Postoperative care and patient instructions for immediate dentures

By Vishaal on Wednesday, July 21, 2010 with 0 comments

Example generic ibuprofen container.Image via Wikipedia

First 24 hours

  • Avoid rinsing, avoid drinking hot liquids/alcohol.
  • Do not remove denture during the first 24 hours because there will be inflammation and if removed it may not fit for 3-4 days until swelling goes down.  If it is removed and reinserted, more sore spots will be likely.  Pain after the extractions will not be reduced by removing the denture.  Ibuprofen is recommended.
  • Swelling is likely.  This can be reduced with the use of an ice pack (20 minutes on, 20 minutes off) on the first day.
  • Expect minimal blood on your pillow the first night.  Hemorrhaging is rare because the denture acts as a bandage.
  • The diet for the first 24 hours should be liquid or soft.

At the first 24-hour visit

  • Ask patient where they feel sore.  Warn them that you’re going to remove the denture and this can cause discomfort.  Have some dilute mouthwash ready for the patient to rinse with.  Remove denture and wash it.
  • Quickly check the tissues for sore spots related to the denture; these will be strawberry-red spots.  Usually found at the canine eminences, lateral to tuberosities, posterior limit areas, retromylohyoid undercuts as well as any undercut ridges.
  • These areas can also be visualized with PIP and relieved with a bur on the acrylic resin.  The denture is kept out of the mouth for a very short time.
  • Adjust occlusal discrepancy in CR/excursions.
  • Evaluate denture for retention.  Place a tissue conditioner if retention is unsatisfactory.
  • Show patient how to remove the denture after eating to clean it and rinse the mouth at least 3-4 times daily to keep the extraction sites clean.

First post-operative week

  • Tell patient to continue wearing the denture at night for 7 days after extraction or until swelling reduces.
  • Remove denture after eating and clean it, rinse mouth 3-4 times daily to keep the extraction sites clean.  Then quickly reinsert the denture and wear continuously.
  • After one week the patient can begin removing the denture at night.

Further follow-up care

  • During the first month, the patient is seen weekly to adjust for sore spots.
  • Denture adhesive can be used during this time if retention is lost between visits.
  • After 2 weeks, remount casts are poured, and the maxillary denture is related to its articulator using the remount matrix made before flasking, a CR is used to remount the mandibular denture, and occlusion can be refined.

Subsequent service for the patient
  • After sore spots are eliminated and tissues have healed, a recall program for changing the tissue-conditioner liner is organized.
  • Ridge resorption is fastest in the first 3 months.
  • Complete socket calcification occurs in 8-12 months after extraction and bone volume of the ridge is reduced 20-30% in the first year.  Resorption in the lower ridge is 2x that of the upper.

Category: Conservative Dentistry Notes , Endodontics Notes , Operative Dentistry Notes , Prosthodontics Notes



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