About two or three times a week, I’ll have a patient come to my office with the need of fixing their old denture. The denture has worked well for many years and still has the smile that is needed, but it no longer fits as well as it used to. Certainly, one option is to make a new denture, but that is not always needed. Usually, there is a way to get a few more years out a denture by refitting the denture and the bite to the gums. Doing a refit is great especially when it seems like denture adhesive fixes the problems which means that there is not that much of a gap to refill. I want to discuss the three types of refits which are soft relines, hard relines, and rebases as well as each’s benefits and issues.
The most common type of refit that I do is a soft reline. I am a huge fan of soft relines for three reasons. First, they are inexpensive and quick to do. I can do a soft reline within 15 minutes for a patient and all of my patients who have healing dentures get as many relines as needed for the first six months. The steps are pretty simple. First, I have to place a primer on the denture and then mix the soft liner material. Second, I place the denture in the mouth and the patient bites into it. Third, the patient will continue to bite for five to ten minutes and I’ll come back and clean up the excess. The worst part of it is that the taste is pretty awful; however, the taste goes away pretty quickly. The other good thing about soft liners is that if for some reason the soft liner does not set correctly, I can easily pull it out and do another one. This advantage of being easy to redo is also it’s biggest disadvantage. Soft liners typically aren’t as strong as the other options, and they are only meant to last for a few months at best. It is not uncommon for a patient to return with a soft liner that has popped out and if that happens, I just place another one. It is not a big deal. The only caveat to soft liners being easy to redo is that occasionally I will have a patient who has a soft liner that they have adapted to, but they request to have another soft liner placed. I will end up placing the soft liner, and it won’t set right. When I pull out the part that did not set right, I also sometimes pull out the part that my patient’s mouth had adapted to. It can be very difficult to get back to the exact way the soft liner was when the patient’s mouth liked it.
The second type of refit that I do is a hard reline. It is probably the least common that I do, but the most common that other dentists do. A hard reline can be done either chairside or in the dental lab. Chairside relines have the exact same procedure as the soft reline whereas lab relines are more complicated. For a lab hard reline, I take models of the mouth and take the patient’s denture for one night. I set the denture on the model, add special acrylic that bonds well with the denture acrylic, and place it in a pressure pot at 30 PSI for 8 hours. By letting it sit for 8 hours at 30 PSI, the acrylic sets better and is much stronger. I don’t do many of these because they are not very easy and there are a lot of ways to mess up this process. I find they work best when I need to do a reline on a partial denture as I am able to set the denture to the teeth and ensure that it is fitting properly. I don’t do these for complete dentures as I would need to take the denture for a couple of weeks to send it to a dental lab that specializes in dentures and it makes the prosthesis thicker which isn’t often desired. Finally, I don’t do many relines on complete dentures because rebases work much better in my opinion.
A rebase is the third type of refit and probably my favorite. I love rebases because they fix the problem completely of poor fit by keeping the teeth and smile the same but replacing all the gums so that everything fits well again. A rebase is done by a dental lab and it takes one to two weeks to do. The steps for a rebase are much like the steps for making a denture. First we use the current dentures to take new molds and we leave those molds on the denture themselves. This shows the lab how the gums have changed compared to the old gums. Second we take the dentures with the molds in them and take a bite so that the lab knows how the jaws line up. Third, the lab mounts the case on an artificial jaw called an articulator, and the gums are ground off but the teeth are left in the same position. New gums are then placed on the teeth using a special type of wax. Fifth, a mold is made of the teeth and wax gums. Finally the wax gums are removed from the mold but the teeth are kept in the same spot and special pink acrylic is placed in the mold and it is processed and cured from there. Rebases are great because we are removing almost all of the old and beaten up denture gums and replacing it with fresh denture gums that fit well and are comfortable and thin. The biggest issue with the rebase is that it has to be done by a lab, and therefore the patient has to be without teeth for a few weeks. For my patients who are having a rebase done, I make a complimentary printed denture to get them through the time.
A refit is a great option to tune up your denture and keep your smile looking good for more years. As I do a lot of dentures in my dental office, I also do quite a few refits. Refits I find work best in patients who already love their smile and wear their dentures with adhesive, though which refit works best is decided on a case by case basis. If you feel that you would benefit from a refit, please call us at 504-392-5104 and we will help you out.