
2. Anteriorteethtoofarlabially 2. Remountandresetbringinganteriorsbacklingually.
3. Flabbyanteriortissue 3. Surgerytoremovepoordenturefoundationand
4. Improperincisinghabits rebase.
5. Lowerposteriorssetoffridge 4. Patienteducationistheanswer.
5. Resetandcorrectposterioralignment.
Whenoccludingincentric 1. Malocclusion 1. a.Remountgrind,andmillinselectiveteeth.
a. Prematureindividualteethhitting b.Remountandreset.
b. Highocclusionononesideofarch c.Trychairsidemillinorremountandset.
c. Bicuspidareaprematurecontact 2. Relievepressurearea
2. Upperdentureridingonhardpalatesurface 3. Removeflabbytissuewithsurgeryandrebase.
3. Flabbytissuesoverridge 4. Remountandresetlingual.
4. Teethsettoofarbucally 5. Remakeonedenture.
5. Centricocclusionnotinharmonywithcentricrelationship

Interference
Interference Causes Solutions
Whenswallowing 1. Upper 1. Upper
a. Overextensionintheposteriorbuccalflanges a. Carefullyreducedistalbuccalflange.
b. Toothickinlingualposteriorflanges b. Adjustbythinningdenturesfromtheoutside,not
2. Lower thetissueside.
a. Overextensioninthelingual 2. Lower
b. Toothickinposterior a. Carefullyreduceflange
3. Overclosedvertical b. Reducefromoutsidedonotgrindtissueside.
4. Toomuchvertical 3. Remountandreset,correctingvertical.
5. Posteriorstoofarlingual,crowdingtongue 4. Sameasabove.
5. Remountandresetopeningarchtoallowmore
tongueroom.

Gagging
Gagging Causes Solutions
Immediateoninsertion 1. Upper:Overextensiontoothickposteriorborder 1. Denturemustbedoublepostdammedandcutback
2. Lower:distallingualflangetoothick toanteriorpostdam.
2. Carefullyreducefromtheoutside.Donotgrindtissue
side.
Delayedgagging:2weeks 1. Faultypostdamallowingsalivaunderdenture 1. Grindoutpostdamareaandtakewashimpression
to2monthsafterdelivery 2. Malocclusionallowingdenturetoloosencausessaliva forlabrebase.
seepage 2. Remountandmillin,sometimesnecessarytoreset
theteeth.


Esthetic
Toobulkyundernose
Sinkinginundernose
Upperlipsinksintoofar
Showstoomuchteeth
Justlookstoofalse
PhoneticSound
WhistleonSsound
LispingonSsound
ThandTsoundsindistinct
FandVsoundindistinct Improperpositionofupperanterioreitherverticallyor
*Phoneticsoundsdonotreacttoaregulartrialbaseplatethesameasthefinaldenture.Aunibaseonyourtryinwillduplicatefinaldenturephonetics.
Esthetics
Causes Solutions
1. Labialflangeofuppertolongortoothick 1. Reducebulkand/orlengthandrepolish.
2. Upperanteriorteethsettoofarout 2. Resetanteriorslingually.
1. Upperlabialflangeneedsmorebulk 1. Addwaxtobuilduptopropercontourandhavelabbuild
2. Upperlabialflangeneedsmorelength outbase.
2. Grindouttissuesideoflabialflange,addcompound
borderandtakewashimpression.
3. Resetanteriorsforlipsupport.
Upperanteriorteethsettoofarlingual Addwaxonteethtopropercontourandhavelabsetteethmore
labialforlipsupport.
1. Verticaltoogreat. 1. Havelabresetallteethclosingvertical.Maintainesthetics
2. Occlusalplanetoolow bydeterminingtoraiseorlowerupperorlowerteeth.
3. Cuspidsandlateralssettooprominent 2. Havelabresetallteethraisingocclusalplane.
4. Upperanteriorteethsetouttoofar 3. Replacecuspidsandlateralswithsmallerteethandrotate
themin.
4. Resetteethbacktoridge.
1. Settooregular;techniquetypesetup 1. Trysculpturinganteriorincisalstogiveabraded
2. Allteethappeartobethesameshade appearance.Rotateandstaggerteethinsetup.
3. Nogingivalcontouringorstaggeringofgingival 2. Changetocharacterizedanteriorteeth.
depth. 3. Havelabprocessnewbasewithanatomicalfinishand
characterizedbase.
Phonetics*
Causes Solutions
1. Notenoughroomfortonguebetweenupper 1. Removeandmovebicuspidstothebuccalorifroom
bicuspids grindoutmoreareaforthetongue.
2. Spacebetweencentral 2. Closespace.
Toomuchspacefortonguebetweenupperbicuspids Narrowpalatespacebetweenupperbicuspidsbyaddingledgeof
acrylic.
1. Notenoughroomindenturesfortongue 1. Thinoutdenturesfromlingualsidesdontgrindtissue
2. IfThandTsoundaliketheanteriorsaretoo side.
farlingual 2. Remountandmoveanteriorsouttothebuccal.
Difficultadjustmentmustdecodeandtrytocorrect.
horizontally.