The process of obtaining dentures is a detailed procedure that spans several weeks and distinct clinical appointments. This journey ensures the final prosthetic is not only functional but also aesthetically suited to the individual. The fabrication of a successful denture requires meticulous planning, precise modeling, and careful adjustment before the final product is delivered.
Assessment and Treatment Planning
The first step involves a comprehensive initial consultation where a dental professional thoroughly examines the oral cavity. This examination includes assessing the condition of the gums, the underlying jawbone structure, and any remaining natural teeth, often utilizing dental X-rays for a complete internal view. This consultation forms an accurate diagnosis and an appropriate treatment plan.
The dentist discusses the patient’s medical and dental history, as well as their specific goals for appearance and function. Based on this, a decision is made on the type of denture, whether it is a complete, partial, or immediate denture. If unsalvageable teeth remain, the plan will include extractions, which may be staged to allow for adequate gum healing before the final fitting.
Treatment planning also involves discussing the estimated timeline for the process, which can take several weeks or months, especially if extractions are required. This initial phase clarifies the financial commitment and sets expectations for the limitations and capabilities of the completed prosthetic.
Taking Impressions and Developing Molds
Once the treatment plan is finalized, the process moves to capturing the precise shape of the oral tissues to create accurate working models. This begins with taking preliminary impressions, typically using alginate in a standard tray. These initial, less detailed impressions are primarily used by the dental laboratory to fabricate a custom-fitted tray for the next stage.
The custom tray is then used to capture the final, or master, impression. Highly stable materials, such as polyether or polyvinyl siloxane, are employed to record the intricate contours of the gums and soft tissues, which are the main support for the finished denture. This detail is essential for ensuring the denture base achieves a proper seal and fit, preventing issues like sore spots or slippage.
The final impression is sent to the lab, where it is used to pour a master cast, which is a stone model of the patient’s jaw. This master cast is the physical mold upon which the denture is built. The lab also uses this information to create wax rims, which are devices used in the next appointment to record the jaw relationship.
Wax Try-In and Establishing Jaw Alignment
The wax try-in phase is a series of appointments where the functional and aesthetic parameters of the denture are established. The dentist first uses the wax rims to determine the proper relationship between the upper and lower jaws, focusing on centric relation and the vertical dimension of occlusion (VDO). Centric relation is the most retruded position of the jaw, while VDO is the vertical distance between the jaws when the teeth are in contact.
The dentist carefully checks the VDO to ensure it is neither too short nor too excessive, often using phonetic tests, such as asking the patient to count or make “s” sounds. This test helps verify the “closest speaking space,” the small gap between the upper and lower teeth during speech, ideally around one millimeter. If the VDO is incorrect, it can lead to problems with speech, chewing, and excessive muscle strain.
A trial denture, with the selected artificial teeth set into a wax base, is then placed in the mouth for the patient to approve the aesthetics. The patient and dentist evaluate the tooth shade, size, and how the teeth align with the smile line and facial features. Because the teeth are set in wax, they can be easily repositioned, allowing for final aesthetic and functional adjustments based on patient feedback before the denture is sent for final processing.
Final Fitting and Adjustment Appointments
The final fitting appointment is where the completed, processed denture is delivered to the patient. The dental professional inserts the new prosthetic and checks the fit against the underlying gums, verifies the bite alignment, and confirms that the aesthetics are correct. At this stage, minor adjustments, such as buffing small areas that cause pressure, are often made right at the chairside.
The patient receives detailed instructions on proper cleaning, storage, and maintenance of the new appliance. The dentist also prepares the patient for the expected adjustment period, noting that initial speech difficulties and minor eating discomfort are common as the mouth adapts to the new device. Patients are advised to begin with soft foods and gradually reintroduce firmer items to rebuild their chewing function.
Follow-up appointments are a required part of the overall process, typically scheduled within 24 to 48 hours and again a week later. During these visits, the dentist addresses any sore spots or areas of pressure that have developed after wearing the denture for a sustained period. These post-insertion adjustments are necessary to refine the fit and ensure the long-term comfort of the custom-made prosthetic.