Excluding mini adjustments that the dentist performs at the chairside whilst you wait eg. Smoothing a sharp area, the main adjustments that may be needed for complete dentures are:
you may fracture the denture base from dropping them, or accidentally sitting on them (it happens!). Over time, a heavy bite or grinding, can fatigue the denture and cause it to crack. Sometimes it is a clean break, other times you see cracks starting to appear . If you notice this happening, a break is imminent, so see your dentist to get it sorted before it does.
you can also fracture teeth by dropping the denture or occasionally by biting something hard at the wrong angle. Sometimes a tooth may come off the denture- this is more likely to be due to a failure of the attachment to the denture base. Teeth can also occasionally look fractured from excessive wear; the actual appearance depends on your bite and the way the teeth have been moving across each other. This is more difficult to repair, since it involves multiple teeth and your bite has become accustomed to the new worn shape.
- Relining or rebasing. To get maximum suction, and the best fit and comfort, the denture needs to fit closely and evenly on your gums and ridges. Where this is no-longer the case (generally as a result of bone resorption over time) yet the teeth are still good and other aspects of the denture ok, a reline or rebasing can be done to improve the accuracy of the fit. Rebasing or relining- these two phrases have become somewhat interchangeable, for describing putting a new underside or fitting surface on your denture to make it fit more closely.
There are three basic types of reline:
this uses the same hard acrylic material as the denture itself.
(ii) Soft reline-
this is, as the name suggests a softer lining inside the denture which improves comfort in situations where a convential hard acrylic can be sore. Special cleaning
is required for this type of reline and it is not as durable as the standard hard acrylic, picking up food and bacteria much more easily. For this reason, it tends to be reserved for:
- After surgery, during healing.
- Older patients, with very thin mucosa or gum overlying their ridges- the denture can be sore with pressure on chewing.
- Exposed mental nerve- sometimes the lower bony ridge can resorb so much that the mental nerve, comes to lie at the surface and this can be painful when anything touches it. A soft lining can really help in this situation.
- Other bony anatomy such as tori, that rubs and requires a little extra cushioning.
- Temporary. During healing phases, whilst changes are still being seen to your gums e.g. after an immediate denture or in order to reduce inflammation e.g. from denture stomatitis- a temporary reline material (such as Viscogel) can be used to improve the fit. This short term soft lining material has a cushioning effect and helps distribute pressure more evenly to your gums. This promotes healing before a more durable, longer term lining, is put into your denture. This reline is done by the dentist in the chair, without the laboratory and as such, is the least durable (hence ‘temporary’). It wears and stains more quickly than the other types of reline and is more tricky to keep clean.