Immediate full or partial dentures are made when teeth are extracted on the same day that the finished dentures are inserted. Immediate dentures are different from regular dentures in that the final impressions are made before some or all of the teeth that are to be removed are extracted. Traditionally, fabricated dentures are constructed to replace an already existing full denture. There is no healing time necessary and the initial fit will be much better because the impressions will exactly reflect the soft tissues on which the denture base rests.
With immediate denture construction, there is an approximation of the fit of the denture base. Because the teeth are still in place when the denture is being constructed and tried in, the fit will not be as exact initially. It is more difficult to try in the immediate denture to check for fit and appearance when the teeth are still in place. This is especially true when the natural teeth that will be removed have drifted far out of their original position. Immediate dentures are made so that the patient will not be forced to be without teeth while the gum tissues heal and the remaining tissue ridges reach their final shape. This final healing can take 3 to 6 months after the teeth are removed.
The immediate denture will be inserted the same day the teeth are removed. Because of this, the patient will be numb and swollen from the local anesthetic, and not really able to tell much about the comfort of the denture base and the set of the denture teeth against the opposing jaw and teeth. Expect several appointments with us during the healing period as the swelling goes down and the denture base settles. Your bite will change and need to be readjusted. The more teeth removed at the time the immediate denture is delivered, the longer it will take to heal and the more sore spots you will have.
Sometimes we will advise removing some teeth as the denture is being made, leaving only a few front teeth in place. This will help make a more accurate fit of the immediate denture. Of course, every case is unique. Expect many sore spots and places where the tissue is rubbed raw. When this happens, take out the denture and see us immediately. If you continue to wear the denture without adjustment, the gum tissue will be badly damaged and it will take longer to heal. Although the general process of making an immediate denture is close to that of a traditional full denture, the immediate denture construction poses different and more significant problems.
After the tissue completely heals at the extraction site, the denture base will need an addition of more plastic. This is called a reline. The extra plastic will fill in the space between the denture base and the new position of the soft tissue. Originally, this space was estimated in the sites where the teeth had not yet been removed. Tissue shrinkage will continue for some time, but after about 6 months, it slows down enough that it is practical to do the reline. With either immediate dentures, or after some years of wearing dentures, the tissue may change enough that relines are again necessary. As you age and have no teeth, the bone in the jaws gets smaller. The plastic base of the denture does not change along with the jaw changes, so a periodic reline is necessary.
It is possible that after many years of missing teeth, the bone on which the denture sits becomes so small that it is difficult, if not impossible, for a denture to remain properly in place. Dental implants may help retain the denture. Some surgical procedures may help.