Obturators: Closing a Palate After Cancer Surgery
An obturator closes a hole between the mouth and the nasal cavity or sinus — most often the defect left after surgery to remove a tumour from the palate or upper jaw. Without one, food and liquid pass into the nose, speech becomes hypernasal and unintelligible, and swallowing is compromised. With one, a patient can eat and speak.
What obturator and resection prosthesis involves
An obturator closes a hole between the mouth and the nasal cavity or sinus — most often the defect left after surgery to remove a tumour from the palate or upper jaw. Without one, food and liquid pass into the nose, speech becomes hypernasal and unintelligible, and swallowing is compromised. With one, a patient can eat and speak. They are staged. A surgical obturator is placed in theatre at the time of the resection. An interim obturator is made during healing and modified repeatedly as the tissue changes. A definitive obturator is made once the defect is stable, typically several months later. Mandibular resection prostheses serve the same function after removal of part of the lower jaw, sometimes with a guide flange to control the deviation of the remaining jaw.
When this treatment is used
Provided as part of the surgical treatment of oral cancer and, less commonly, after major trauma or for congenital clefts that have not been closed surgically. Palatal lift and augmentation prostheses address speech problems from soft palate dysfunction.
Why the prosthodontist should be involved before surgery
The best outcomes come from planning the prosthesis before the resection happens. Where the surgeon places the incision, how much of the palate and how many teeth are retained, and whether the remaining teeth can carry a prosthesis all profoundly affect whether a functional obturator can be made afterwards — and small changes in the surgical plan can make a very large difference. Patients facing maxillary resection should ask whether a maxillofacial prosthodontist has been consulted. In centres where this is routine the functional results are markedly better than where the prosthetic problem is handed over after the fact.
Costs and insurance in summary
Typical fee range across the group: $0–$0 where a single band applies. Several codes here are priced individually and carry their own range on their own page. Costs are substantial and staged across surgical, interim and definitive phases, with modification visits in between.
Benefit category: Medical / maxillofacial, variable on a typical plan. Usually pursued through medical insurance as part of cancer or trauma care. Pre-authorisation and documentation of medical necessity are standard.
Common restrictions: Submit to medical insurance in most cases; Pre-authorisation essentially always required; Modification visits are reported separately; Staged treatment may span benefit years.
The codes this guide covers
Each of these describes a variant of the same procedure. Follow a code for its own fee range, its coverage notes and what distinguishes it from the rest of the group.
| Code | Variant | Typical fee |
|---|---|---|
| D5931 | Obturator prosthesis, surgical | $1,200–$4,000 |
| D5932 | Obturator prosthesis, definitive — most reported | $2,500–$8,000 |
| D5933 | Obturator prosthesis, modification | $400–$1,200 |
| D5934 | Mandibular resection prosthesis with guide flange | $3,000–$9,000 |
| D5935 | Mandibular resection prosthesis without guide flange | $2,500–$8,000 |
| D5936 | Obturator prosthesis, interim | $1,500–$5,000 |
| D5937 | Trismus appliance (not for TMD treatment) | $800–$2,500 |
| D5954 | Palatal augmentation prosthesis | $1,500–$6,000 |
| D5955 | Palatal lift prosthesis, definitive | $1,500–$6,000 |
| D5958 | Palatal lift prosthesis, interim | $1,500–$6,000 |
| D5959 | Palatal lift prosthesis, modification | $1,500–$6,000 |
Common questions
What is an obturator?
A prosthesis that closes a hole between the mouth and the nasal cavity or sinus, usually after surgery to remove a tumour from the palate. Without one, food and liquid enter the nose and speech becomes hypernasal.
When is an obturator made?
In stages — a surgical obturator at the time of the operation, an interim one modified repeatedly during healing, and a definitive one once the defect is stable months later.
Is an obturator covered by insurance?
Usually through medical rather than dental insurance, as part of cancer or trauma care, with pre-authorisation and documentation of medical necessity.