Receiving new dentures involves a personalized sequence of appointments designed to ensure the replacements for missing teeth are functional and aesthetically pleasing. This process is a collaboration between the patient, the dentist, and the dental laboratory, focusing on capturing the unique contours of the mouth and the precise relationship between the upper and lower jaws. Crafting a successful denture requires patience through multiple stages, as the final result depends on the accurate transfer of patient data into a prosthetic device. The goal is to create a removable replacement that supports facial aesthetics and enables comfortable speaking and eating.
Phase One: Planning and Primary Molds
The denture fitting process begins with an initial consultation where the dentist conducts a thorough oral examination of the gums, underlying bone structure, and any remaining teeth. This appointment includes a detailed review of the patient’s medical history and a discussion of their needs to determine whether a full or partial denture is the appropriate treatment plan. The dentist assesses the health of the oral tissues, as existing conditions like gum disease or residual roots must be addressed before prosthetic fabrication.
The first physical step is taking a preliminary impression using a stock tray, which is a standardized, off-the-shelf tray that comes in limited sizes. A material like alginate or impression compound is used to capture a rough, negative mold of the denture-bearing areas, including the gums and surrounding soft tissues. This primary impression is not precise enough for the final denture, but it serves an important purpose in the overall process.
The resulting preliminary mold, or cast, is sent to a dental laboratory, where technicians use it to fabricate a custom impression tray specifically shaped to the patient’s unique anatomy. This individualized tray is made from materials like acrylic resin and is designed to cover the exact area the final denture will occupy. The custom tray allows for the use of more accurate impression materials and ensures a uniform thickness during the next, more detailed molding stage.
Phase Two: Precision Impressions and Jaw Relationship
The custom tray created in Phase One is used in the next appointment to take the highly accurate secondary impression, which serves as the detailed blueprint for the final denture base. The dentist first refines the tray’s edges to ensure they terminate precisely where the muscle tissues of the cheeks, lips, and tongue meet the stable gum tissue. This process, called border molding, is performed to ensure the denture will have a functional seal that aids retention.
Using a low-viscosity material such as polyether or zinc oxide eugenol paste, the dentist captures the precise detail of the soft and hard tissues that will support the denture. This secondary impression is then used by the laboratory to create the master cast, an accurate replica of the mouth upon which the final denture will be built. This level of detail maximizes the fit and stability of the finished prosthetic.
A separate, important step in this phase is recording the jaw relationship, which involves determining the correct vertical and horizontal alignment of the upper and lower jaws. The dentist uses temporary wax rims built on temporary baseplates to establish the vertical dimension of occlusion, which represents how far the jaws open when the teeth are together. They also record the centric relation, the most retruded and superior position of the mandible relative to the maxilla, ensuring the new bite is stable and repeatable. This measurement process is fundamental to the comfort and chewing function of the final denture.
Phase Three: The Aesthetic Try-In
Once the master casts and jaw relationship records are complete, the dental laboratory fabricates a wax mock-up, setting the artificial teeth into the wax baseplate according to the recorded measurements. This mock-up allows the patient and dentist to evaluate the dentures before they are permanently processed into hard acrylic. The aesthetic try-in appointment is the last opportunity to make significant changes to the appearance and function of the prosthetic.
The primary focus during this appointment is on aesthetics and patient approval, including the shade, size, and arrangement of the teeth. The dentist evaluates the lip support, the visibility of the teeth when speaking and smiling, and the alignment of the midline with the patient’s facial features. The patient is given a mirror to check the appearance and is encouraged to speak and make facial expressions to ensure the teeth look natural and appropriate for their face.
The functional aspects are also checked, using the wax model to confirm the established vertical dimension and centric relation. The dentist ensures that the upper and lower teeth meet correctly, which is important for comfortable biting and chewing. Any necessary adjustments to the tooth placement are made directly in the soft wax before the model is sent back to the laboratory for final processing.
Phase Four: Final Delivery and Adjustments
The final appointment involves the delivery of the finished dentures, which have been processed from the wax mock-up into acrylic resin. The dentist places the new dentures into the patient’s mouth, checking for a secure fit, retention, and stability. They perform a final check of the bite to ensure the chewing surfaces meet evenly across both arches, which helps prevent uneven pressure and discomfort.
Upon delivery, the patient receives detailed instructions on how to properly insert and remove the dentures, along with guidance for daily cleaning and storage. The dentist also sets realistic expectations regarding the initial adjustment period, explaining that the mouth muscles and tongue will require time to adapt to the new prosthetic. Patients are advised that speaking and eating will initially require concentration and practice.
It is normal for minor sore spots or pressure points to develop on the gums within the first 24 to 48 hours of wearing the new prosthetic. Follow-up appointments for adjustments are typically scheduled for a review within the first week. These adjustments involve the dentist selectively smoothing and relieving areas of the denture base that are causing irritation. This ensures the final fit is comfortable and the health of the underlying tissues is maintained.