Inserting full upper and lower dentures requires a consistent routine to ensure maximum comfort and a secure fit. Establishing a good technique minimizes the potential for gum irritation and promotes long-term satisfaction with the prosthetic devices. A correct insertion method is foundational to a successful experience, allowing the wearer to speak and eat with confidence. This routine begins with meticulous preparation and follows a specific sequence for placement.
The Standard Rule: Maxillary First
The standard practice in prosthodontics is to insert the upper (maxillary) denture before the lower (mandibular) denture. This sequence is based on anatomical differences that affect denture stability. The upper jaw offers a large, relatively flat surface with a prominent palate (the roof of the mouth). This broad contact area allows the upper denture to achieve a strong seal and retention through suction alone.
The upper denture uses this stable platform, with gravity assisting the downward seating process once the suction seal engages. The lower jaw presents a challenging environment for a denture by contrast. The mandibular ridge is smaller, often partially covered by the tongue, and constantly exposed to movement from surrounding cheek and floor-of-mouth muscles. Seating the stable upper appliance first creates a fixed, secure surface against which the lower denture can be aligned and seated with less difficulty.
Preparing Dentures for Secure Insertion
Before physical placement, both the mouth and the dentures must be prepared to ensure a hygienic and secure fit. The mouth should be rinsed, and the gums, tongue, and palate should be gently cleaned with a soft-bristled brush. This stimulates circulation and removes residual food particles or bacteria. The dentures themselves must be meticulously cleaned and rinsed to remove any soaking solution or debris.
If denture adhesive is used, the type dictates the preparation of the denture surface. Paste or cream adhesives are most effective when applied to a dry surface, while powder adhesives are sprinkled onto a clean, wet denture. For paste, a small amount (three or four pea-sized dabs) should be placed along the ridges of the fitting surface, avoiding the edges to prevent overflow. Using too much adhesive does not improve retention and creates more residue that needs to be cleaned later.
Step-by-Step Insertion Technique
The first step is to hold the upper denture firmly with both hands, using the thumbs on the inside surface and the fingers supporting the outside. The maxillary denture should be angled slightly, with the back edge inserted first, aiming toward the roof of the mouth at about a 45-degree angle. Once the rear of the denture is positioned against the upper jaw, the front portion is gently rotated and pushed upward until it sits flush against the gums and palate.
To confirm the upper denture is fully seated, apply firm but gentle pressure upward along the entire base of the prosthetic. A slight feeling of suction or a secure seating sensation indicates that the air has been expelled and the retention seal is engaged. The lower denture is then inserted, requiring a different approach due to the lack of a palatal suction area. The tongue should be relaxed and slightly raised to keep the floor of the mouth clear during insertion.
The mandibular denture is aligned over the lower gum ridge, often starting with the front teeth placed first against the gums. The wearer gently rocks the denture back, guiding the entire horseshoe-shaped device to settle over the mandibular ridge. Using the index fingers, gentle and even pressure is applied across the top of the lower denture to seat it fully. Allowing the tongue to find its natural position after seating will help maintain stability, as it plays a dynamic role in stabilization.
After both dentures are seated, the wearer should perform a final check by closing the mouth naturally and swallowing. This helps settle the prosthetics into their final positions and confirms that the bite alignment, or occlusion, feels comfortable and correct. If sharp pain or discomfort is felt, the denture should be removed and checked for obstructions. Forcing the device into place can cause damage to the gums or the denture itself.