The first 48 hours
Do not remove your immediate denture during the first 48 hours. Let it act as a bandage during the initial healing of the surgical area. If the denture is removed during this period, the gums may swell and make it hard to get the denture back in place. Take your pain medicine as prescribed. It is best to take the first dose as quickly as possible so that it enters your system before the anesthetic (“numbness”) wears off. Research has demonstrated that taking pain medicine on a regular basis, as advised, is far superior to waiting until you “really need it”. It might also be beneficial to apply an ice pack to the region during the first few hours: on for 20 minutes, then off for 20 minutes. If you follow these instructions, modest pain medicines may be sufficient to alleviate your suffering.
Specific instructions for you: For pain relief: take 400mg ibuprofen (2 Advil) with 1,000 mg acetaminophen (2 Extra-Strength Tylenol) immediately, then repeat every 8 hours as needed. *Do not take more than 3000mg in 24 hours. *Advil Dual Action with acetaminophen is the above already combined. Take 2 tablets every 8 hours.
It is normal for some bleeding to occur during the first 2-3 days. When bleeding occurs, close your teeth together tightly for 10 minutes and the pressure from the denture will slow down the bleeding. Do not rapidly clench and release as this only “pumps” the site and can increase the bleeding. If you have excessive bleeding, contact your dentist immediately. Do not take any additional medications or herbal products during this time unless prescribed by your dentist or physician. Many seemingly harmless products can cause increased bleeding. Of course, if you are on any prescription medications for medical conditions, continue to take these as directed. If you forgot to tell your dentist about any medications you are taking, tell them at once. Clean the rest of your mouth and any remaining natural teeth as usual.
Keeping a clean mouth can aid the healing process.
Do not spit forcefully during this time or the denture could become dislodged. If you need to remove liquid from your mouth, let it drool out gently over a sink. Avoid mouthwashes during the first 48 hours unless prescribed by your dentist.
At the end of 48 hours remove the denture
Pour 1/4 cup warm water into your mouth and, with your lips securely clenched, proceed to press the water beneath the denture to loosen it. Spit the water out gently. The lower denture is usually easy to remove by lifting straight up. Often, the upper denture comes out best in a downward and forward direction. The upper may be harder to remove, especially the first time. If it is stubborn, take your index finger and place it between your denture and cheek moving up and back until you feel the back upper corner of the denture. Place your finger on top of the denture border at this place and slowly pull down, increasing the force till the denture becomes detached. The exact way your denture most easily comes out is dependent on your mouth’s unique shape. After a couple of times, you will know just what to do. There may be very dark blood inside your denture. This is normal. You may also develop some dark spots inside your mouth or on your face over the area of the surgery. This condition, called ecchymosis, is not of any lasting importance; it goes away in a couple of days.
Brush your denture inside and out with dishwashing liquid and rinse well with warm water. Put some more warm water in your mouth. Use your tongue to gently scrub the gums that were covered by the denture. Do not spit; let the water drool out of your mouth into the sink. Put your denture back in place and press it onto your gums for 10 seconds. Close together, swallow, and hold together an additional 10 seconds to correctly seat the denture.
Eating during the first week
It is very important to maintain good nutrition during the healing process. It is especially important to drink plenty of fluids. During the first 24-36 hours you need to eat food that does not require chewing. Some suggestions are:
- Cereal/bread group: thin oatmeal or cream of wheat
- Vegetable group: thin soups, juices
- Fruit group: blended drinks, juices, and shakes
- Milk group: Milk, yogurt, cheese soup, Carnation Instant Breakfast.
- Ensure, Sustacal (these two products are nutritionally complete, lactose free drinks)
- Meat group: eggs, pureed meats, meat broths or soups
After the first or second day, gradually increase the consistency of the diet. In addition to the items listed above, try soft foods such as tiny pasta, well-cooked carrot and green beans, creamed veggies, mashed potatoes, soups, well-cooked fruits (no seeds), scrambled or softboiled eggs, canned fruits, and minced meats. Cut your food into small pieces and eat slowly. Eating with a denture is very different from eating with natural teeth. You may find it helpful to put food on both sides of your back teeth and chew straight up and down. Biting food off is generally better done at the corners of the mouth instead of the very front as is common with natural teeth. However, it is hard to predict exactly what biting and chewing movements will be best for you because they vary widely from person to person. You will soon learn what works best for you. Be patient with yourself.
Speech
Certain sounds may be hard to pronounce when you first get your denture. Some people find it helpful to read out loud to themselves for the first few days to train their speech. Over time your speech will improve.
Becoming accustomed to your denture
Having a denture in your mouth can be overwhelming at first. This initial reaction is to be expected. Our mouths are designed to detect even very small foreign objects. Therefore, something as large a denture can be quite a “shock.” You will probably notice additional saliva in your mouth. This is because objects in the mouth are usually food so saliva is increased to aid the eating process. It may take a couple of weeks for your mouth to realize the denture is now “part of you.” In most cases, a lower denture will cause more problems than an upper denture. Even with an “ideal fit,” the curvature of the lower gums typically restricts suction, causing a lower denture to seem wobblier than an upper denture. A denture adhesive might be effective in this circumstance. There are many types of adhesives available, and your dentist can offer advice on which one best fits your needs. If you continue to have problems with the lower denture, ask your dentist if implants might be right for you. Patients have fewer problems with the upper denture. In some cases, a feeling of fullness in the roof of the mouth may cause some gagging at first. This declines as the mouth realizes the denture is not a foreign object but is now “part of you.”
Sore spots
Sore spots might develop even in a denture with a “perfect fit.” This is because the gums on which the denture sits vary from place to place. Some regions are quite thick and resistant, whereas others are thin and readily harmed. You should see your dentist as soon as a sore appears so that an adjustment may be performed; attempting to “tough it out” can result in a bigger sore that is more difficult to manage. You can buy ointments to numb the region until you can see the dentist, but these can disguise the problem and cause worse sores if used for too long. Never try to modify the denture yourself.
Dry mouth (xerostomia)
Dry mouth might make wearing dentures more difficult. Saliva helps keep dentures in place and reduces uncomfortable places by supplying lubrication beneath the denture. Your dentist might recommend items designed for this situation to make denture wearing more comfortable.
Caring for your denture after the first 48 hours
Starting from the day you remove your denture for the first time, remove your denture and rinse it out after every meal or snack, and then place it back in your mouth. For the first 5 days, keep your denture in at all times except to clean. Avoid mouthwashes the first 5 days unless prescribed by your dentist; some mouthwashes may slow the healing process. You can use warm water rinses as described above during this time. To clean the denture, partially fill the sink with water to absorb the impact if it is dropped. To clean the inside and outside of the denture, use liquid dishwashing soap and a denture brush. Toothpastes designed for real teeth are overly abrasive, causing microscopic scratches that will wear down the denture material and teeth with time. After healing has occurred, a soft toothbrush with toothpaste is helpful for cleaning the gums where the denture rests. Your tongue should be cleansed as well as it harbors many of the germs that cause bad breath. After the first 5 days, it is best to leave the denture out at night and let it soak in a denture cleanser. This allows the gums to relax and maintain optimal health. Under certain circumstances it may be necessary to keep your denture in all night. If this is the case, you are more likely to get certain conditions, such as oral yeast infections. Consult your dentist about other techniques to maintain your dental tissues healthy based on your specific condition.
Regular dental care is still important
You may think that since you no longer have your natural teeth, you only need to see your dentist if you notice a problem. That is a dangerous myth. The supporting tissues under your dentures continue to change throughout the rest of your life. The amount of change varies from person to person. As the gums shrink, the denture and the gums become mismatched. This change is especially great during the first 6 months to a year following the removal of natural teeth. If this change is expected to be very large, your dentist may call this first denture a temporary denture because it is only meant to function until healing has occurred after which a new denture will be made to match the new shape of your gums. At other times only a reline may be needed. A reline is a technique in which more denture material is introduced to the area of the denture that meets the gums, allowing the denture to again closely fit to the contour of the mouth. During the healing process, your dentist may insert a tissue conditioner (temporary soft liner) inside your denture. The liner may be replaced periodically as the gums recede to keep you comfortable during the healing process. As mentioned above, your gums continue to change throughout life. These changes occur gradually and are typically not seen by the denture user until considerable tissue damage has occurred, which may necessitate surgery. Your dentist is trained to detect these changes and correct them early when the treatment is less expensive and less troublesome for you. Your dentist will also closely observe your tissues for signs of oral cancer. Many of the oral cancers diagnosed in North America occur in people that have dentures.
Myths about dentures abound.
Although well meaning, friends and relatives may give you advice that can be damaging to your new dentures and your mouth. Each individual is very different, and what might work for some may create problems for others. Never adjust your denture yourself; a minor alteration might be very expensive to correct. Your dental staff is trained to give you the best advice based on your unique needs.
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