Which of the following represents a contraindication to providing a mandibular complete denture?

Correct answer: D. The patient still has all of their natural maxillary teeth

• A. High frenum attachments require frenectomy or adequate relief in the denture flange — they are surgical/design challenges, not absolute contraindications.
• B. Xerostomia reduces denture retention (saliva needed for suction/adhesion) and increases mucosal irritation but is not an absolute contraindication to mandibular denture provision.
• C. Severe mandibular bone resorption is a significant CHALLENGE (poor retention/support) but not an absolute contraindication — implants or specialty techniques can help.
• D. CORRECT. When a patient has all of their natural maxillary teeth and no mandibular teeth, providing a mandibular complete denture creates an extremely unfavorable occlusal force situation: the natural teeth are stronger and more stable than denture teeth, leading to severe trauma and progressive bone loss in the mandible. This 'combination syndrome' (Kelly's syndrome) makes a mandibular complete denture against all natural maxillary teeth a RELATIVE CONTRAINDICATION unless the maxillary teeth are also managed.