Anatomy & Histology · patient case question
Which nerve is responsible for this patient's pain?
Patient case: Long-standing complete denture with ridge pain
Patient: Female, 74 years old
Chief Complaint: “The lower denture hurts on the right side, near the back corner of my lip.”
Background: The same mandibular complete denture has been worn for over fifteen years without relining.
Current Findings: Severe mandibular ridge resorption. The denture is markedly overextended relative to the resorbed ridge, and the fitting surface bears directly on a discrete area in the premolar region. Sharp, well-localised pain and some numbness of the lower lip on that side.
Show answer and explanation
Correct answer: B. The mental nerve
- A. The maxillary division supplies the upper jaw and has nothing to do with a mandibular denture.
- B. CORRECT. As the mandible resorbs, the alveolar crest recedes until the mental foramen comes to lie at or near the crest of the residual ridge. The mental nerve then sits directly beneath the denture base and is compressed with every occlusal load, producing sharp localised pain in the premolar region and paraesthesia of the lower lip and chin. The remedy is generous relief of the denture base over the foramen.
- C. The lingual nerve runs along the lingual aspect of the mandible near the third molar region and supplies the tongue and lingual mucosa; it is not compressed by a denture base over the ridge crest.
- D. The buccal nerve supplies buccal mucosa and skin of the cheek, and it is not positioned to be compressed by the denture-bearing surface.
Note: Mandibular resorption follows a DOWNWARD AND OUTWARD path, so the ridge becomes BROADER as it resorbs. The maxilla resorbs UPWARD AND INWARD and becomes NARROWER. This is why the intra-arch relationship progressively shifts toward a pseudo-Class III appearance in long-term denture wearers.
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