complete dentures, complaints, post insertion , common and uncommon complaints, management

1. Vinay Pavan Kumar.K
2nd year P G student
Dept of Prosthodontics
AECS Maaruti College of Dental Sciences

2. Post insertion
complaints
Classification of post
insertion denture
problems
Management
Common
Complaints
Uncommon
Complaints
Complains on
aesthetics of
the denture
Complains on
phonetics
Complains on
comfort of the
denture

3. “ Most of the complaints associated with complete dentures
are actual and not psychological, contrary to the belief of
most clinicians.”
Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending
Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pg: 1-8
“There was no statistically significant relationship
between patient age, gender, systemic health and denture
complaints; but statistically significant relationship exist
between types of denture, denture faults and complaints.”
Ogunrinde.T.J, The Influence Of Demographic Factors And Medical
Conditions On Patients Complaints With Complete Dentures. Ann Ibd. Pg.
Med 2012. Vol.10, No.2 16-21

4. Classification of post insertion
denture problems
 Complaints abut comfort of the denture:
- Sore spots
- Burning sensation
- Redness
- Pain in TMJ
- Tongue & cheek biting
- Swallowing & sore throat
- Nausea & gagging
- Deafness
- Fatigue of the muscles of mastication.

5.  Complaints about function of the denture:
- Instability or poor fit
- Interference
a) When swallowing
b) Clicking
• Complaints about esthetics:
- Fullness under the nose
- Depressed philtrum or naso-labial sulcus
- Upper lip sunken in
- Too much of teeth exposed
- Artificial look

6.  Complaints about phonetics:
- Whistle on “S” sounds
- Lisp on “S” sounds
- Indistinct “TH” & “T” sounds
- “T sound like “TH”
- “ F” & “V” sounds indistinct
www.medkaau.com

7. According to Sharry
 Frequent Complaints :
- Excessive bulk
- Speech difficulties
- Masticatory shortcomings
- Insufficient retention
- Mucosal irritation
- Unattractive Apperence
Sharry.J.J Complete denture Prosthdontics, 3rd edition, chapter 17, pg 358

8.  Uncommon Complaints:
- Whistling - Rough & sharp surfaces
- Ear ache - Dull teeth
- Difficult swallowing - Halitosis
- Loss of taste sensation - Dry mouth
- Saliva under the dentures - Noisy teeth
- Peculiar taste - cheek, lip & tongue biting
- Food under the denture - nausea & gagging
- Dislodgement on sneezing - tingling of the lower lip
- Dislodgement on drinking - burning of mouth
- Drooling at the corner of the mouth
- Inability to chew with equal vigor on both side.

9. According to Grant.A.A
 POST INSERTION PROBLEMS CAN BE BROADLY
GROUPED INTO:
 Looseness of dentures
i. Decreased retentive forces
ii. Increased displacing forces.
 Discomfort associated with dentures
i. Related to impression surface of denture
ii. Related to occlusal surface
iii. Related to polished surface
iv. Related to possible systemic association

10.  Support problems
 Problems associated with retention and stability
 Other difficulties
i. Noise on eating and speaking.
ii. Speech problems.
iii. Eating difficulties.
a. Altered taste sensation.
b.Gagging (nausea).
A.A.Grant, J.R.Heath, J.F.McCord- complete prosthodontics problems,
diagnosis & management (1994)

11. Denture Complaints in relation to
time of delivery
 Immediate complaints.
 Delayed complaints.
 Problems without complaints.

12. Presentation of patient with
complaints
 Informed patient of possible problems.
 Un-informed patient:
 Sense of pain.
 Sense of loss (waste of time and money).
 Sense of deceit.

13. Pain
 Over extension of borders
 Poor fitting or rough surface dentures
 Error during impression making
 Incorrect centric relation or cuspal interferences.
 Excessive vertical dimension
 Uneven occusal balance and anterior contact at CR
 Inadequate relief to the prominent genial tubercle &
myloid ridge

14. Loose denture
 PPS is not successfully made.
 Lingually placed posterior teeth
 Labially placed mandibular anterior teeth
 Dryness of mouth
 Occusal discrepancies
 Inaccurate impression making
 Rocking, tilting dentures (poor retention)
 Nodules of acrylic- faulty impression /poor
processing techniques

15. Faulty esthetics:
 Unrealistic expectations
 Over supported or under supported dentures
 Altered vertical dimension
Defective speech:
 increased vertical dimension
 deficiency of palatal contour
 Poor PPS region
 Thick lingual flanges or restricted tongue
movements

16. Inefficacy
 Discrepancies in vertical dimension and CR
 Worn off teeth
 Zero degree posteriors
 Lack of occlusal balance
 Occusal plane se at higher level
Nausea & Gagging
 Over extended posterior limit of maxillary denture
 Thick posterior borders or loose denture
 Uncommon belief

17. Fibrous hyperplasia
 Continous wearing of ill fitting denture
 Usually painless
Microbial Infection
 Poor oral & denture hygiene maintainance
 Diabetes and oral habits

18. Costen’s syndrome:
• Prolonged over closure
• Deafness, tinnitus,
• Tenderness over the TMJ
• Dryness of mouth
• Neuralgic symptoms – burning sensation of
tongue, throat and headache.

19. Uncommon complaints
 Whistling : high vault palate
 Ear ache : TMJ problem
 Food & saliva under denture : may be deficient of borders
 Loss of taste
 Cheek biting : lack of horizontal overlap, decreased VD
or buccal placement of teeth
 Drooling saliva : inadequate VD
 Allergy : pigment or residual monomer of denture resin

29. CONCLUSION

30. References
• Nair KC, A primer on complete denture fabrication, 1st
edition, 2013, Ahuja publication, India Pp 158 -166
 Winkler S, Essentials of complete denture Prosthodontics
2nd edition, 2012, AITBS Publishers, pp 318 – 330
 Sharry JJ, Complete Denture Prosthodontics, 3rd edition,
USA, Mcgraw-Hill Book Company, 1974, pp 289-294.
 Heartwell C M , Syllabus of complete dentures, 4th edition,
1984, Varghese Publishing House, 407 – 420

31.  GrantA.A, Heath.J.R, McCordJ.F, complete prosthodontics
problems , diagnosis& management (1994)
 McCord J. F. and Grant A. A. , Identification of complete
denture problems: a summary, British Dental Journal 2000;
189: Pp:128–134
 Jethlia.H, Post Insertion Problems And Their Management In
Complete Denture journal of Evolution of Medical and Dental
Sciences.Vol 2(3) Jan, 2013 pp 194-99
 Verma.M ,Post Insertion Complaints in Complete Dentures - a
never Ending Saga; Journal of Academy of Dental Education,
Vol 1, No 1 (2014), Pp: 1-8