Immediate dentures

The results of a carefully-planned immediate denture can be both pleasing and predictable. Tacoma Denture Clinic has perfected this procedure with 25 years of experience.

Smile Before	Smile After

How are immediate dentures made? How do you take a patient with problem natural teeth to a successful immediate denture finish?

Our approach at Tacoma Denture Clinic has been refined from many years of experience delivering immediate dentures. The primary advantage of an immediate denture is that the patient never goes completely without teeth. If careful planning isn't exercised to control the final result, patients can have an excessively difficult time adjusting to the immediate denture. Our goal is to give the patient the most pleasing, and comfortable immediate denture possible. This makes the patient's transition from their natural teeth to the denture as easy as can be expected for each case we complete.

The general order of appointments required to complete immediate dentures goes as follows:

1. The initial exam appointment: After x-rays and a clinical exam of the teeth indicate that immediate dentures are the appropriate treatment option, the patient is informed of costs and the general course of treatment and appointments required is explained. Informed consent forms for the extractions and the immediate dentures are reviewed and signed by the patient.
2. If the patient has posterior molar teeth present, then the second appointment is set to extract those molars before the denture fitting begins. These teeth are extracted first because it is not possible to guess the shape of the bony ridge the dentures are fit to where larger teeth are removed. That means a denture fabricated on a model taken with the molars still present will fit poorly in these areas. This makes managing the denture fit difficult for both the patient and the dentist. Thus all posterior molar teeth are removed first. After two to three weeks healing, we know the posterior ridge form and the patient is ready for impressions.
3. Impressions are taken of the upper and lower mouth. These impressions give us the models that the dentures are designed on. Before the patient's next appointment, the lab makes bite blocks using these models. These are used in the following appointment.
4. The bite record appointment: Using the bite blocks fabricated on the models from the prior appointment, bite records are taken. These give the dentist and lab the jaw relationships (bite). At this appointment, the dentist also selects the tooth shape and shade. We then consult with the patient about what the tooth positioning will be compared to their natural teeth. The lab then takes the teeth, models, and doctor's directions and uses them to finish the dentures. With the dentures ready, the patient is appointed for the delivery appointment.
5. The delivery appointment: With the dentures finished and ready, we extract the remaining anterior teeth and insert and adjust the dentures as necessary. We can predict the ridge form closely where the anterior teeth are removed, so this does not compromise the immediate denture fit. The patient is asked to keep the dentures in place overnight until the next day. The patient is seen the next day for a post op check. The patient's healing is checked as is the denture fit.

As the patient heals and ridges remodel from the extractions of the teeth, adjustments and soft liners are used to keep the fit comfortable until the patient is six months from the time they received the denture. At this time, the remodeling process from the extractions is over and the patient can be given a more lasting fit. A laboratory reline of the immediate denture is done, which usually allows a comfortable fit for two to three years. The total time for the patient from the extractions of the posterior teeth (the first extraction appointment) to the delivery of the finished immediate denture is generally five weeks