Introduction

ction
Removable complete dentures continue to be one of the preferred treatment modalities for
,edentulous patients. Post-delivery complaints are mostly related to actual physical issues
while psychological concerns are relatively rare. In most cases, educating the patient before
starting the treatment process can greatly help both the clinician and the patient to
understand the limitations associated with complete denture use. Most importantly, patient
.motivation plays a key role in overcoming these limitations and ensuring
successful adaptation .
Understanding problems after dentures is important for several reasons. First, it can help
identify unexpected problems early, allowing corrective action to prevent further problems.
Second, it helps improve patient satisfaction with dentures and reduce anxiety or
frustration. Third, it contributes to long-term oral health
Objectives
To identify the problems and complaints experienced by completely
.edentulous patients following the insertion of new dentures

.To analyze the underlying causes of these problems and complaints

Post insertion denture problems
Complaints about comfort
Complaints about function
Complaints about the esthetics
Complaints about the phonetics
Others...
Complaints about comfort
- Sore spots
- Burning sensation
- Redness
- Pain in TMJ
- Tongue & cheek biting
- Swallowing & sore throat
- Nausea & gagging
- Deafness
- Fatigue of the muscles of mastication
Complaints about function of the denture:

Instability or poor fit

Denture dislogment
during function
Complaints about esthetics:
- Fullness under the nose
- Depressed philtrum or naso-labial
sulcus
- Upper lip sunken in
- Too much of teeth exposed
- Artificial look
 Complaints about phonetics:
- Whistle on “S” sounds
- Lisp on “S” sounds
- Indistinct “TH” & “T” sounds
- “T sound like “TH”
- “ F” & “V” sounds indistinct.
Problems Related TO Soft Tissue
Sore spots
Causes
Inadequate coverage of the edentulous ridge
Overextended flanges in the vestibular area

Excessive vertical dimension of occlusion

Sharp bony projections on the ridge

Thin or atrophic mucosa

Unrelieved tori (maxillary or mandibular)

Harmful habits (clenching, bruxism, tobacco chewing)

Local bacterial or fungal infection

treatment
Ensure full coverage of the ridge by the denture base
Reduce and smooth any overextensions
Maintain proper vertical dimension
Smooth sharp bony areas
Relieve or remove any tori
Treat infections with appropriate medication
Advise patient to discontinue denture use for 24–48 hours if needed
Burning sensation
Causes
Pressure on anterior palatine foramen Relieve area over foramen
Pressure on posterior palatine foramen
Pressure on mental foramen
Allergic reaction xerostoma

treatment
Relieve area over foramen
Reline denture; replace as much as possible base
material with new acrylic resin
Redness
Causes
Denture base allergy (very unusual)

treatment
Remake denture and use all metal
base (after allergy test)
Pain in TMJ
Causes
Insufficient vertical dimension of occlusion
Maximum intercuspation not in harmony with centric relation
Arthritis
Trauma

treatment
Increase vertical dimension of occlusion
Make new occlusal record, regrind and
remount occlusion
Treat with analgesics
Gagging
Causes
Overextended or thick posterior border (maxilla)
Poor retention

Thick distolingual flange (mandible)

Incomplete border seal → saliva enters

Improper occlusion → denture shifts + saliva leaks

treatment
Adjust denture or thin posterior border
Reline denture
Reduce thickness or distolingual flange
Increase border seal with self-curing acrylic resin (
possibly at the posterior palatal border
Correct occlusion (clinical remount)
Tongue and cheek biting
Causes
Thin or under extended periphery (base material does not
provide enough support for the cheek)
Insufficient interarch clearance between distal parts of
denture basesImproper Tooth Placement:
Posterior teeth set too buccally or lingually may encroach
on tongue or cheek space, increasing trauma risk.
Occlusal Discrepancies:
Premature contacts or unbalanced occlusion result in
mandibular deviation and accidental biting.

treatment
Denture Border Extension: Add material to extend or thicken denture
flanges for better protection
Tooth Modification: Recontour or reposition teeth to reduce cheek or
tongue irritation.
Occlusal Adjustment: Correct bite imbalances by selective grinding.
Temporary Soft Liners: Used to cushion tissues and help healing.
Patient Education: Teach slow chewing and proper tongue positioning.
Follow-Up Visits: Important to monitor progress and adjust as needed.
Problems Related TO function
Instability or Poor Fit
Causes
Inaccurate impression
Unbalanced occlusion
Lack of proper suction (especially in upper denture)
Severe ridge resorption

Effect on Patient
Discomfort or pain during use
Soreness in the supporting tissues
Difficulty eating or speaking

treatment
Denture relining and rebasing
Denture adjustment
Dental implant
New denture fabrication
Digital denture
Soft liners
Denture adhesive
Denture Dislodgement During Function
Causes
Poor peripheral seal
Lack of muscular control (especially if the patient is new to dentures)
Overextension or underextension of borders
Poorly balanced or high occlusion
Denture is too heavy or uneven

Effect on Patient
Embarrassment in social situations
Loss of confidence in wearing the denture
Fear of eating or speaking in public

treatment
Denture relining and rebasing
Denture adjustment
Dental implant
New denture fabrication
Digital denture
Soft liners
Denture adhesive
Problems Related To Esthetics
Fullness under nose
Causes
Labial flange of maxillary denture too long or too
thick

treatment
Reduce length or thickness of labial flange
Too much of the teeth are exposed
Causes
Labial flange of maxillary denture too
shortExcessive vertical dimension of occlusion
Incisal plane too low
Cuspids and lateral incisors too prominent

treatment
Reduce the vertical dimension of occlusion
Reset teeth at higher plane
Adjust accordingly
bial flange
Artificial appearance
Causes
Technique setup (teeth are too regular in
alignment)
All teeth in same shape
Lack of individualization of teeth
Lack of individualization of denture base

treatment
Individualize by rotating and shortening some teeth
Choose different but complimentary shades; use staining
techniques
Grind incisal edges and angles
Individualize gingival contour and color of denture base
Others..
Maintenance and Hygiene problems

Denture Stomatitis
Bad Odor and Plaque Accumulation
Bad breath (halitosis)
Staining and discoloration of the denture
Faster wear and tear of the denture
Mouth sores and ulcers

Post-Insertion Maintenance
Protocols
Daily Denture Hygiene
Oral Mucosa Care
Night Removal
Regular Recall Visits
Psychological aspects
Psychological Adaptation
Anxiety and Discomfort
Patient Dissatisfaction

Role of Counseling in Adaptation

Providing Psychological Support:
Patient Education
Improving Satisfaction

Adaptation Period
Initial Adaptation :Period take several weeks.
Gradual Adaptation : occur over time, especially if the
patient follows the dentist's instructions and maintains
good oral hygiene.
Regular Follow-Up: improve adaptation to complete
dentures and reduce potential problems.
General Tips
Open Communication: There should be open communication
between the patient and dentist to ensure that the patient's
needs are met and satisfaction is improved.
Good Care: Patients should follow the dentist's instructions on
how to care for their dentures to maintain their health and
prevent problems.
Patience and Commitment: Patients should be patient and
committed to the adaptation period to achieve the best results.
Dentures and Oral Cancer Risk
Poorly fitting dentures can cause chronic irritation,
which over time may increase the risk of developing
precancerous lesions or even oral cancer.
Chronic trauma from ill-fitting dentures is a known risk
factor, particularly when combined with other factors
like smoking or heavy alcohol use.
Old or unclean dentures can harbor Candida or
bacteria, leading to infections or inflammation that
may also contribute to tissue changes.
Signs :
Persistent red or white patches under the denture

Ulcers or sores that do not heal within 2 weeks

Pain, bleeding, or difficulty wearing the denture

Lumps or thickening in the cheek or gums

Prevention & Monitoring Tips
Regular dental check-ups: Even if you have full dentures and no
natural teeth, yearly oral exams are crucial
Proper denture hygiene: Clean daily and remove at night.
Good fit: Replace or adjust dentures every 5–7 years or as
needed.
Avoid risk factors: Smoking and excessive alcohol significantly
increase oral cancer risk
Role of Vitamins in Oral Health

Water-soluble vitamins (B2, B3, B6, B12, folic acid,

C) affect soft oral tissues.

They are not stored in large amounts → need

daily intake.

Vitamins A, D, and K affect hard tissues (teeth,

Effects of Vitamin Deficiencies

Lack of B-complex and C affects tongue,

gums, and lips.
May cause: mouth sores, gum bleeding
(petechiae), weak enamel, and fungal
infections like oral candidiasis.
Vitamins deficiency related to
complete dentures in prosthodontic

Vitamin C deficiency can complicate denture

insertion and negatively impact tissue healing
around the gums and implants. It is important
to address this deficiency before and after
denture placement to ensure optimal healing
and long-term success.
Vitamin C Deficiency on Dental
Healing can lead to :

Impaired Wound Healing

Gingival Bleeding and Inflammation
Pain and Discomfort
 Addressing Vitamin C Deficiency
Before and After Denture Insertion
Pre-Insertion
Assessing and addressing vitamin C deficiency before denture
insertion is crucial for optimal healing. A dental professional may
recommend dietary changes, including increased intake of fruits and
vegetables rich in vitamin C.

Post-Insertion:
Monitor vitamin C intake after denture placement to support gum
healing, reduce inflammation, and maintain oral health.
How we can prevent post insertion
problems related to vitamin c ?

Dietary Recommendations
Supplementation
Maintain good Oral Hygiene

These factors enhance patient

comfort and denture fit and stability
Post-Insertion Instructions
Remove denture at night to rest tissues
Clean denture daily with soft brush & soak
overnight
Start with soft food, chew bilaterally
Practice speech (read aloud)
Report any pain or looseness immediately
Conclusion
CONCLUSION
A thorough knowledge of different factors
required for the fabrication of complete
denture is must before entering the post
insertion checkup. A patient should always
be recalled so that the remaining complaints
can be eliminated.