What is the first aspect to check when a patient reports pain under a denture?

When a patient reports pain under a denture, the first aspect to check is the occlusion. This is because occlusal discrepancies can lead to undue stress on the underlying tissues, causing discomfort or pain. It involves examining how the upper and lower teeth come together when the patient bites down, which is crucial in ensuring proper alignment and even distribution of forces during mastication. Inadequate occlusion can lead to areas of excessive pressure on the supporting tissues, leading to inflammation or soreness.

While other factors such as soft tissue changes, denture fit, and the patient’s oral hygiene are also important and should be assessed, checking the occlusion first allows the dentist to determine if the pain is a result of improper alignment of the denture with the opposing arch. If occlusion is off, adjustments may relieve the pressure and alleviate pain before investigating further issues.