Immediate denture or immediate prosthesis | Van Hoften Tandprothetiek

An immediate denture or immediate denture is a denture that is placed immediately after the last teeth have been extracted. This means you don't have to go home without teeth. The prosthesis is immediately placed over the fresh wounds and also works as a kind of protective bandage in the initial period.

The Dutch term “noodprothese” (emergency denture) can suggest a simple emergency solution. In fact, an immediate denture is a carefully planned appliance for a period when the mouth, gums and jaw change rapidly. Good preparation, clear expectations and several aftercare appointments are therefore essential.

Immediate prosthesis, immediate denture and temporary prosthesis

These words are often used interchangeably:

Immediate prosthesis: the prosthesis is placed immediately after extraction.
Immediate denture: a common patient term for the same direct facility.
Temporary prosthesis: a prosthesis that bridges an unstable healing period until a more permanent or permanent solution can be created.

An immediate denture is often temporary because the jaw changes significantly after extraction. Sometimes the existing prosthesis can be adjusted after healing and used longer. Sometimes a new full denture, overdenture or implant-retained removable denture is desirable later.

Who is an immediate prosthesis intended for?

This treatment can be considered when several or all remaining teeth cannot be preserved and you do not want or cannot function without teeth. Suitability depends on:

the condition of teeth, molars and gums;
the reason for tooth extraction;
general health and medication;
wound healing and bleeding risk;
expectations about appearance, eating and speaking;
possible preservation of roots;
a possible future implant process;
planning with dentist, dental surgeon or implantologist.

The complete route

1. Introduction and intake

We discuss your complaints, health, medication, anxiety, wishes and expectations. We look at which teeth are still present and which practitioner will perform the extraction. Bring a current medication list with you when taking important medications.

The intake is also the time to discuss photos of your previous smile, wishes for color and shape and experiences with previous treatments. Be honest about what you are afraid of; we guide the process step by step.

2. Examination and treatment plan

The dentist or implantologist assesses which teeth and molars need to be extracted and whether additional treatment is necessary. Van Hoften Tandprothetiek assesses the prosthetic options. We coordinate the planning so that the prosthesis is ready on the day of the extractions.

Depending on the treatment plan, extractions can be performed by your own dentist, an oral surgeon or Implant Company. When Implant Company treats in our practice, this is done as an independent healthcare provider in Gulpen. Their billing records are processed through their own system and possibly Infomedics.

3. First impression or digital scan

We record the shape of the jaws, teeth and surrounding tissues. This can be done with impression material, digital mouth scan or a combination. Existing teeth sometimes make this phase technically more challenging.

4. Final impression

If necessary, a more accurate impression or additional scan will follow. This ensures that edges, support areas and the shape of the jaw are captured as best as possible before the teeth are extracted.

5. Bite assessment, tooth selection and design

We record how the upper and lower jaws are relative to each other. We also discuss the color, shape, size and position of the artificial teeth. Where possible we use your natural teeth, face, photos and wishes as a starting point.

6. Try-in – where possible

With regular complete dentures, teeth can often be fitted in wax. With an immediate denture, your own teeth are still in the mouth and those parts cannot be completely fitted in advance. As a result, certain aspects of appearance and bite can only be definitively assessed after extraction. We explain this limitation in advance.

7. Extraction and immediate denture placement

On the appointed day, the remaining teeth are extracted. The prosthesis is placed immediately afterwards. So you leave the treatment area with teeth. The prosthesis helps cover the wounds, but healing, swelling and bleeding remain possible.

8. Initial check-up and aftercare

The first check takes place according to the agreement with your practitioners, often shortly after the installation. We assess wound healing, pressure points, bite, bleeding, swelling and whether the prosthesis can be removed and replaced safely.

9. Adjustments during healing

In the weeks and months after extraction, the jaw changes rapidly. The prosthesis may become looser. Temporary adjustments, correction of pressure points or a soft lining may be necessary.

10. Relining or a more lasting solution

When the worst of the changes have subsided, the fit can often be restored more permanently with a relining. Later we will assess whether the immediate denture is still suitable, needs to be renewed or whether another solution - for example implant-retained removable dentures - may be appropriate.

The first 24 hours

On the first day, specific instructions from the practitioner who extracted the teeth apply. In general:

do not immediately remove the denture from the mouth on your own initiative;
the prosthesis may be tight due to swelling;
light blood loss can turn saliva red;
do not rinse vigorously during the first 24 hours, as blood clots are needed for healing;
drink carefully and choose soft, not hot food;
only use pain relief that has been agreed with your practitioner;
do not smoke or consume alcohol around the procedure;
avoid strenuous exercise.

The precise instructions may vary due to the extent of the procedure, anticoagulant medications, implants or other medical conditions. Always follow the instructions given to you on the treatment day.

When can the prosthesis be removed for the first time?

According to the general patient information, an immediate denture is usually only removed after the first day. Sometimes the practitioner does this during the first check-up; sometimes you can do it yourself according to instructions. Removing it too early can make reinsertion difficult due to swelling.

When removing the denture for the first time, do so calmly and carefully. Clean it as agreed and care for your mouth without disturbing fresh wounds.

Bleeding and swelling

Slight bleeding and swelling may occur after extractions. Saliva may therefore appear redder than the amount of blood actually is.

Contact the practitioner who extracted the teeth immediately if:

bleeding does not subside;
the mouth keeps filling with bright red blood;
swelling increases rapidly or breathing becomes difficult;
you develop a fever or feel clearly ill;
pain increases significantly despite agreed pain relief;
the prosthesis is no longer secure due to swelling.

Pain and pressure points

The prosthesis lies directly on fresh wounds and may be tender or tight at first. A pressure spot can often be remedied with a small correction. Never file or sand the prosthesis yourself.

If pain prevents you from wearing the denture, please call. Where appropriate, try wearing it for a while before your check-up so we can identify the painful area. For fresh wounds, follow your treating clinician’s instructions first.

Eating with an immediate denture

Start with soft and lukewarm foods, for example puree, soft vegetables, scrambled eggs, yoghurt, fish, minced meat and soft fruit. Cut everything into small pieces and chew slowly and evenly on both sides.

Build up the structure gradually. Avoid very hot, hard, sharp, chewy or highly spicy foods at first. Op Eating and speaking you will find a detailed gradual progression plan and exercises.

Speech and appearance

Your lip support, tooth position and tongue space change in one day. Lisps, different sounding words and a full mouth are therefore not strange. Read out loud quietly and give yourself time.

Your face and smile may also be different. Do not judge the appearance only on the first day: swelling and tension affect the lips and mouth. During aftercare we discuss what healing is and what technical adjustments can be made.

Cleaning during wound healing

Initial cleaning instructions may differ from normal denture maintenance. As soon as the prosthesis can be removed:

rinse the denture gently;
brush the denture without toothpaste and without forcing the fragile parts;
do not use hot water, bleach or aggressive cleaner;
clean the mouth and wounds exactly as advised;
gently replace the prosthesis without biting or pushing.

After further healing the usual instructions apply Cleaning and storage.

Why does the prosthesis become looser?

After pulling, the wounds heal and the jaw shrinks. This can happen quickly, especially in the first months. The hard prosthesis does not change. This creates space and reduces grip.

Loosening does not automatically mean that the prosthesis is poorly made. It is an expected consequence of healing. However, assessment is necessary to prevent pressure points, misalignment, chattering and breakage.

Temporary soft lining and relining

A temporary soft layer can provide comfort when the jaw and mucous membrane are still changing significantly. This layer is not permanent and must be checked and kept clean.

A more durable new plastic liner can be fitted later. This is called relining. This makes the inside fit again. The right time varies per person and depends on wound healing and stability of the jaw.

When will a permanent prosthesis be available?

There is no date that is the same for everyone. It is often assessed after several months how stable the mouth is and what the best next step is. Sometimes the immediate prosthesis is adjusted and used for longer; sometimes a new prosthesis is desirable after about a year. Insurance conditions and medical necessity are assessed separately.

Can implant-retained removable dentures be made later?

This can be investigated if there is insufficient support and a suitable medical and anatomical situation. Implants are not automatically placed because someone has an immediate denture. First, the dental implantologist and denturist assess the healing, jaw, oral hygiene and treatment needs.

When implantological treatment takes place in our practice, this takes place in Gulpen. Also read Implant Company in our practice.

What do you take with you to appointments?

a valid ID;
your insurance details;
a current medication list;
information on allergies and major conditions;
photos of your past smile if you want to use them when choosing your teeth;
questions or concerns you wrote down at home.

Costs and reimbursement

The reimbursement depends on the type of prosthesis, the extractions, the healthcare provider performing the surgery, the insurance country, the policy, the deductible and the patient contribution. Extractions, prosthetic treatment and implant care can be billed by different healthcare providers.

Read Reimbursement Netherlands or Reimbursement Belgium. If you receive an invoice from Implant Company or Infomedics, take a look Invoice from Implant Company or Infomedics.

Frequently Asked Questions

Will I be left without teeth after extraction?

No. If the procedure goes according to plan, the immediate denture is placed immediately after extraction.

Can I pre-fit the teeth?

Only to the extent that the existing teeth allow it. Parts occupied by natural teeth cannot always be completely fitted in wax. We will discuss this limitation in advance.

Is an immediate denture the same as my permanent dentures?

Not always. Because the mouth changes significantly after extraction, the immediate denture is often a temporary provision or requires extensive adjustment later.

Why are multiple checks needed?

Wounds heal, swelling subsides, the jaw shrinks, and the bite may change. Multiple contact moments are necessary to safely guide fit, pain and function.

Can I take off the prosthesis on the first night?

Only do this according to the personal instructions of your practitioner. Different rules apply to an immediately placed denture than to a healed mouth.

When should I call urgently?

In case of persistent heavy bleeding, rapidly increasing swelling, breathing problems, fever, serious symptoms or uncontrollable pain, contact the practitioner or emergency service immediately.

More information and appointment

Read also Tooth extraction and immediate dentures. Would you like to discuss whether an immediate denture suits your situation? Go to appointment and contact.

Sources

This page provides general explanations. The instructions of the dentist, oral surgeon or implantologist who carries out the extractions and the personal appointments with Van Hoften Tandprothetiek always take precedence.

All about immediate dentures