Adjustments seem simple. Look for the irritation, match it to the spot on the denture and relieve judiciously. Bony projections with thin mucosa are likely sorespot areas. Sometimes a tiny bony spicule penetrating the mucosa will be the problem.

Sometimes there is no obvious ulceration. I ask the patient to hold a mirror handle and touch the spot. I then take the handle and touch in and around the area seeing if the patient can identify the same spot.

If need be I can identify the area on the denture by using the wooden end of the Q tip to place a small dab of pressure paste on the dry tissue. After inserting the denture the spot will imprint the denture.

Sometimes two white spots come out on the denture; one on the denture border and one on the ridge. In this case the border hits the paste first before it is seated. You have to judge which area is causing the irritation.

There are times when the patient is vague but consistently complaining in one area. Let us say the tuberosity. Perhaps the trouble is the posterior palatal seal in the hamular notch. Maybe the seal was too deep.

On rare occasions the denture will press on the mental nerve. The patient will get the feeling of an "electric shock" when pressure is applied. Locate and relieve that area.

At any adjustment you want to look at the occlusion. Presumably it was corrected before delivery, but it is worth checking. A hyper occlusion can cause a sore spot.  A prematurity on one side can cause the mandibular denture to rock with each closure.  This also can cause a sore spot.

Sorespots on the occlusal plane are caused by cheek biting. I tell the patient to chew slowly so the cheek has time to slide out of the way. It is usually caused by lack of overjet. You may have to reduce some of the buccal cusps if the biting continues.

Sometimes the patient complains of gagging due to the maxillary denture. Your first thought is that it is too long. Reducing the thickness of the posterior border will often solve the problem.

If a patient complains of a sore throat the day after the delivery of complete dentures the chances are the distolingual border of the mandibular denture is overextended.

1981 Board Question

1981 Board Question

The probable cause of a sore throat after insertion of a removable mandibular partial denture is
1. the lingual bar is impinging upon the lingual frenum.
2. the distolingual flange of the partial denture is overextended.
3. insufficient relief has been provided for the lingual bar.
4. the distofacial flange is overextended.
5. None of the above.
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At the first appointment after insertion of complete dentures, the presence of generalized soreness on the crest of the mandibular ridge is most likely due to
1. improper occlusion.
2. the newness of the denture.
3. defective tissue registration.
4. incomplete polymerization of the denture base.

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1999 by Julius Rosen, D.D.S.