Over the years, we have worked with many people who have fought with a poorly-fitting partial denture for months or even years. In some cases, the fit was uncomfortable enough that they had to stop wearing the partial altogether. Most of the time, these patients did follow up with the dental professional repeatedly in an attempt to improve the fit.

For cast partial dentures to fit properly, attention to detail is a requirement.

This all starts with a well-taken impression of the teeth and gums. The stone model created from this impression must be detailed and accurate, otherwise the resulting partial frame will not fit.

Some might say, "Well that isn't a big deal, just grind, or bend with pliers, the areas of the frame that are too tight". The problem is figuring out exactly where the inaccuracy is. Even if it can be found, the alloy is very stiff and can only be bent slightly. As for grinding, the frame is only about 1mm thick. If it is ground too much it will become weak and will likely break under normal use. The simple solution is to get it right the first time.

Some people have teeth with an angle and/or curvature that make it difficult for a partial denture to stay in place well but the fit must be, at the least, accurate and comfortable even if it is somewhat loose.

If a new partial is inserted and it has what I call a "wedge fit", do not continue to wear it. With a wedge fit, it feels as though the more the partial is pushed into place the tighter it gets; the pressure does not let up and some of the natural teeth may feel as though they are being pushed out of their normal position resulting in discomfort. In some cases, a partial denture that fits this poorly could do damage to the natural teeth if it continues to be worn.

How can a partial like that be made to fit well?

This would be accomplished one of two ways, either through careful adjustments or, if that fails, by starting all over with new impressions. Perhaps that would explain why sometimes patients are told things like:

     "Give it time to settle into place."

or

     "You will get used to it eventually."

or

     "There is nothing more I can do for you."

The moral of this story is to know how a properly-fitting cast partial denture should feel. If you suspect that it is ill fitting, then trust your instincts and communicate promptly with the practitioner to achieve the accurate fit that you paid for.