Comfort

Discomfort	Causes	Solutions
Sore spot in vestibule- upper or lower denture	Overextended borders Rough spot in base	Shorten borders and polish. Refinish borders.
Sore spot in upper post dam. (posterior limit of upper)	Post dam too deep Sharp edges on the posterior seal Overextension	Reduce base carefully and gradually to avoid loss of the border seal. Same as above, make sure post dam is on soft tissue. Same as above.
Single sore spots on the crest of the ridge	Premature occlusion Inaccurate denture base Voids or porosity in acrylic Nodules under base	New centric registration or accurate bite. Remount dentures on articulator and adjust. Take wash impression and rebase after tissue treatment. Same as above. Remove nodules.
General overall soreness on ridge	Vertical open too much Totally inaccurate denture base Malocclusion or improper interdigitation	Remake 1 of the dentures to correct vertical, if plane of occlusion is correct. Try a wash impression and rebase, or remake denture after tissue treatment. See solutions 1a, 1b, 1c from solutions “when occluding in centric”.
Sore under lower lingual flange	Centric off, mastication drives lower forward Lingual flange overextended Posteriors too far distal	Recheck vertical and centric. Rearticulate and remove the interfering cusps or change to non-interfering teeth. Shorten and polish flange. Remove second molars.
Sore under lower labial flange	Too much overbite Over extended labial flange When masticating patient throws lower forward	Rearticulate and change tooth position. Shorten flange and repolish. Recheck vertical and centric. Check lingual flanges, shorten.

Burning Sensation*

Discomfort	Causes	Solutions
Burning feeling on hard palate area or on lower anterior ridge	High pressure area in the acrylic base*	Locate the high area, remove and polish.
Burning feeling in bicuspid area to tuberosities	High pressure area in the acrylic base*	Same as above, grind first bicuspid out of occlusion.
Burning feeling on upper anterior ridge	Burning feeling on upper anterior ridge	Relieve.

*Burning sensations are usually caused by pressure on a nerve as it leaves nasopalatine or by undercured bases. Diabetics experience burning occasionally.

Biting Cheeks and Tongue

Discomfort	Causes	Solutions
Keeps biting cheeks and/or tongue	Posterior teeth set end to end Overclosed Posterior teeth set too far to the lingual or buccal	Rearticulate and reset posteriors (wax try-in highly recommended). Rearticulate and reset all teeth opening bite. Rearticulate and reset posterior teeth.

Redness of Tissue

Discomfort	Causes	Solutions
Tissue getting red in dentureͲbearing area	Ill fitting denture base Improper cure of denture base Aviaminosis	Take a wash impression and rebase denture. Check for prematurities in the occlusion. Rebase (heat cure acrylic). Prescribe vitamins.
All tissues becoming fiery red including cheeks and tongue	Denture base allergy (extremely rare)	Change base material by having lab “jump” a vinyl base material. Remove all acrylic teeth and replace. A patch test should be taken.

Pain in Mandibular Joint

Discomfort	Causes	Solutions
Pain in Mandibular joint	Vertical overclosed Centric relation off Arthritis Trauma	Rearticulate and reset all teeth to open bite. Take intra-oral tracing and reset. Retrial advised. Consult patient’s doctor Difficult to correct.

Instability

Instability	Causes	Solutions
When not occluding	Overextension of borders and posterior limits Under extended borders Loss of post dam seal Post dam on hard palate Post dam not over hamular notches Insufficient post dam Dehydration of tissue due to alcoholism or medication. Flabby tissues displaced when taking impression due to improper tray.	In all cases a new impression is necessary. Best to grind out the tissue side and take a wash impression, using compound where necessary to extend impression to include post dam area. Rebase entire denture.
When chewing food	Loss of post dam seal Anterior teeth too far labially Flabby anterior tissue Improper incising habits Lower posteriors set off ridge	Same as above. Remount and reset bringing anteriors back lingually. Surgery to remove poor denture foundation and rebase. Patient education is the answer. Reset and correct posterior alignment.
When occluding in centric	Malocclusion Upper denture “riding” on hard palate surface Premature individual teeth hitting High occlusion on one side of arch Bicuspid area premature contact Flabby tissues over ridge Teeth set too far bucally Centric occlusion not in harmony with centric relationship	Remount grind, and mill-in selective teeth. Remount and reset. Try chairside mill-in or remount and set. Relieve pressure area Remove flabby tissue with surgery and rebase. Remount and reset lingual. Remake one denture.

Interference

Interference	Causes	Solutions
When swallowing	Upper Over extension in the posterior buccal flanges Too thick in lingual posterior flanges. Lower Overextension in the lingual Too thick in posterior Over closed vertical Too much vertical Posteriors too far lingual, crowding tongue	Upper Carefully reduce distal buccal flange. Adjust by thinning dentures from the outside, not the tissue side. Lower Carefully reduce flange Reduce from outside - do not grind tissue side. Remount and reset, correcting vertical. Same as above. Remount and reset opening arch to allow more tongue room.

Gagging

Gagging	Causes	Solutions
Immediate on insertion	Upper: Over extension too thick posterior border Lower: distal-lingual flange too thick	Denture must be double post dammed and cut back to anterior post dam. Carefully reduce from the outside. Do not grind tissue side.
Delayed gagging: 2 weeks to 2 months after delivery	Faulty post dam allowing saliva under denture Malocclusion allowing denture to loosen causes saliva seepage	Grind out post dam area and take wash impression for lab rebase. Remount and mill-in, sometimes necessary to reset the teeth.

Esthetics

Esthetics	Causes	Solutions
Too bulky under nose	Labial flange of upper to long or too thick Upper anterior teeth set too far out	Reduce bulk and/or length and repolish. Reset anteriors lingually.
Sinking in under nose	Upper labial flange needs more bulk Upper labial flange needs more length	Add wax to build up to proper contour and have lab build out base. Grind out tissue side of labial flange, add compound border and take wash impression. Reset anteriors for lip support.
Upper lip sinks in too far	Upper anterior teeth set too far lingual	Add wax on teeth to proper contour and have lab set teeth more labial for lip support.
Shows too much teeth	Vertical too great. Occlusal plane too low Cuspids and laterals set too prominent Upper anterior teeth set out too far	Have lab reset all teeth closing vertical. Maintain esthetics by determining to raise or lower upper or lower teeth. Have lab reset all teeth raising occlusal plane. Replace cuspids and laterals with smaller teeth and rotate them in. Reset teeth back to ridge.
Just looks too false	Set too regular; technique type set-up All teeth appear to be the same shade No gingival contouring or staggering of gingival depth.	Try sculpturing anterior incisals to give abraded appearance. Rotate and stagger teeth in set-up. Change to characterized anterior teeth. Have lab process new base with anatomical finish and characterized base.

Phonetics*

Phonetic Sound	Causes	Solutions
Whistle on “S” sound	Not enough room for tongue between upper bicuspids Space between central	Remove and move bicuspids to the buccal or if room grind out more area for the tongue. Close space.
Lisping on “S” sound	Too much space for tongue between upper bicuspids	Narrow palate space between upper bicuspids by adding ledge of acrylic.
“Th” and “T” sounds indistinct	Not enough room in dentures for tongue If “Th” and “T” sound alike the anteriors are too far lingual	Thin out dentures from lingual sides – don’t grind tissue side. Remount and move anteriors out to the buccal.
“F” and “V” sound indistinct	Improper position of upper anterior – either vertically or horizontally.	Difficult adjustment – must decode and try to correct.

*Phonetic sounds do not react to a regular trial baseplate the same as the final denture. A uni-base on your try-in will duplicate final denture phonetics.

Denture Trouble Shooting Guide.pdf