Dentaltown July 2018 - 42

message board

Severe Gagger Needs Dentures
Townies share their advice on how to deal with patients who gag

nibpatte
Member Since: 07/01/06
Post: 1 of 31

Hi, all. I have a patient who is in need of immediate maxillary and mandibular dentures.
He currently wears a horseshoe partial and it took him some time to adjust to that. During
the try-in phase, it became very clear that he will not be able to tolerate wearing a traditional
denture, so options are limited to implant-retained. I have done some All-on-4 cases with a
transitional prosthesis during the healing phase. Is a transitional prosthesis able to be worn on a
Conus type of implant system, or will he have to remain edentulous during the healing stage of
the implants prior to fabricating the final prosthesis? Any other options? ■
4/3/2018

almunk
Member Since: 12/17/05
Post: 2 of 31

You can make a denture, then start chopping off its palate until he can stand it, then use
adhesive until the implants heal. It will likely be about half-size when you are done. ■
4/3/2018

BreakingFree
Member Since: 09/03/09
Post: 3 of 31

I had a severe gagger once who needed immediate dentures. I sent her home with an impression tray and had her continue to put it in her mouth until she could do it without gagging. Have
them start for two seconds at a time while watching TV. Work up to it not bothering them. It
worked for her, but now my N=1. So, take that advice for what it's worth. ■
4/3/2018

extractor
Member Since: 10/29/02
Post: 4 of 31

Make sure you under-promise and over-deliver. I would make sure the patient knows that
they will absolutely hate the denture. Hate it. For at least a year. If that scares them off, then
great. Then do your best to make a nice denture. If they hate it for only six months, you are
the hero. ■
4/3/2018

nibpatte
Member Since: 07/01/06
Post: 5 of 31

So, I did this with the upper during the wax bite stage. He was able to tolerate it long enough
to verify level occlusal plane, but when I attempted to place the lower bite rim so that I could
establish a bite record, he lost it. Could not have both in at the same time. ■
4/3/2018

Timmy G
Member Since: 04/14/02
Post: 6 of 31

I stopped this madness a long time ago. I have no power to change anyone's gagging response.
If they cannot tolerate impressions, base plate, try-in ... I'm out. Off to the prosthodontist. Life
is too short. These have never had a good ending for me. If others want to tackle it, so be it. ■
4/3/2018

earned
Member Since: 11/16/08
Post: 7 of 31

Can you get creative and leave a few teeth for transitional partial while implants heal? I've
had great luck doing this for patients with BioTemps in fi xed-implant cases. ■
4/3/2018

nibpatte
Member Since: 07/01/06
Post: 8 of 31

I don't think so. He is missing all posterior teeth on max right side up to #8. I would love to
send him to prostho but the closest one is 2.5 hours away. ■
4/3/2018

JULY 2018 // dentaltown.com

http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown July 2018