Name of the Procedure:

Common name(s): Immediate Denture
Technical or medical term: Immediate Denture - Mandibular (HCPCS: D5140)

Summary

An immediate denture for the lower jaw (mandible) is a removable dental appliance that is placed in the mouth immediately after the extraction of the natural teeth. It helps the patient to have functional teeth while their gums heal and adjust to the new dentures.

Purpose

Immediate dentures address the problem of tooth loss and assist in maintaining aesthetics and functionality. The goals are to replace lost teeth, support facial structures, and allow the patient to chew, speak, and smile effectively right after tooth extractions.

Indications

• Severe tooth decay or gum disease that requires full extraction of the lower teeth.
• Patients needing an immediate solution to avoid being without teeth.
• Individuals with significant tooth loss affecting their appearance and function.

Preparation

• Initial dental assessment and impressions of the mouth.
• Oral examination and X-rays to evaluate the need for extractions.
• Instructions to fast for a few hours before the procedure if sedation or general anesthesia is required.
• Adjustment of any medications as per dentist or doctor's advice.

Procedure Description

1. Impressions: Preliminary impressions of the patient's mouth are taken prior to extraction.
2. Design: The immediate denture is fabricated based on these impressions.
3. Extraction: On the day of the procedure, the remaining natural teeth in the lower jaw are extracted.
4. Placement: The immediate denture is placed over the extraction sites right after the teeth are extracted.
5. Adjustments: The dentist will make any necessary adjustments to ensure comfort and proper fit.

Tools and equipment: Dental impression materials, extraction instruments, immediate denture appliance.

Anesthesia or sedation: Local anesthesia is typically used for extractions, though sedation or general anesthesia may be employed, depending on the patient's needs and comfort level.

Duration

The procedure for extractions and immediate denture placement usually takes about 1 to 2 hours, depending on the number of teeth being extracted and the complexity of the case.

Setting

Typically performed in a dental office or an outpatient clinic specialized in oral surgery and prosthodontics.

Personnel

• General Dentist or Oral Surgeon
• Dental Assistants
• Lab technicians (involved in the fabrication of the denture)
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Discomfort and swelling in the gums post-extraction.
• Adjustment issues, leading to multiple follow-up visits.
• Risk of infection at the extraction site.
• Difficulty in speaking or chewing initially.
• Possible denture sore spots that may require adjustments.

Benefits

• Immediate replacement of missing teeth, maintaining aesthetics and functionality.
• Support for facial structure, avoiding sunken facial appearance.
• Immediate ability to chew and speak more normally.
• Psychological benefit of avoiding a period without teeth.

Recovery

• Swelling and discomfort in the first few days are common; pain medication may be prescribed.
• Soft diet recommended for the initial healing period.
• Regular follow-up visits for adjustments and ensuring proper healing.
• Healing period can range from a few weeks to several months.

Alternatives

• Traditional dentures made after gums have healed, though this involves a waiting period without teeth.
• Implant-supported dentures which are more permanent but require surgery and healing time.
• Partial dentures if not all teeth require extraction.

Patient Experience

Patients may feel discomfort and pressure during the extraction process but are generally numb due to anesthesia. Post-procedure, they might experience swelling and sore spots that may require adjustments. Pain management strategies and follow-up care aim to ensure comfort and proper adaptation to the new dentures.