Hi dental fans, I’m Dr. Rich. In this video I’m going to go over the steps involved
when I make an immediate denture.
So because patients are all a little bit different, I’m going to make some assumptions
for this video. Your particular situation may be different than what I’m going to describe
but it should be pretty close. First I’m going to assume you’ve already been treatment planned
for immediate upper and lower dentures, you have 28 teeth that need to be pulled,
and none of the teeth are so loose that they will get pulled out by the impressions I’ll be taking.
In my video, “what is an immediate denture” I described what an immediate denture is and
listed it’s pros and cons. I’ll leave a link to that video up here and down in the description.
But basically, an immediate denture is a set of dentures I’ll make for you while you still have
your own teeth that you can smile and eat with. So the first step I do is extract some back teeth.
I’ll extract all the molars and second premolars to get them out of the way. I’ll leave the first
premolars so you can still eat somewhat normally. When I extract the molars and second premolars, I
can extract them all at once or I can extract them in groups, whichever way will work better for you.
Step two after your back teeth are extracted, I’ll take some molds with a material called alginate
in stock impression trays, so I can have the dental lab make a set of custom impression trays.
By removing your back teeth, the impressions will be more accurate.
Once I get the custom impression trays back from the dental lab it’s time for step three.
I’ll take the custom trays and border mold them in your mouth. That means I’ll add material to
the edges of the custom trays to make them even more custom fit. I’ll add material,
insert the tray in your mouth, and then pull on your lips and cheeks
as well as have you open and close and move your tongue all around as the material sets so that way I can get
the most accurate impression of your mouth possible. The more accurate the impression,
the better the immediate dentures will fit. Once I have all the borders of the custom trays finished,
I’ll take a final wash impression to get the rest of the details. At this visit I’ll also
take a bite registration to show the dental lab how your teeth fit together, as well as
have you pick the color of your denture teeth. Step four is the wax try in of the dentures.
Since you still have your front teeth, we can’t try in that part of the denture,
but I will try in the back teeth to make sure they are in the correct position.
We will also double check the color of the teeth you picked to make sure you still like them.
Once I know the bite looks good and you like the color you picked it’s time for step five.
Step five is a big one. I get the finished dentures back from the lab and it’s time
to extract your remaining teeth. Once you are numb and I have extracted your remaining teeth,
I’ll do a procedure called an alveoloplasty.
That’s a fancy name for trimming down your jawbone where your teeth used to be.
I try to remove enough bone so that there are no large undercuts on which your dentures will rub
but I try not to remove too much bone because then the immediate denture will be very loose.
Once the alveoloplasty is done and I suture your gums up, I’ll place the immediate dentures in
your mouth and make some preliminary adjustments to them and to the bite to make sure it’s even.
Once the dentures are in place, I’ll tell you to leave them in until tomorrow morning,
they will act like a bandage on top of your jawbones. I’ll have you come back into the
office the next day so I can check on how you are healing and make any needed adjustments at that time.
I tell my patients that the day they get their dentures is the halfway point of getting immediate
dentures, not the end point. Now once you have them you have to learn how to eat and speak with them in your mouth.
It’s a process and it takes time and practice to learn how to do that. If
you had lost part of your leg and had a prosthetic leg fitted, it would take you time and practice to
learn how to walk and run with it. Well, you just had your teeth replaced with prosthetic teeth.
It's going to take you some time to learn how to eat and speak with them.
From there on out I’ll see you for adjustments as needed. At first the immediate dentures will
feel tight due to the swelling associated with having your teeth pulled. But as your gums heal,
the swelling will go down and the dentures will start to feel loose. Once the gums have closed up
you can start using denture adhesive to help the dentures stay in place. Your jawbone will shrink
quite a bit during this time too. I explain why that happens in my video “why do dentures
get looser over time”. I’ll leave a link to that up here and down in the description.
After about six to eight months, the shrinkage of your jawbone will have slowed down considerably.
At this time I’ll do a denture reline on your immediate dentures.
This involves adding plastic to the inside of your dentures to get a tighter fit.
You may still need to use denture adhesive though depending on how your gums have healed. After the
relines, I’ll be seeing you for adjustments again since the inside of your dentures are brand new now.
So those are the steps I take when I make a set of immediate dentures.
How was your experience with immediate dentures? Please let me know in the comments below.
If you found my video interesting, please give it a thumbs up, and please subscribe to my channel.
Thanks very much for watching, and see you in the next video.