When “Immediate” Doesn’t Mean “Done”
There are few things more intimidating than the prospect of extracting your teeth and getting a denture; it’s a big decision, emotionally, physically and financially.
That’s why immediate dentures can feel like such a lifesaver! We place them the same day as your extractions, so you don’t have to leave with missing teeth. You walk in with discomfort and walk out with a full smile.
But – and this is a big but – your denture journey doesn’t stop there. A recent case reminded us (and the patient) just how important it is to keep up with follow-up care after the denture is in place.
Getting your immediate denture is only the beginning, not the end, of your denture journey.
The Patient Who Ghosted His Gums
About four years ago a patient came to us with unrestorable (severely compromised) upper teeth and lower front teeth with a “guarded” long-term prognosis due to periodontal disease.
After a thorough evaluation, we recommended:
- Removing the remaining upper teeth
- Delivering an immediate full upper denture
- Follow-up Treatment Plan:
- Non-surgical periodontal therapy – a deep cleaning below the gumline to help save the lower front teeth
- Fabricating a lower partial denture to restore his back teeth (posterior support) and prevent denture-related complications like Combination Syndrome (I’ll get to what this is in a minute).
It was a solid plan. But unfortunately, he didn’t follow up. Life happened. Time passed. And when he finally came back years later, things had changed dramatically.
What Changed and Why It Was a Big Deal
Here’s what we saw when he returned:
- His remaining lower teeth? No longer salvageable.
- His upper denture? Didn’t fit anymore.
- His bite? Collapsed, thanks to Combination Syndrome (more on that below)
By skipping the scheduled follow-ups, the structures we were trying to protect – teeth, gums, and bone – had slowly deteriorated. In fact, without the necessary cleaning below the gums and restoring the missing back teeth, his dental condition worsened so significantly that our original treatment plan was no longer salvageable (nor were his remaining teeth or dentures, for that matter). By skipping maintenance care, the healthy tissues and structures we were trying to preserve had slowly deteriorated. And a simple adjustment was no longer on the table.
Wait, What’s Combination Syndrome?
Think of it like a bad game of Jenga, only instead of blocks, it’s your bite.
Combination Syndrome occurs when a full upper denture chews against only the front lower teeth (with no back teeth to balance things out). Over time, this causes:
- Bone loss in the front of the upper jaw
- Overgrowth of the back (tuberosity) areas of the upper jaw
- Over-eruption (overgrowth) of the lower front teeth
- Bite collapse and even facial changes
- A denture that no longer fits well and needs extensive reline or full replacement
This is why we recommended a lower partial denture in the original treatment plan, to restore balance and prevent exactly this outcome.
What About the Reline?
When you get an immediate denture, it fits well on day one. That’s the whole point of an immediate denture.
A reline is always part of the immediate denture process. Why? Because the natural healing process to the inflamed gums and jawbone after extractions means that an immediate denture will eventually start to feel loose. That’s totally normal! As your gums and jawbone heal, the shape of your mouth naturally changes.
This is why we schedule a routine reline. A reline is a routine adjustment where we reshape the inside of the denture to better fit the healed gum tissue. Most people need it within 6–12 months.
But in this case, the delayed follow-up care meant he never got that routine reline. By the time he did, his denture no longer needed a tune-up, it needed a full overhaul. And because of Combination Syndrome, that process was now much more complex.
What Was Supposed to Happen: This Patient’s Timeline
Here’s what the recommended care plan looked like in this immediate denture case. (Your plan would, of course, look different based on your specific needs):
| Timeline | Treatment | Purpose |
|---|---|---|
| Day of extractions | Immediate denture delivered | Restores smile same-day |
| 1-2 weeks | Sore spot checks, initial healing check | Comfort and progress |
| 4-6 weeks | Deep cleaning (if needed) | Controls gum disease, protects remaining teeth |
| 2-3 months | Impressions for lower partial denture | Prevents bite imbalance |
| 6-12 months | Reline of denture | Adjusts fit to healed tissues |
Every treatment plan is unique. Even if you don’t need periodontal therapy or a partial, everyone with an immediate denture needs a reline. It’s part of the healing process.
In our patient’s case, delaying follow-up treatment led to significant bone loss and an unstable foundation for his denture. Rather than a simple, routine reline to tighten his denture after normal healing, a more complex reline was necessary to manage the unpredictable bone resorption and tissue changes caused by Combination Syndrome. In some cases like this, achieving a good fit again can be difficult without additional surgery or more frequent adjustments.
It’s important to remember that if you have an immediate denture (or are considering one), it is only one step in the journey toward a healthy, functional smile.
Why People Skip Follow-Up
Honestly? Lots of reasons.
Some patients think they’re “done” once they get their immediate denture. Others get caught up in life (work, caregiving, health stuff, or just trying to stay afloat) and the next appointment keeps getting bumped. Some assume the reline can wait, or worry that coming back means another big bill.
And yeah, for others, the idea of getting teeth “scraped” below the gumline sounds about as appealing as jumping into a hot tub full of electric eels.
Look, we get it. Dentures are a big step. You’ve already gone through an extraction appointment and walked out with immediate dentures. You’re ready to hit pause.
But here’s the thing: Skipping follow-up doesn’t make the work go away. It just makes it harder (scarier) and more expensive (than the original plan and follow-up) down the road. It’s like skipping an oil change and ending up with a blown engine.
Skipping follow-up doesn’t make the work go away. It’s like skipping an oil change and ending up with a blown engine.
Combatting the Fear
A reline, done as follow-up to your immediate dentures, is a painless and easy appointment. There’s nothing to fear here, we’re simply ensuring your denture fits as your mouth heals to ensure there aren’t any denture-related fit issues happening.
As for the tooth scraping fear, we get it! It sounds horrid. But technology has evolved and now we have a rather pleasant solution in the form of the AIRFLOW® Prophylaxis Master. We use Guided Biofilm Therapy (GBT), the modern standard of care for saving teeth before it’s too late! It’s a cutting-edge approach that allows us to target and remove bacterial biofilm gently and thoroughly below the gumline, where traditional cleanings can’t reach (and feel more like being electrocuted in a hot tub).
This technology helps us:
- Save at-risk teeth by controlling periodontal disease earlier
- Promote healthier gums to stabilize remaining teeth
- Extend the life of dentures and dental implants
Delaying care doesn’t just risk losing more teeth, it can turn a simple denture reline into a complicated, frustrating experience. Timely follow-up care, proper maintenance of remaining teeth, and regular professional cleanings are essential to protect your investment and your health.
If you have an immediate denture or are considering one, remember – it is only one step in the journey toward a healthy, functional smile. Timely follow-up care, proper maintenance of remaining teeth, and regular professional cleanings are essential to protect your investment and your health.
Bottom Line: Don’t delay your next step (and always check your hot tub for eels)!
