Immediate Dentures: What to Expect

By Brian J. Gray, DDS, MAGD, FICOI

Immediate dentures are placed in the mouth directly after remaining teeth are extracted. This approach is utilized when a person does not want to be without any teeth for several months while extraction tooth sockets heal and a denture is fabricated.

A Two-Denture Process

Optimally, an immediate denture is the first denture of a two-denture process and should be considered as a temporary interim prosthesis until a second refined and esthetically enhanced denture may be constructed after healing.

First Stage

  • Usually, most or all of the back teeth are removed and extraction sites are allowed to heal for a minimum of six weeks or more, depending upon an individual's healing rate.

  • After adequate healing, an immediate denture is fabricated.

  • Remaining teeth are extracted and the immediate denture is placed in the mouth. Wearing a denture immediately over extractions normally is no more uncomfortable than the extractions alone. Discomfort is managed with proper anesthesia and pain medication. The immediate denture acts like a Band Aid bandage, holding tissues together and protecting them during healing.

  • Generally, the dentist does not remove an immediate denture until the day after surgery. Surgery is checked and denture adjustments are made as necessary.

  • The immediate denture will gradually become loose because of bone shrinkage as the jaw continues to heal. Provisional liners are placed in the loosening denture to help hold it in place during healing. Adhesives also maintain the denture in place as it becomes looser. If the immediate denture becomes too loose during this healing period of several months, it may be necessary to reline multiple times.

Second Stage

  • After adequate healing has occurred, a second refined denture is fabricated. This denture allows the dentist to artistically position teeth in an optimal and enhanced esthetic relationship, which was not possible with an immediate denture. It also is now possible to establish better functional relationships of the jaws.

  • Approximately six months after the second denture is delivered, it will most likely need to be relined to compensate for continuing jaw shrinkage. After this reline, a patient usually needs annual relines to accommodate a continually shrinking jaw. The frequency of relines is an individual matter unique to each patient and is best determined by a licensed dentist after a thorough periodic examination that should occur at six-month intervals.

Modified Approaches

  • It is possible to extract all the back and front teeth at one time and insert an immediate denture. However, such an approach is problematic and generally is discouraged unless the patient has no other alternatives.

  • All teeth may be extracted with no interim denture while the jaws heal and a denture is fabricated. This is generally a more economical approach, but an individual would be without teeth for several months.

Advantages of an Immediate Denture

  • A person is not without teeth for any extended period of time.

  • The immediate denture acts as a bandage while bony tooth sockets are healing after tooth extractions.

Disadvantages of an Immediate Denture

  • A second refined and esthetically enhanced denture is necessary soon after the immediate denture.

  • While the cost of an immediate denture is generally about the same as a conventional denture, the second denture needs to be fabricated soon after the immediate denture. Therefore, a person would be experiencing the additional cost of the second denture sooner.