Immediate dentures, often referred to as temporary dentures, are prosthetic devices custom-made and inserted immediately following the removal of natural teeth. They are designed to ensure a patient does not have to go without teeth during the initial recovery period after extractions, maintaining social confidence and function. These restorations serve as a transitional appliance while the mouth heals and adapts to the absence of teeth. The duration for which these prosthetics are worn depends on the body’s natural process of healing and tissue change.
Understanding Immediate Dentures
Immediate dentures are prepared using impressions and measurements taken before the teeth are extracted, so they are ready to be placed as soon as surgery is complete. This immediate placement is protective, acting like a surgical bandage over the extraction sites to control post-operative bleeding and minimize swelling. The presence of the denture also helps protect the delicate blood clots that form in the sockets, reducing the risk of complications such as dry socket.
Beyond protection, the immediate denture restores the patient’s appearance and ability to speak and chew from day one. While chewing ability is limited, it is an improvement over exposed gums and provides functional continuity during healing. They also help the dentist determine the patient’s preferred bite, which can guide the fabrication of the eventual permanent denture.
The Initial Wearing Period and Healing Timeline
The duration an individual wears immediate dentures is primarily governed by the biological timeline of post-extraction healing, which involves significant tissue remodeling. This healing phase typically dictates a wearing period ranging from six to twelve months, though the exact time varies based on individual healing capacity. The underlying bone and gum tissue undergo a process called resorption, where they naturally shrink and change shape after the teeth roots are removed.
In the initial 24 hours following the extraction, the immediate denture must be worn continuously, including while sleeping, as directed by the dentist. This continuous wear manages swelling and bleeding, as removing the denture too early can cause the gums to swell, making reinsertion difficult or impossible. The most significant changes to the ridge shape occur rapidly, especially in the first six to eight weeks, as the soft tissues close and toughen. Because the immediate denture was made to fit the mouth before the extractions, this predictable shrinkage means the prosthetic will quickly become loose and ill-fitting.
Managing Tissue Changes and Necessary Adjustments
As the gum tissue and underlying bone change shape during the healing timeline, the immediate denture’s fit inevitably deteriorates. A loose-fitting denture can cause discomfort and sore spots, which necessitates frequent professional intervention to maintain function and comfort. These necessary adjustments ensure the appliance remains functional and does not irritate the recovering tissues.
Soft Reline
In the early stages of healing, when the tissues are still sensitive and undergoing rapid change, a dentist may apply a soft reline. This procedure involves adding a flexible, cushion-like material, often silicone-based, to the internal surface of the denture that contacts the gums, providing immediate comfort and molding to the changing contours of the tissue. Soft relines are considered a temporary fix, as the material is porous and needs more frequent replacement, often every few months.
Hard Reline
Later in the temporary phase, closer to the time the tissues begin to stabilize, a hard reline may be performed. A hard reline uses a more durable, rigid acrylic material, similar to the denture base itself, to reshape the inner surface for a tighter fit. This procedure is typically done when the bulk of the initial tissue shrinkage has subsided, providing a more stable and longer-lasting adjustment than a soft reline.
Transitioning to the Final Prosthesis
The phase of wearing immediate dentures concludes when the oral tissues have fully healed and stabilized, a process generally taking six to twelve months. The dentist determines readiness for the final prosthesis by monitoring the stability of the gum and bone structure. Once the rate of tissue change slows significantly, the foundation is considered stable enough to support a long-term appliance.
At this point, new impressions are taken of the healed mouth, which has a different shape than the pre-extraction contours used for the immediate denture. These final impressions allow the laboratory to craft a permanent denture that is precisely tailored to the current, stable shape of the jaw and gum tissue, ensuring optimal fit and comfort. Depending on the case, the immediate appliance may sometimes be converted into the permanent one through a final, laboratory-processed hard reline. The final prosthesis offers a superior fit, enhanced comfort, and greater durability compared to the temporary immediate denture.