Desperate Over Immediate Dentures

[TraumatizedinNOLA]

I've long been terrified of the dentist, which eventually cost me my teeth. Right at a month ago, I bit the bullet and let a highly rated dentist in my area pull my remaining 19 teeth and give me immediate upper and lower dentures. It was devastating at age 32, but there was really nothing else left to be done.

I haven't had any problems with the upper. I had the teeth on the upper right quadrant pulled 3 years ago and wore an acrylic flipper, so I was already used to the palate and all.

The lower has been an unmitigated disaster. When I went in for my 24 hour checkup, I told him it didn't fit properly and was pulling my jaw to the right. He gave me an antibiotic for swelling, never even took the denture out of my mouth, and sent me on my way.

I was in his office almost daily for adjustments for the first 2 weeks, and each time he wouldn't even look at the pressure sores, just grabbed the denture, shaved off a touch, and put it back in my mouth. At my insistence, I've also had 3 soft relines done. Every time I have a reline, I have to spend 2-3 hours with an emery board afterward filing all the excess reline material off the front of the teeth.

Two weeks ago, I went in for another soft reline and adjustment, which finally got the thing to more or less seat right. I then headed out of state to visit friends who have no idea I have dentures, and I managed to keep it a secret. I was in agony the whole time, but I have a super high pain tolerance so I just dealt with it. Fortunately the last reline managed to keep it tight enough that I didn't have to deal with adhesive during my trip. Meanwhile, during the trip I developed full-blown TMJ symptoms (popping, clicking, jaw locking so badly I have trouble opening my mouth enough to put food in, and a strong deviation to the right). Still struggling with those symptoms.

Since I got back a few days ago, I literally haven't been able to wear the lower. Now that the swelling is about gone, I can say with 100% confidence what I thought was the case on day 1. The lower denture is not the same size or, more importantly, shape as my mouth. At the back of the teeth, the denture is heavily curved. My mouth is not. So there's a huge gap at the top, and then the bottom edge curves back directly onto the bone. Literally every time I bite or chew, all of the forces are pushed directly into that edge. I have a row of pretty bad pressure sores/ulcers right along that bone. In addition, the left side of the denture is huge and wide and open. I have a layer of soft liner in it right now that's at least a half-inch thick, and it's still floating right off my gums. Also, the bite is not aligned. I can chew on the left OR right side of my mouth, but not both simultaneously. And now I guess I'm due for another reline, because the whole freaking thing is now floating freely. I can't use adhesive because the spaces are too big, there's no actual contact points for the adhesive to cling to.

The dentist has not done a single pressure test or bite test. He doesn't even look in my mouth. Meanwhile, he's told me there's nothing else he can do because "if I cut it back any further, you'll lose suction." He wants me to put up with it for another 5 months until he's ready to make my perms.

I'm at the end of my rope. My extraction sites are healed up just fine, and when I can stand the pain I can eat pretty much anything. But the stupid denture is not and never will be the same size or shape as my mouth, and my dentist is pretty much calling me crazy.

Oh, and on top of everything else, the office owes me money. They billed the entire bill to my credit card AND got paid for half of it by my insurance. So they've got 1700 of my dollars tied up.

What do I do now???

 

[Sevena]

I think you should get someone else to look at it. There is NO reason they can't reshape your bottom immediate denture - they did it for my top immediate because it was a terrible fit. I had to go without for a few days while it was in the lab (this was at a dental hospital, a clinic might have a lower wait time but I'd expected to at least go without for a day or two regardless), but it was worth it.

Call/email around for a practice that deals with dentures. See if you can get an appointment to have it looked at. They can take a new mould of your mouth. Immediates are difficult thanks to gum shrinkage, and the bottoms are always harder, but they shouldn't give you jaw problems and a decent dentist would look into the issue for you a lot more and try give you something reasonable.

As for the money, have you asked them what the hold-up is? Best to email to have the conversation in writing. Do you have confirmation that your insurance has paid them for sure? If so, I'd say as much and mention that you are willing to sue in small claims court for the money.

 

[comfortdentist]

Dentures are a substitute for not having teeth. Immediate dentures are the worst type of dentures. Your complaints sound like things aren't lined up with your bite and that the dentist wants to do very little to get you to a reasonable level of comfort at this time.
So do you really want this doctor to make your next set?
My thoughts at the young age of 32 I would consider actual porcelain teeth for the top denture and perform at least 2 try-ins so that you get the right aesthetics. Denture teeth(plastic) wear over time. By placing Porcelain in the top arch you maintain the same look while the opposing lower teeth wear down. By recording the actual mould of teeth in your chart you can compare the original size to the worn size 5 years later to see the rate of wear. As the teeth wear down you have to close further which will give you line at the edge of your lips on the side. These side areas have a tendency to then get fungus and get raw (Angular cheilitis). Also as you lose the vertical height by over closing your jaw starts to stick out more. This is the cause for so many people who have had dentures for many years to have that certain look that one can see from 20 feet away.
The good news is that doesn't have to happen but it is much more difficult to fabricate a proper denture. This explains why some dentists will charge a few thousand for just one denture and double for a pair. It is so much more than just sticking in teeth.
Part of my reply is a general reply for denture questions.

 

[TraumatizedinNOLA]

Thank you both for your thoughts. @comfortdentist, would you recommend porcelain for the lower arch as well, or only the upper?

I went back to my dentist's office today with my dad as backup. Dad is a retired government contract negotiator and he looks intimidating as hell, and it's amazing how much better I was treated with him in the room lol. The dentist did a thorough exam of my mouth (first one ever!) and finally saw the ulcers I've been talking about. He's taking new impressions and making new top and bottom temporary dentures, at his own expense. The only problem is that he 3-D prints his temporaries, and his printer is currently out of service. So I go back next Monday for impressions and I'll have the new temporaries on Tuesday.

I definitely don't trust him to make my permanent set. There's a prosthodontist nearby with excellent customer reviews, so I plan to have a consult with him soon. In the meantime, though, I'm willing to let my current dentist try to make it right for the interim. I doubt I'm going to wait six months to see the new guy and get permanents started--my dentist even noted today that I've healed incredibly fast and there shouldn't be a lot more shrinkage. But I know the longer I wait the better, so if my dentist can make a functional temporary, I'm all for it.

In the meantime, I've stocked up on soup and protein shakes to get me through the week. So frustrating, when I've been eating pretty much everything, but at least there's a light at the end of the tunnel.

 

[comfortdentist]

In general see the prosthodontist. It will cost more but should be much better

 

[TraumatizedinNOLA]

So the current dentist's "fix" was to make new impressions inside the badly fitting denture. And then make a new one that literally just sits on the gum. No support structure at all. Then tell me it's my fault for having sensitive gums.

The new top fits great. The new bottom looks and feels like Bubba teeth, and is currently sailing freely around my mouth.

Appointment with the prosthodontist on Thursday. Over this crap.

 

[TraumatizedinNOLA]

So after nearly swallowing the new lower when it rotated 90 degrees in my mouth during lunch, I demanded he print a third version with some kind of support structure. I went in to pick it up this morning, and the tech literally handed it to me across the counter!

The good news is, it's not cutting me. Once I shave down the spot where it's squeezing a nerve, I think I can wear it cosmetically during the 3 weeks it will take to get a new set from the prosthodontist. The bad news is, when I close my back teeth, there's at least a 3 inch gap in the front between the top of the bottom teeth and the bottom of the top teeth. So cosmetic is a relative term. And it doesn't function at all, way too loose for that.

 

[TraumatizedinNOLA]

Final verdict: Prosthodontist was wonderful, but said it would take 2 months because of lab time. I found a guy 2 hours away who has an in house lab and has been making dentures longer than I've been alive. I went in at 8 am today, went back for try-ins after lunch, and left at 4pm with a perfectly fitted set of permanent dentures. They can normally only do their lowest level same day, but they happened to have the materials on hand for the upgraded portrait dentures!

I ate pasta with crawfish and shrimp, along with a side salad, for dinner tonight! I've noticed 3 very minor irritated spots, which they said would happen, so I'm going in tomorrow to have them corrected. But on a pain scale of 10, they're maybe a 1.5, and only when chewing tough shrimp. They're also staying put without a drop of adhesive.

I seriously couldn't be happier. I have back the smile I had in high school, after a decade of awful teeth. Next up: saving for implants, primarily to minimize bone loss.