Managing Pain from Dentures: Solutions for Elderly Patients

If you have been experiencing persistent pain in the upper mouth due to a removable denture and it hasn't improved, consider the following steps: 1. Consult Your Dentist: Schedule an appointment with your dentist to evaluate the fit and condition of your denture. They may need to make adjustments or repairs. 2. Check for Sores or Irritation: Your dentist will check for any sores or irritation caused by the denture. They may recommend treatments

Hello, Dr.
Huang! My elderly father has been fitted with dentures (with some residual tooth roots remaining in both the upper and lower jaws).
Recently, for over a month, he has been experiencing pain in the right cheek and upper area, initially thought to be due to mouth sores.
After seeing an ENT specialist with no improvement, he was referred to a dental clinic.
The dentist informed us that the pain was caused by the dentures being damaged and ill-fitting, and that he could no longer wear them.
They extracted a decayed tooth root from the upper right and prescribed antibiotics and painkillers for three days, but my father still experiences pain at night, preventing him from sleeping.
He returned for a follow-up visit a few days later, and the dentist indicated that the issue was not related to the extraction site but rather an infection and inflammation of the bone caused by the dentures.
They prescribed pain medication and a sedative to help him sleep without pain.
They also mentioned that in order to remake the dentures, all remaining tooth roots must be extracted first.

I have a few questions for you, Dr.
Huang:
(1) How long will the bone and nerve pain caused by the dentures last? Will it heal naturally? Why were only painkillers and sedatives prescribed without muscle relaxants?
(2) My father is over 80 years old and has high blood pressure and has had a heart stent placed.
Is it appropriate to extract all remaining tooth roots from both the upper and lower jaws? Could there be any complications?
(3) The clinic requires the extraction of all decayed tooth roots before they will assist in making new dentures; otherwise, we would have to go to an outside facility.
After the first extraction, my father experienced dizziness.
Could this be due to the anesthetic? Since he felt dizzy after just one extraction, I am concerned about the safety of extracting the remaining roots.
The dentist is very kind, but I am genuinely worried and have no one else to consult.
Please help clarify these concerns and provide your advice.
Thank you!

An An, 30~39 year old female. Ask Date: 2019/10/26

Dr. Huang Tingfang reply Dentistry

Dear Ms.
An-An,
Hello!
1.
How long will the bone nerve pain caused by dentures last? This primarily depends on clinical examination and X-ray evaluation.
If it is just soft tissue, improvement can be expected within a week (without wearing the dentures).
However, if there is a bone issue (such as osteomyelitis), debridement will be necessary for recovery.
2.
Regarding hypertension and having a heart stent, is it appropriate to extract all remaining tooth roots from both upper and lower jaws? Will there be any complications? Generally, there should be no issues as long as antibiotics are administered preoperatively to prevent infection.
3.
If I extract the remaining tooth roots, is there a concern about potential problems? Essentially, dentures are the final step in treatment.
If there are still decayed tooth roots or loose teeth in the mouth, it can lead to pain after the dentures are made, and they may not last long, requiring remaking at an additional cost.
Take care! Wishing you peace and smooth recovery!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2019/10/26

More Info

Managing pain from dentures in elderly patients can be a complex issue, especially when underlying dental problems and systemic health conditions are involved. Your father's situation, involving discomfort from ill-fitting dentures and the need for dental extractions, raises several important considerations.

1. Duration of Pain from Dentures and Healing: The pain caused by dentures, particularly if they are poorly fitted or damaged, can lead to inflammation and discomfort in the surrounding tissues, including the bone and nerves. The healing process can vary significantly from person to person. Generally, once the source of irritation (in this case, the ill-fitting denture) is removed or corrected, the pain should gradually subside. However, if there is an infection or significant inflammation, it may take longer for the tissues to heal. The use of pain medications, as prescribed, can help manage discomfort during this period. While muscle relaxants may be beneficial in some cases, they are not always necessary unless there is significant muscle tension contributing to the pain.

2. Considerations for Tooth Extractions: Given your father's age and medical history, including hypertension and a heart condition with a stent, it is crucial to approach the decision to extract all remaining tooth roots with caution. While it may be necessary to remove these teeth to facilitate the fitting of new dentures, the risks associated with surgery in elderly patients must be carefully weighed. Potential complications can include excessive bleeding, infection, and delayed healing. It is essential to have a thorough discussion with the dentist about the risks and benefits of the procedure, considering your father's overall health status.

3. Post-Extraction Symptoms: The dizziness your father experienced after the extraction could be related to several factors, including the effects of the local anesthetic, anxiety, or even a drop in blood pressure. It is not uncommon for elderly patients to feel lightheaded after dental procedures, especially if they have underlying health conditions. If your father is concerned about further extractions, it may be helpful to consult with his primary care physician or a cardiologist to ensure that he is stable enough for additional dental work.

4. Alternative Solutions: If the dentist insists on extracting all remaining roots before proceeding with new dentures, it may be worth seeking a second opinion from another dental professional, preferably one who specializes in geriatric dentistry. They may offer alternative solutions, such as partial dentures or immediate dentures that can be fitted after extractions, minimizing the time without teeth.

5. Pain Management Strategies: In addition to prescribed medications, consider non-pharmacological approaches to pain management. These can include warm compresses to the affected area, maintaining good oral hygiene to prevent infection, and ensuring that any new dentures are fitted properly to avoid further irritation.

In conclusion, managing pain from dentures in elderly patients requires a comprehensive approach that considers both dental and medical factors. Open communication with healthcare providers, careful monitoring of your father's health, and exploring all available options will be key to improving his comfort and quality of life. If you have further concerns, do not hesitate to reach out to healthcare professionals who can provide tailored advice based on your father's specific situation.

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