In what order should teeth be extracted for an immediate denture?

Extracting the posterior teeth first and potentially leaving some premolars is a strategy used in preparing for immediate dentures that facilitates better management of the extraction site and minimizes the impact on the patient's ability to function during the transition to dentures.

When posterior teeth are extracted first, it allows the patient to maintain some functionality with their remaining teeth, which helps in managing chewing and stability in the mouth. By leaving some premolars, the extraction area is less traumatic, and it helps provide additional support and guidance for the immediate denture fitting. Once the posterior teeth are extracted, the impressions for the denture can be taken, and the remaining premolars can be extracted later if needed, which allows for easier adjustment and healing in stages.

This approach is particularly advantageous as it helps the practitioner evaluate the patient's soft tissue healing and allows for better fitting of the prosthesis immediately after the extractions. It also assists in managing the patient’s comfort levels and adhering to the goals of esthetics and function during the period of adjustment to the new dentures.