before the pt arrives for insertion appointment
- Decontaminate dentures
- Are they the correct dentures? (can put identifying plate or mark on palate esp in care home to minimise risk of mix up)
- Have they been processed properly – porosity, inclusions of plaster in the denture
- Slight reduce strength (depends on where they are)
- Anterior – appearance
- Posterior – ask pt if they are ok with them
- Slight reduce strength (depends on where they are)
- Any sharp, rough, prominences which should be removed prior to insertion?
- Do before pt comes in
- Look for undercut areas that may need adjusted
- Wait for pt to try in before adjusting if needed as usually provide retention
when pt arrives for insertion appointment inform them
may make some adjustments, very common
what to check when insert denture (6)
- Extension – if moves on manipulation, want seal on function (don’t be excessive)
- Retention – pull anterior region
- Stability – measure of adaptation, rock, minimal movement ok
- Occlusion
- Occlusal Planes
- OVD, FWS (measure old and new and check if changes done)
- Appearance
- Speech
- Will change slightly as pt needs to acclimatise to the new dentures, in a few days will get used to them
- Most common is lisp – denture is thick and not sufficient space for tongue – ask lab to reduce thickness down as much as possible
- Will change slightly as pt needs to acclimatise to the new dentures, in a few days will get used to them
what to do to aid insertion of denture
moisten them and leave to settle for a moment before checking
how to check extension
- if moves on manipulation, want seal on function (don’t be excessive)
how to check retention
- – pull anterior region
how to check stability
measure of adaptation, rock, minimal movement ok
how to check occlusion
- Occlusal Planes
- OVD, FWS (measure old and new and check if changes done)
appearance check
ask pt if happy
speech assessment
- Will change slightly as pt needs to acclimatise to the new dentures, in a few days will get used to them
- Most common is lisp – denture is thick and not sufficient space for tongue – ask lab to reduce thickness down as much as possible
should you assess a C/C with both dentures or individually initially
individually
check stability, retention and extention
then together for occlusion, speech and appearance
adjustments of final dentures
- Roughness can cause pain
- Extension into Undercuts can be painful
- Over and under-extension may cause pain/looseness
- Occlusion may require adjustment
Smooth & polish if necessary (e.g. pumice & whiting). We have a small lab on level 6
why would occlusion need adjusted
- Occlusal interferences occur at delivery
- Inaccuracy of recording retruded contact position due to limitations of articulator
how to adjust occlusion in final dentures (2)
- Selective grinding
- Re-record occlusion
selective grinding
to adjust occlusion
- Use articulating paper (mark high spots)
- Remember bases are unstable and denture moves slightly
- Never as solid as natural teeth
- Adjust carefully
BULL rule for adjusting occlusion
- Buccal upper (Palatal surface of buccal cusp) and
- Lingual lower (buccal surface of lingual cusp).
Adjust the contacting surfaces rather than the tips of the cusps (avoid changing appearance)
how to re-record occlusion
check with member of staff before doing as lengthens tx plan
clinic
- Remove the lower teeth (if upper is fine)
- Replace with wax
- Re-Record the registration
- Prescribe another wax trial
- Give both dentures to the lab
laboratory
- Laboratory remount on articulator
- Reset lower teeth
clinic
- Retrial of wax try in
advice for pt (5)
Pain
- Too sore, take out and go back to old dentures but wear the new ones the day before appointment so can highlight areas of rubbing
Speech
- will adapt to in a few days
Eating
- Not eat anything too hard or challenging initially, eggs -> fish -> chicken
- Do not expect be able to eat fully until used to new dentures
Removal at night
- Lets tissue breathe
- Reduce thrush risk
- Wouldn’t wear shoes in bed
Dry mouth?
- Affect retention – always place in moist
denture cleaning
- Toothbrush twice daily and toothpaste
- Cheap and easy
- Trauma to denture material? ensure not abrasive as damage denture material
- Chemical cleaners
- Effervescent Peroxides (steradent)
- Alkaline Hypochlorites (Milton – 30mins 3-4 times a week)
- Acids
- Disinfectants
- Enzymes
leaflet given
