P O S T-P L A C E M E N T 

    P R O B L E M     S O L V I N G

PROBLEMS RELATED TO SOFT TISSUE

Complaints/area Causes Treatments

Sore spots - mandible

Peripheral areas Overextension Adjust denture accordingly
Unpolished or sharp edge Polish denture borders
Herpetic or apthous ulcer Leave denture out as much as
possible and wait 7-10 days
Crest of ridge Bone spicules Identify the area in denture with
pressure – indicating paste and
provide relief over spicule
and/or surgically remove
spicule
Spinous ridge crest Provide relief in the denture
Pressure spots at time of impression Use PIP or indelible pencil to
determine the areas and adjust
accordingly
Occlusal prematurities Correct occlusal defects,
recheck vertical dimension and
clinical remount
Side of ridge-  Overextension Use pressure indicating paste
anterior area and adjust denture border
involved
Maximum intercuspation not in harmony with  Enlarge centric area; grind
centric relation mesial inclined planes of
maxillary teeth and distal
inclined planes of mandibular
teeth using a clinical remount
Side of ridge-  Lingual tori ( nonyielding areas) Provide adequate relief in
bicuspid area denture base
Pressure spots at time of impression Adjust denture accordingly
 Shrinkage of denture during Rebase denture
processing ( dimensional changes)
Error in occlusion - occlusal prematurities Check occlusion on the
opposite side of arch from the
sore spot
Pressure on mental foramen if ridge is greatly Provide adequate relief
resorbed
Side of ridge- Overextension in lateral throat area Shorten posterior of lingual
posterior area flange
Error in occlusion Check teeth diagonally across
the arch from the sore area
Spinous projection of mylohyoid ridge Correct undercut surgically; you
distolaterally ( feeling of sore throat) must under extend the denture. 
Relieve denture if not severe
Overextension in anterior area (causes rotation Adjust peripheral overextension
of distal flanges)
Under lingual flange Maximum intercuspation not in harmony with Enlarge centric area and adjust
centric relation (drives mandibular denture local area-
forward)
Under labial flange Excessive overbite Adjust anterior occlusion
Habit- mastication in protrusive relation Train patient to masticate in
centric
Generalized Heavy biting force- strong musculature Reduce buccolingual width of
soreness and teeth; reduce vertical
redness dimension; use soft lining if
necessary
Excessive vertical dimension of occlusion Reduce vertical dimension
Locked occlusion Enlarge centric area
Failure to provide freedom for Bennett Reduce cusps to a
movement (soreness usually on working side nonanatomical plane or reset
teeth
Improperly processed base material Rebase denture

Sore spots - maxilla

 
Peripheral areas Overextension Adjust denture accordingly
Unpolished or sharp edge Polish denture borders
Herpetic or apthous ulcer Leave denture out as much as
possible for 7-10 days
Maxillary frenum Overextension Open a V-shaped notch for the
labial frenum and widen the
buccal frenum areas
Posterior border of Sharp edge at the post dam area Adjust sharp edge slightly
denture without reducing dam area
Midline of denture Prominent midsuture or torus maxillaries Provide some relief over the
area

Generalized discomfort
 
Improper occlusion Correct occlusion (clinical
reline)
Maximum intercuspation not in harmony with centric relation Enlarge centric area (clinical
reline)
Excessive vertical dimension of occlusion Reduce vertical dimension
(clinical reline)

Burning sensation
 
Maxillary anterior Pressure on anterior palatine foramen Relieve area over foramen
hard palate and
anterior alveolar
ridge area
Maxillary bicuspid Pressure on posterior palatine foramen Relieve area over foramen
area or molar
tuberosity
Mandibular anterior Pressure on mental foramen Relieve area over foramen
region
Generalized Improperly processed Reline denture; replace as
much as possible base material
with new acrylic resin
Tongue Allergic reaction xerostoma

Redness
 
Fiery redness - All Denture base allergy (very unusual) Remake denture and use all
tissue contacted by metal base (after allergy test)
denture including
tongue and cheeks
Bearing tissues Ill-fitting denture, Avitaminosis Remake or rebase dentures.
Employ vitamin therapy
regimen

Tongue and cheek biting

 
Thin or under extended periphery (base material does not provide Build out thin areas, or extend
enough support for the cheek) the short periphery
Insufficient interarch clearance between distal parts of denture bases Thin maxillary denture over
tuberosity; if more space is
required, remove it from the
retromolar area of the
mandibular denture
Inadequate amount of horizontal overlap in molar region Re-contour buccal surface of
mandibular molars and
bicuspids; eliminate the tight
contact of the maxillary buccal
cusps on the mandibular buccal
surfaces

Pain in TMJ
 
Insufficient vertical dimension of occlusion Increase vertical dimension of
occlusion
Maximum intercuspation not in harmony with centric relation Make new occlusal record,
regrind and remount occlusion
Arthritis Treat with analgesics
Trauma Treat with analgesics

Gagging
 
Immediately upon Maxillary denture overextended or too thick in Adjust denture or thin posterior
insertion posterior border border
Lack of retention Reline denture
Mandibular denture too thick in distolingual Reduce thickness or
flange distolingual flange
Delay (2 weeks - 2 Incomplete border seal allowing saliva under Increase border seal with self-
months after denture curing acrylic resin ( possibly at
insertion) the posterior palatal border
Improper occlusion causing denture to loosen Correct occlusion (clinical
and allowing saliva under denture remount)

Deafness
 
Excessive vertical dimension of occlusion Excessive vertical dimension of
occlusion

Fatigue of the muscles of mastication

 
Excessive vertical dimension of occlusion Reduce vertical dimension of
occlusion
Insufficient vertical dimension of occlusion
PROBLEMS RELATED TO FUNCTION
Complaints/area Causes
Instability
Looseness of mandibular denture Error in occlusion (maximum
intercuspation not in harmony with
centric relation)
Occlusion plane too high
Underextension of periphery
(inadequate impression)
Inability of patient to master denture develop skill in handling denture
Tongue position (retracted tongue)
Looseness Occasionally
of maxillary Underextension in some area
denture
Faulty occlusion
Overextension of peripheries
Dehydration of tissue due to
alcoholism
Displacement of flabby tissues when impression technique to change
making impression
When eating on Nonyeilding area in hard palate
either side (ridge tissue yields under chewing
stresses; denture rocks on hard area
Incorrect tooth position (teeth may
beset too far buccally off ridge
Chewing resistant foods
Approximately every
2 hours
Heavy mucinous saliva
Incorrect tooth position ( teeth may
Increase vertical dimension of
occlusion
Treatments
Correct faulty occlusion by
remount and regrind procedure
Reset teeth at a lower plane
Rebase denture providing proper
extension
Use denture  adhesives to help
( for a short time only)
 
Correct with self-curing acrylic
resin; first check with compound
for diagnostic purpose
Correct Occlusion
Adjust denture accordingly
Remove cause
Correct surgically; modify
primary denture stress-bearing
area to the buccal shelf
Provide relief chamber over non-
yielding area
Rebalance in lateral excursions;
reset teeth where nature should
have had them
Instruct patient to maintain soft
diet until mouth is conditioned to
wearing denture
Prescribe astringent
mouthwashes and regular
scrubbing of dentures; reduction
of carbohydrate
Correct surgically; change
 primary denture stress -bearing 
be set too far buccally and labially
area to the buccal shelf
Train patient to masticate in
Improper incising habits
centric relation
Loss of posterior palatal seal (seal
Increase postpalatal seal with
on hard palate; posterior limit not in
self-curing acrylic resin; first use
hamular notches; insufficient valve
compound as a diagnostic aid
seal)
When yawning or Denture base too thick in buccal
opening wide posterior area (coronoid process
Reduce thickness of denture
exerts forward and downward force
base
on posterior of denture upon
opening)
Shorten denture until
pterygomaxillary ligament does
Overextended in hamular notch not exert tension on posterior
border when mouth is opened
wide
Increase postpalatal seal with
Inadequate posterior palatal seal
self-curing acrylic resin
When talking Increase postpalatal seal with
Inadequate posterior palatal seal
self-curing acrylic resin
Shorten posterior until soft palate
Overextended in posterior region does not lift upward and break
contact with the denture base
When occluding in Improper occlusion Correct occlusion
centric relation
Correct surgically; change
Poor denture foundation  (flabby
primary denture stress-bearing
tissues over ridge)
area to the buccal shelf
Incorrect tooth position (teeth set too
Reset teeth
far buccally)
Maximum intercuspation not in
Enlarge centric area
harmony with centric region
Nonyielding area in hard plate Provide relief in area
Only a feeling of
looseness (support
Provide relief chamber, adequate
and retention are Large area of nonyeilding tissue in
to permit denture to be properly
present yet denture hard plate
seated
feels suspended in
mouth

Interference
When swallowing Maxillary denture too thick or over-
extended in posterior region
Mandibular denture too thick or
overextended in posterior lingual
Reduce thickness or adjust
posterior
Reduce thickness or adjust
posterior lingual flange area
 flange area
Insufficient vertical dimension of
Reduce vertical dimension
occlusion
Excessive vertical dimension of
Reduce vertical dimension
occlusion
Incorrect tooth position (posterior
teeth set too far lingually - tongue Reset teeth
crowded
Clicking Excessive vertical dimension of
Reduce vertical dimension
occlusion
Ill-fitting dentures New dentures
Overextended lower dentures Reduce peripheral length

PROBLEMS RELATED TO ESTHETICS

 
Complaints Causes Treatments
Reduce length or
Fullness under nose Labial flange of denture too long or too thick thickness of labial
flange
Increase length or
Depressed philtrum Labial flange of mandibular denture too short thickness of labial
flange
Reset anterior teeth
Upper lip sunken in Maxillary anterior teeth set too far lingually
labially
Too much of the teeth are Reduce the vertical
Excessive vertical dimension of occlusion
exposed dimension of occlusion
Reset teeth at higher
Incisal plane too low
plane
Cupids and lateral incisors too prominent Adjust accordingly
Artificial appearance Individualize by rotating
Technique setup (teeth are too regular in
and shortening some
alignment)
teeth
Choose different but
All teeth in same shape complimentary shades;
use staining techniques
Grind incisal edges and
Lack of individualization of teeth
angles
Individualize gingival
Lack of individualization of denture base contour and color of
denture base

 
 PROBLEMS RELATED TO PHONETICS
 
Complaints Causes Treatments
Whistle on "S" sounds Increase the palatal
resin convex
contours  lingual to
the maxillary central
Air stream passes unimpeded or with inadequate
incisors to impede
impedance between the dorsal surface of the
the air stream
tongue and the anterior palate
passing between the
tongue and palate. 
Create rugae if
necessary
Lisp on "S" sounds Reduce occlusal
The air stream passing between the tongue and vertical dimension
anterior palate is excessively impeded, usually until premolars no
by rugae or excessive resin contour longer contact during
speech
Maxillary & Mandibular incisors Reduce occlusal
or premolars contact during vertical dimension
sibilant (s, sh, z, ch) sounds Occlusal vertical dimension too great until premolars no
longer contact during
speech
Clinician observes that incisal Evaluate lip support
edges of maxillary incisors and overall
contact the lower lip 1 mm or appearance of
more labial to the wet/dry junction anterior teeth as they
of lower lip when "F" & "V" are positioned. 
sounds are made Reset to a more
lingual postiion as
Maxillary teeth may be set too far labially
needed.  incisal edge
of maxillary incisiors
should contact the
wet dry junction ro
just lingual to it during
production of the "F"
& "V" sounds.