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Upper Denture
Upper Denture  

Upper Denture
Upper Denture  
Hi Dr. Kaufman,

         I wear upper dentures and due to excessive gagging, my Dentist was able to create a horse shoe pattern. So far the adhesive denture cream is holding them in place. Unfortunately, I am still experiencing some gagging on occasion. The fustrating part is that my Dentist is asking me to tell him where the trouble some,discomfort area is. My dentures need to be trimmed back more, but I don't have any idea where. I've enclosed two photos. Would you be able to determine where my dentures need to be trimmed by examining my pictures?

Thanks!
Glenn

Answer
Dear Glenn:
You must have posted your question at the same time that I have signed out for vacation.  Our paths have crossed and I am sorry for the delay.  I am still on vacation, but I finally got to a computer and have the time to give you some insight.
Yes, the denture can be trimmed back some more.  It is typically on the sides where your tongue rests.  If you look at the top picture of the denture that you have posted (the one where you see more of your thumb...) you can see a shaded area in the palatal area, which was not trimmed.  This area can be removed.  It will improve the sensation for you.  
You can also ask your dentist to create a palatogram, which is a way to visualize where the tongue touches denture upon speech.  Typically a special marking spray is sprayed onto the denture surface and it delivers a dry powder onto the surface.  As you move the tongue, the dry, sprayed on powder will indicate (turn wet) where your tongue touches.  This is available in the dental literature and your dentist can look it up.  The Journal of Prosthodontics V.7 Issue 2.  p.84-90, 1998 has a good article, but you have to pay to obtain it, or if your dentist is a Prosthodontist, he/she will have access to it trough his/her membership.  There are many other articles about this, however.
The other issue is, of course, retention.  You should definitely consider having four implants placed in your maxillary (top) jaw and have this same denture connected with special attachments to the implants.  It will still be a removable denture, yet it will be held in place by the implants, providing you excellent stability and retention, requiring no glue.
Happy Holidays and a Happy New Year,
Dr. Zev Kaufman  

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Zev Kaufman, D.D.S.

Expertise

I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.

Experience

Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Organizations
Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Education/Credentials
Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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