Dental OSCE (Objective Structured Clinical Examination) Practice Exam

What is a likely cause of pain on swallowing in a patient with a removable partial denture (RPD)?

1. Lingual impingement

2. Loss of dental support

3. Improper denture fit

4. Gingival inflammation

The correct answer is: Lingual impingement

Pain on swallowing in a patient with a removable partial denture (RPD) can often be attributed to lingual impingement. This condition occurs when the edges or contour of the denture clasp or base exert pressure against the soft tissues of the tongue or the floor of the mouth. When there is inadequate space or excessive bulk in the RPD design, it can lead to irritation and discomfort during swallowing, as the tongue and oral cavity move to accommodate the act of swallowing. This discomfort can manifest as a sharp or dull pain, particularly when the patient attempts to swallow food or liquids. Lingual impingement is not just uncomfortable; it may also impact the patient’s ability to eat or speak comfortably if left unaddressed. While issues like loss of dental support, improper denture fit, and gingival inflammation can cause a variety of dental issues or discomfort, they are less specifically connected to the immediate pain experienced during swallowing compared to lingual impingement. Loss of dental support could affect the stability and retention of the RPD, while improper denture fit might lead to generalized discomfort in the oral cavity rather than focused pain during swallowing. Similarly, gingival inflammation may cause sensitivity but would not directly relate to the mechanical action of swallowing