February 01, 2021
Dentures are one of the most important treatment modalities that can help individuals retain their necessary functions (chewing, speech, etc) and aesthetic appearance. The process of making a denture can include multiple dental visits. During these visits a dentist takes a proper impression of the arch where your artificial teeth are supposed to be seated, fabricates a tray that replicates the oral cavity, seats a temporary denture in the mouth to check if the relations of the upper and lower teeth to the facial symmetry and muscles are synchronized and eventually places the final denture.
The above-mentioned procedure involves a lot of dental visits which might not be comfortable for all the patients. Individuals requiring a denture will always opt for a speedier process by which they can be satisfied at a psychosocial level. In order to get a denture on the same day one visits the dentist, an immediate denture is indicated. When multiple teeth need to be extracted, a patient will look forward to retain his or her teeth as quickly as forwards. An immediate denture is a denture that is placed as soon as the teeth are extracted. This is generally accepted by the patients due to instant completion of the denture. However, there are pros and cons of the immediate denture.
An immediate denture that you get on the same day can be of two types. In the world of dentistry, these are called Conventional Immediate Dentures (CID) and Interim Immediate Dentures (IID). Both these dentures are given after a certain number of teeth extractions are carried out in any one arch or both the upper and lower arches. Based on the number and the site of teeth extraction, a dentist decides and informs the patient as to which type of immediate denture would be suitable for him or her. Let us discuss both these dentures in detail.
CIDs are given when an individual's back teeth need to be extracted. In one appointment these teeth would be extracted after which the extraction sites are allowed to teeth. Once these teeth are extracted, an impression of the arch is taken. A replica of the arch is then fabricated with the help of this impression. The teeth that are present (front teeth) in the patient's mouth will also be seen on the cast. These teeth are trimmed off the cast as they would be extracted in the next visit. The artificial teeth are then placed in the region of the teeth that need to be extracted. A sturdy denture is then fabricated that would be delivered to the patient. The next appointment would involve extracting the patient's front teeth, followed by immediate delivery of the immediate denture. The dentist ensures that the denture seats properly. The time between the extraction of the back teeth and the extraction of front teeth is between 6 to 8 weeks. As stated before, the day the front teet are extracted, the denture is delivered. The patient is scheduled for follow-ups after 1 day, 1 week and 1 month. During these sessions, the denture is refitted each time as bony changes may occur as the extraction sockets heal.
IIDs involve the delivery of two types of dentures - a temporary one and a permanent one. An IID is given when both the front and back teeth need to be extracted at the same time. Before the appointment of the extraction, the patient is scheduled for the impression of the arch or arches that need the denture. Once this impression is obtained, two sets of replicas are made. One where the teeth present in the oral cavity are fabricated and the other which is used for placement of the artificial teeth that need to be replaced. Based on this, dentures are fabricated. On the day of extraction, the teeth are extracted and the patient is given these dentures. These are temporary dentures. After 6 months, a better and permanent denture is delivered.
Immediate dentures are a tricky alternative. The patient needs to be informed about both the dentures and their possible repercussions. In case of a CID, the patient should be advised that he or she might have to spend a few weeks without the back teeth. The back teeth are vital for chewing and patients might have to compromise on their diet for this time period. Moreover, in case of CIDs, there are two visits where a patient needs to get multiple teeth extracted. This might cause a uneasiness in the patient's mind. CIDs are almost like regular complete dentures but may not fit on the arches as good as them. Furthermore, since there is no temporary denture involved, changes in the vertical dimensions of the face are compromised. Muscle tonicity of the adjacent muscles and speech might be difficult in the initial days.
IIDs leave the patient wit two dentures. This means that the overall cost of the treatment would be higher than CID. But this also mean that the patient will have better esthetics and harmony of the oral cavity as the permanent denture takes care of the most important aspects of a denture. An existing prosthesis can be converted to an IID which is another advantage. The day when IIDs are delivered there are multiple teeth that need extraction in both front and back teeth region. This is an important information that the patient needs to be given beforehand.
The change in the tissues after the delivery of immediate dentures is unpredictable. A patient might need refitting of the dentures constantly in the first couple of years. All the refitting appointments carry a charge will might make it a bi expensive for the patient. A single-visit at the dentist will be longer than expected. Besides, after the immediate denture is delivered, chewing and speech need to be learnt again all over again.
Immediate dentures are advantageous since a patient is never without his or her teeth for a single day. Once the extraction is done, the dentures that are immediately delivered help in controlling the operative site bleeding. Since the extraction site is covered, there will be relatively less pain due to the extraction. Chewing might not be efficient but the nutrition intake is maintained since the teeth will help in breaking down of food. Over the period of time the bony structure under the dentures will get adapted. It is important to note that immediate dentures are not preferred for patients with bleeding, cardiac, neurological and endocrinal disorders.
Thus, immediate dentures are a good solution for immediate rehabilitation of lost teeth, but they come at a cost of a period of uneasiness and re-learning important functions that the oral cavity aids us in.