I needed to get my upper denture replaced as it was getting quite old. My dentist started with the impression, then did the wax bite and two wax try-ins. At both wax try-ins I mentioned that the denture wasn’t fitting properly. I could not keep the denture in. He assured me that would not be a problem because the wax-try ins were mostly to get the shape of the teeth correct. But when the denture came in there was no suction at all Just like the wax try-ins, I could not keep it in. The dentist told me to come back in a week and by then my gums should have adjusted. I waited. He thought maybe my bite was off and did some grinding. That included really grinding down my molars. Then he gave me some Fixodent and told me to wear that for another week to help keep them in while my gums adjust (again). but that did not help. Now he’s talking to his assistant about doing a reline? Is this something that could actually help or should he just make a new denture?

Brooke

Dear Brooke,

The good news is doing a reline should help solve this problem. I am sure you are frustrated and have lost confidence in this dentist. While I wasn’t there, based on what you said, he skipped a few steps we were taught to do in dental school when it comes to fitting dentures. This is rather common because there is a lot of competition in the denture market. Some dentists will try to get their prices lower than the next guy to draw patients in and try to make up the lost income by cutting some corners. In many cases, it can work out anyway, but obviously, for yours it did not. Doing this reline should fix the problem because to do that they will basically have to redo the impression.

The most accurate impressions use a two (or three) step impression. The only difference between the two and three is in how the custom tray is made. In the three step process, the dentist will use an alginate to make a preliminary impression and model of the patient’s jaw, from which they or their assistant will make a custom tray to fit the patient’s impression. In the two step process, instead of this preliminary impression, they will use a moldable stock tray. Many dentists find that to be just as good. Whichever method they use, the most important part of the process is what follows.

The borders of your denture are what is responsible for keeping it in with suction. To accomplish that you need good border molding. Dentists should use a heavier impression material to help register what will be those borders. Using a heavier material, helps it to press into the tissue better giving a more accurate result. This will be followed by a light material, called a wash, that will get all the tiny details needed. Some dentists combine these two steps into one using a medium material.

To do the reline, your dentist will probably use your current dentures as the tray, which will help him get a more accurate impression this time around. If he has not already taken the new impression, ask him to do the two-step impression.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.