Expert: Mark Bornfeld DDS - 11/2/2007

Question
I am planning on getting my upper teeth pulled and getting dentures due to soft teeth! I have 14 teeth to be pulled. The dentist said he will pull them all at one sitting and place immediate dentures. Is this common to have this many teeth pulled in one setting and should i be concerned about the amount of lidocaine that will be used to do this type of procedure?

Answer
Dear Brant,

Although the amount of lidocaine required will not come anywhere close to a toxic dose, what your dentist is proposing is both inhumane and inadvisable if you're to have any hope of wearing your immediate denture.

Traditionally, all the back teeth are extracted first, while the front teeth are temporarily allowed to remain while the back extractions are healing and the denture is being fabricated. A sufficient amount of time is allowed for the gums in the back of your mouth to heal from those extractions before the impression is taken for your denture. In this way, a substantial amount of gum tissue will have healed and will present a more stable foundation for your immediate denture. The front teeth are only extracted AFTER the denture is made. In this way, although the fit of the denture to the gums will be a bit imprecise over the fresh extractions in the front, the denture will derive stability from its superior fit in the back of the mouth where the previous extractions will have already healed and become stable.

So, unless you have some urgent need to get your denture made as soon as possible, I advise against having all your extractions done at once-- the extractions should be done in two stages: first, the back, then wait for healing, then construct denture, and only then should the remaining front teeth be removed. Otherwise, your denture will be floating on 14 fresh extractions, which not only won't feel great, but your denture will have no stability. This is a sure fire way of discouraging you as a new denture wearer. Your dentist should be making things easier for you, rather than economizing on time and effort for his own benefit and at your expense.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY