Dr. Frank Vascimini, Sound Bites, 09/18/12

Q: I am writing you this question regarding my 45-year-old daughter. She, like me, has dentures. I have no problem with my dentures; however, she has trouble with her upper one.

It was done about 10 years ago when she had teeth removed at the same time the denture was given to her. Since then, she has had a few relines. One of them was done at the very beginning. The others were done recently.

This is why I am looking to you for some possible answers. Even though she has had two relines at two different dentists, the denture still does not hold in. In fact, it is still as loose as when she started with the relines.

Do you have any ideas on what is going on? I can’t stand to see her go through this. It is becoming a real issue for her. I believe it is even affecting her personality. I hope you can help me help her in some way.

A: First, how nice of you to have such concern for you daughter. Things like this can be very frustrating, embarrassing and disappointing. You are probably right that it is affecting her personality. She may not be eating properly. She probably won’t smile because of the fear of them dropping down.

When you combine all she is experiencing with this, how can it not affect your personality?

Back to the dentures. Knowing she originally had an immediate denture (one that is placed at the same time the teeth are removed) with a subsequent reline that worked tells me a reline should work now. The reasons why the recent relines are not working could be many. I will discuss a few.

Despite what some people may think, what is done during a reline is just as important, if not more important, than the actual materials used. Many offices will sell their products based on materials alone.

Your daughter’s situation is a perfect example where the expertise of the dentist is of the utmost importance.

The dentist needs to evaluate whether all the anatomical landmarks are being recorded in the reline procedure. If any of these landmarks are being missed, you will not get the same retention from the reline. The material used will make no difference if workmanship is not there.

Here is one example I see all the time in my office: In addition to the dentist taking a reline impression without the landmarks being recorded, they do not remove enough of the material from the denture itself to leave room for the reline material.

What happens under these circumstances is the palate area of the denture gets thicker and thicker. This adds weight, which adds to the denture’s dislodgment.

Another thing that happens in this case is more room is taken up in the mouth by material, leaving the patient with less room to speak and chew.

The patient will come to me saying she does not have enough room in her mouth anymore. In addition, she may experience headaches and pain in the tempero-mandibular joint (what many people refer to as TMJ).

Honestly, I can go on and on with this scenario. To put your mind at ease, please know there are probably a few things that can be done to help your daughter.

Unfortunately, it may involve a new denture if the original has been changed to the point that things cannot be corrected with it. Also realize that, though materials are important, materials will not matter at all without the proper skill set.

A good example involves what my brother does in the process of making furniture and cabinetry. If I were to get the same five sheets of plywood and the same 50 board feet of hardwood, along with the same glue and nails as my brother, and was told to build the same cabinet, you would surely choose my brother’s cabinet over mine any day.

This is an exaggeration, but I want to make a point. Materials are important, but what you do with them is more important to attain an end result that you can be proud of.

I wish you all the best for your daughter.

Dr. Frank Vascimini is a Homosassa dentist. Send your questions to 4805 S. Suncoast Blvd., Homosassa, FL 34446 or email them to him at info@MasterpieceDentalStudio.com.