Question about impressions following extractions for upper denture.
 

I am currently wearing an upper partial however the 7 upper teeth that are remaining are now very decayed and I am going to have an upper denture made. The dentist I went to has a lab in his office with a full time lab tech making dentures. He also does general dentistry. He wants me to have my upper teeth removed by an Oral Surgeon. I have already had that consult and 6 of the teeth are considered simple extractions and 1 is being called surgical because it is broken and I am sure it is infected. My sinus cavity is also close to the molars on one side. The dentist will not make immediate dentures for me ahead of time. He said he does not like the fit he gets when he does this. The soonest I can have the impressions is 3 days after the extractions. He will then make the wax try ins that day and will then have the final denture made and ready to insert the next day. My concern is about having the impressions 3 days post extractions. I can wait longer if I want to although the idea of being without teeth horrifies me. I do heal very quickly and my teeth have short roots. Would it be better to wait perhaps a week to get the impressions done? He did explain that I will need many adjustments as the gums shrink. Also will I be putting myself at risk for dry socket if I have the impressions made that soon? Thanks for any advice you can be. This decision has been keeping me awake most night worrying.

Hi roxie,

I personally do not see the difference between taking the impressions before or 3 days post op extractions. Certainly there will be minimal healing by the third day, so the impression will be of what is present at the time. To wait a week is no much different.

Most dentists in my experience, prefer to take the impressions before the surgery and have the immediate denture made ahead of time so it can be placed in the mouth immediately after the extractions. This way, the denture acts as a bandade against the surgical areas, lessens the swelling and it also helps shape the bone and gum to the form of a denture. Frequently, the patient needs to have a new denture made about 6 months to a year later once the mouth has healed. But needing a new denture can occur whether or not the denture is placed immediately after the surgery or a few days later. Sometimes, the immediate denture can be relined a few times and eventually worn permanently without needing to buy a new one for several years.

It could be that the surgeon is going to do what is called alveoloplasty and perhaps some bone grafting when he removes the teeth? Sometimes the dentist will wait a few days or more to place the denture when these procedures are done.

Perhaps you should discuss your surgery and denture placement in more detail with your dentist so you have a clear understanding of what is going to be done and why you need to wait.

If you have more questions, please let me know =)

Bryanna

The dentist I am using will not make dentures ahead of time. He makes all of his patients wait a minimum of 3 days to have their impressions done. He likes to be able to try in the wax impressions with the teeth in them before making the denture and can't do this with teeth still in there. He will not make it ahead of time. I understand that this is different than most dentists and I am not concerned with waiting the 3 days, I was just worried about causing dry socket by making impressions so soon afterwards. He does make dentures all the time this way and I have checked his references and he is rated A+ with the BBB. Thanks for your help.
Roxie

Hi roxie,

To answer your question... yes, there is a slight risk of disturbing the surgical areas when taking the impression for the denture 3 days post op which are bleeding, pain, and loosening of the sutures. Ideally, the surgical areas should not be disturbed for several days or more depending on the degree of surgery that was done. The risk of developing a dry socket is not so much an issue as long as the surgical areas have already clotted completely.

As far as not trying in the wax impressions while the teeth are present.... that is his personal choice but as far as the fit and esthetics, it really does not make any difference on the outcome of the denture.

It is great that his services come so highly recommended!! I wouldn't worry so much about the impressions.... you will probably be ok and if for any reason he thought he should wait longer than the 3 days, then I'm sure he would.

Please keep us posted !
Bryanna

Bryanna,
I just wanted to give you a follow up on my extractions and dental appointment. I had my extractions done 5 weeks ago tomorrow. I did have 1 small sinus perforation but that has healed now. I went back to my dentist on day 4 and had my impressions done and it was no problem at all. I asked my dentist why he wouldn't do immediates and take the impression ahead of time and he said he has been making dentures for many years and that he gets a far better fit by waiting until the teeth have been removed because things can change, there can be bone loss etc... and he is very picky about getting the bite exact. He had me come back after 2 hours and try in the wax ins and then his lab guy came in so the dentist could go over the changes he wanted made for the denture. I received my denture the next evening. I will say that I belong to a dental support group and I have seen many people have problems with their immediates fitting properly and I didn't have that at all. My midline is exact, my bite is now perfect and I have a great fit. By week 3, I was able to go back to completely normal eating. I have had steak, corn on the cob and several other foods that I wasn't able to eat before because my teeth were so bad. I can't tell you the relief it has been to be able to smile, eat and be infection free.
roxie197

Hi roxie.

That is all great news!!!!!!

Dentistry is like any other profession in that not everyone is good at doing everything. Some dentists have a talent for making great dentures while others never seem to get it right. There is no way to know ahead of time how qualified or talented your dentist is going to be and many people feel they just have to put up with the outcome. I personally stress over this issue every day, believe me. I feel that dentists should be honest with themselves and refer their patients to other dentists who they know can do a better job than they can with certain things. But after 30+ yrs..... nobody is listening to my rant anymore ;(

Hope everything continues to go well for you!! It is great to hear of your positive experience... thanks so much for sharing it with us!!

Bryanna