Pt with denture has swallowing problem and sore throat. The problem is.. Posterior over extension at distal palatal end

Pt with denture has swallowing problem and sore throat. The problem is:

  • A. Posterior over extension at distal palatal end.
  • B. Over extension of lingual.
  • C. Over extension of hamular notch.

The problem is A. Posterior over extension at distal palatal end.

Here's why:
  • Swallowing problem: A posterior overextension can interfere with the tongue's movement and the soft palate's function during swallowing, leading to discomfort and difficulty.
  • Sore throat: The overextended denture can irritate the back of the throat and cause soreness.
While overextension of the lingual or hamular notch can also cause discomfort, they are less likely to directly affect swallowing and are more commonly associated with pain and irritation in the mouth.

Posterior Overextension in Dentures: A Deeper Dive

Understanding the Problem:

A posterior overextension in a denture, specifically at the distal palatal end, can lead to a variety of issues, including swallowing difficulties and sore throat. This occurs when the denture base extends too far back onto the soft palate, interfering with normal oral function.

Why Does it Cause Problems?

  • Interference with Swallowing: The soft palate plays a crucial role in swallowing by closing off the nasal cavity. When a denture extends too far back, it can hinder the soft palate's movement, leading to difficulties in swallowing and a feeling of food or liquid going up the nose.   
  • Irritation of the Soft Palate: The soft palate is sensitive tissue, and when a denture rubs against it, it can cause irritation, inflammation, and pain. This can lead to a sore throat and discomfort.   
  • Gagging: In some cases, a posterior overextension can trigger the gag reflex, making it difficult to wear the denture comfortably.

Clinical Manifestations:

Patients with posterior overextension may present with the following symptoms:
  • Difficulty swallowing.
  • Sore throat.
  • Gagging.
  • Pain or discomfort in the back of the mouth.
  • Difficulty speaking clearly.

Diagnosis and Treatment:

A dentist can diagnose posterior overextension through a careful examination of the denture and the patient's symptoms. Treatment typically involves:
  • Relining or Remaking the Denture: The denture base can be relined to adjust its extension, or in severe cases, it may need to be remade.
  • Adjusting the Posterior Border: The dentist can carefully trim the posterior border of the denture to reduce the overextension.
  • Soft Tissue Conditioning: If the soft palate is irritated, a topical anesthetic or a soft tissue conditioning agent can be used to alleviate discomfort.

Prevention:

To prevent posterior overextension in dentures, it is important to:
  • See a qualified dentist: Ensure that the denture is made by a skilled professional who understands proper denture fabrication techniques.
  • Follow post-insertion care instructions: Adhere to the dentist's recommendations for caring for the denture, including regular cleanings and check-ups.
  • Report any discomfort or problems promptly: If you experience any issues with your denture, consult your dentist as soon as possible.
By understanding the causes, symptoms, and treatment options for posterior overextension in dentures, patients can work with their dentists to achieve a comfortable and functional denture that improves their quality of life.
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