My Denture Still Makes Me Gag After Four Refittings

Despite four refittings from my dentist since February, my new denture still makes me gag. My dentist suggested making a new denture, but what if that doesn’t solve the problem? Thanks. Tyler from MD

Tyler,

For a loose denture that causes gagging, an implant-supported denture is often the best approach. Unlike traditional removable dentures, which must cover the entire hard palate for suction, an implant-supported denture rests only on the gum tissue. This design significantly reduces or eliminates the gag reflex.

However, if getting dental implants to support a palateless denture is not feasible for you, alternative solutions with a conventional denture are available.

How to Minimize Gagging and Maximize Denture Fit

For optimal suction, a denture’s base should ideally extend to the vibrating line, the boundary between your hard and soft palates. If a denture causes gagging, a customized approach may be necessary.

One technique, demonstrated by prosthodontist Dr. Finlay Sutton, involves carefully shortening the denture’s posterior edge. This precise modification can alleviate gagging while maintaining enough suction for stability. Here are key considerations:

• The denture must be skillfully trimmed to avoid weakening its hold.
• Trimming too much, or in the wrong areas, can lead to a loose and unstable denture.

It’s also important to verify that your current denture doesn’t extend onto your soft palate, which is an improper fit for any patient. If you suspect this is happening, especially if gagging is a new issue for you, a second opinion could help clarify the situation.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post.1

I Regret Bypassing My Dentist and Going to the Lab for a New Partial Denture

I made the mistake of going directly to the lab for a new partial denture. I bypassed my dentist to save money. I have coworkers who use the same lab and have no problems. My partial denture is uncomfortable and too short. It rocks when I chew. The lab couldn’t fix it and told me I need my dentist’s impressions to fix it. Why would they agree to do it? I’m embarrassed. What should I do? Thanks. Karl from SC

Karl,

We understand that dealing with a partial denture that moves when you chew must be frustrating and uncomfortable. A secure and comfortable fit is essential for any dental appliance to function correctly and feel natural.

Creating a partial denture that fits precisely involves crucial steps a qualified dentist takes. Your dentist takes accurate impressions of your mouth and makes a detailed model of your teeth and gums. They use this information to design the denture and write a specific prescription, which they then send to a dental laboratory. A dentist’s guidelines ensure the lab technicians have the exact specifications to craft an appliance tailored to your unique oral anatomy.

Legally, dental laboratories in the United States cannot create partial dentures, complete dentures, or any other dental restoration directly for a patient without receiving a prescription from a licensed dentist. While you may have approached the lab directly to save money, the lab operates under these legal requirements and should have declined to make the denture without a dentist’s order. Because the lab professionals know these rules, the primary fault lies with them for proceeding without the necessary prescription and dental guidance. Lab technicians are skilled in fabricating appliances but do not take dental impressions or design restorations directly in a patient’s mouth; this expertise belongs to the dentist. Skipping the dentist’s essential diagnostic and design work leads to an inaccurate fit and the type of movement you are experiencing.

If you want a refund from the laboratory, you can inform them that making the appliance without a dentist’s prescription is illegal. Mention that you are prepared to report this violation to the state dental board. They will likely agree to refund your payment to avoid formal action.

After addressing the issue with the lab, we strongly encourage you to consult with your dentist or find a new dentist you feel comfortable with. They can take precise impressions and oversee the creation of a new partial denture that will fit correctly, feel comfortable, and remain stable when you chew.

What Is an Alternative to a Partial Denture?

As you think about replacing the ill-fitting partial denture, you may also want to learn about dental implants as an alternative solution for missing teeth. A dental implant is a small, artificial root (usually made of titanium) that a dentist surgically places into your jawbone, which integrates to support a replacement tooth.

Dental implants offer several advantages over partial dentures, which are worth considering, especially when it’s time for a replacement. Understanding these benefits can help you make an informed decision about your long-term dental health:

1. Durability: Dental implants can last 20 years or significantly longer with proper care, while partial dentures generally require replacement every five to seven years.
2. Self-Sufficiency: An implant supports a dental crown (the visible part of the replacement tooth) without relying on adjacent natural teeth for support, unlike partial dentures, which often use clasps on neighboring teeth.
3. Stability: Because the implant fuses directly with your jawbone, it provides a very stable foundation that does not move or shift when you chew or speak.
4. Bone Preservation: Implants stimulate the jawbone like natural tooth roots, helping maintain bone density over time.

If you want a more permanent and stable tooth replacement option, consider discussing dental implants with a dentist with implantology experience. They can evaluate your needs and oral health to determine if you could benefit from this advanced treatment.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post.