PROSTHO SEM 2 LESSON 3

COMPLAINTS ABOUT COMFORT OF THE DENTURE 5. Tongue & cheek biting

1. Sore spots or epulis fissuratum

Cause: pressure spot on that area; over extended

denture also causes sore spots Cause: not enough buccal corridor
Tx: put paste then check for the pressure spot then Tx: create buccal corridor, check on the buccal corridor
reduce (should be sexy)
2. Burning sensation Cause: setting posterior off-ridge buccally
Cause: seen on anterior part of the upper due to pressure Tx: place central fossa on crest of the ridge
on anterior palatine foramen or incisive papilla
Cause: increased or decreased vertical If increased
Tx: relieve the incisive papilla wherein we have nerve vertical
endings
Tx: reduce the vertical
3. Redness
Tongue biting - setting the teeth too lingual
Cause: allergic reaction on material used on denture
Tx: place central fossa of the lower on crest of the ridge
Tx: change self-cure acrylic with _____
6. Difficulty in swallowing & sore throat
Cause: newly installed denture; wrong occlusion or
increased vertical dimension
Tx: Change the material 7. Nausea & gagging
Cause: overextended denture on posterior palatal seal
(PPS); thickness of denture bases on posterior part or
palatal area
8. Deafness
Cause: increased or decreased vertical dimension
9. Fatigue of the muscles of mastication
Willis Measurements (1939)
• Proportional measurements
• Lower border of septum of nose – lower border of
chin = Outer cantus of eye – corner of mouth
4. Pain in TMJ
Cause: wrong vertical dimension (decreased or
increased); setting of artificial teeth; wrong occlusion
Solution: correct the vertical or occlusion
 PROSTHO SEM 2 LESSON 3

Consequences of Increased Vertical Dimension

• trauma on tissue – due to premature striking of teeth
• pain in the TMJ
• more awkward to manipulate – due to longer
leverage
• clicking of dentures
• more easily displaced
• face appears long
• patient could hardly close his mouth
• rapid destruction of residual ridges
• facial muscles appears strained
Consequences of Decreased Vertical Dimension
• reduces function of the muscles with resultant loss Before pic:
of muscle tone
• cause creases at the corners of the mouth 1. anterior teeth should touch the lower lip.
• causes loss of space in the oral cavity with an adverse Cause: pontics on anterior used are too short;
effect on the eustachian tube – affecting hearing abrasion on anterior teeth
• trauma on the TMJ Tx: replace the anterior teeth, use a longer pontic
• chin appears too far forward 2. too much teeth are exposed, no buccal corridor
• shrunk appearance of the face Lip Length vs Incisal Display
• vermillion border of the lips reduced approximately
to a line
• lips lose their fullness
• face is flabby instead of being firm
• corner of mouth turn down or droop
COMPLAINTS ABOUT FUNCTION OF THE DENTURE
• instability or poor fit – ill-fitting
Tx: denture relining
• interference
a) when swallowing – increased vertical Lip Length Incisal Display
Tx: adjust setting (try-in); if minimal 2mm 10-20 mm 3-4 mm
reduction on the occlusal, if 3-4mm remake the 20-25 mm 2 mm
denture (delivery); or reduce the pontics 26-30 mm 1 mm
b) clicking 30 and over 0 mm
COMPLAINTS ABOUT ESTHETICS
• fullness under the nose → reduce the wax or Female Male
remove the flanges; check side-view (base of nose Young +2 +1
and upper lip should be in right angle, if obtuse angle Middle +1 0
you need to add sufficient lip support, if acute there’s Old 0 -1
too much support)
• depressed philtrum or nasolabial sulcus
• upper lip sunken in due to insufficient lip support
• too much of teeth exposed
• artificial look
 PROSTHO SEM 2 LESSON 3

(From the internet, doc said self-study)

• Dry mouth may lead to loose dentures, irritations,
sores, and possible infections for denture wearers.
• There are several factors that may contribute to dry
mouth:
→ Aging.
→ Medications.
→ Illness.
→ Cancer treatment.
→ Nerve damage.
→ Smoking.
2nd pic: gummy smile due to wrong setting of upper
anterior teeth, setting it too low → Mouth breathing.
→ Poor hygiene or unhealthy eating habits.
Tx: reset it a little higher to its correct position or level
3rd pic: incisal of upper does not touch the lower lip due
to wrong size of pontics • occlusal discrepancies – wrong setting or occlusion,
increased or decreased vertical affects retention
Tx: replace to shorter pontics • inaccurate impression making
COMPLAINTS ABOUT PHONETICS • rocking, tilting dentures (poor retention) – wrong
taking of final impression → Tx: Relining and Rebase
• whistle on ‘S’ sounds – if too much air, decrease the of denture
freeway space • nodules of acrylic – faulty impression/ poor
• lisp on ‘S’ sounds processing techniques
• indistinct ‘TH’ & ‘T’ sounds
Normally if there is problem with retention the
• ‘T’ sound like ‘TH’ – tongue touches lingual of upper
laboratory is at fault due to wrong processing
anterior teeth; setting of upper anterior is too lingual
techniques.
• ‘F’& ‘V’ sounds indistinct – lower lip touches the
incisal of upper; upper anterior is set too low Green – Relief Areas
(problem with f & v) or set too high (pag mahangin)
Red – Supporting Areas
Phonetics - thickness of denture bases on posterior part
or palatal area Blue – Limiting Structures

COMPLAINTS ABOUT RETENTION

• PPS not successfully made

• lingually placed posterior teeth – tongue will
displace the denture
• labially placed mandibular anterior teeth – if too
much it will dislodge the denture
• dryness of mouth – too sticky saliva affects retention
What type of saliva is good for denture retention?
Mucous, Serous, or Mixed?
➢ It is best to work with a serous type. Thick saliva
makes dentures more difficult to wear. The amount
and consistency of saliva affects the impression
making procedure. Excessive salivation, particularly
by the submandibular and sublingual glands,
presents a problem in impression making.
 PROSTHO SEM 2 LESSON 3

DENTURE COMPLAINTS IN RELATION TO TIME OF

DELIVERY
• immediate complaints (pain, problem with TMJ)
• delayed complaints
• problems without complaints
It is a must to recall patient after 24-hours after time of
delivery.

UNCOMMON COMPLAINTS
• rough and sharp surface – causing sore spots
• ear ache
• dull teeth
• halitosis – patient hygiene or denture cleaning
• loss of taste sensation
• dry mouth
• saliva under dentures
• allergy
• noisy teeth – clicking of denture due to increased
vertical
• peculiar taste – may be due to material used
• food under the denture – tissue side is not properly
adapted to ridges
• dislodgement on sneezing
• tingling of the lower lip – there relief areas being
impinged
• dislodgement on drinking
• drooling at the corner of the mouth – due to decreased
vertical
• inability to chew with equal vigor on both sides
• lack of horizontal overlap
• decreased VD