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Geriatrics > 11. Denture Issues > Flashcards

11. Denture Issues Flashcards

1
Q

Reasons why are replacement denture may not be practical

A
  • Finances
  • Cooperation (patient is used to denture)
  • Time
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2
Q

T/F Everyone can learn to wear a denture

A

F- not everyone can wear a denture

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3
Q

As we age we become (more/less) adaptable

A

less

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4
Q

T/F Psychological issues can transcend technical excellence

A

t

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5
Q

Potential causes for when patient complains of pain

A
  • Excess salivation
  • Sore mouth-new denture
  • Non-specific pain- new denture
  • Generalized soreness after repeated adjustments
  • Cheek biting
  • Burning sensation- upper lip and side of nose
  • Sore throat
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6
Q

Areas of the denture to check when patient reports pain

A
  • Relief of tori, tuberosities and sharp bony areas
  • Errors in occlusion causing a shift (check occlusion and remount to correct)
  • Overextension in masseter area of mandibular denture
  • Insufficient relief over undercuts
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7
Q

Overextension of the denture in the masseter areas results in pain where

A

lingual mandibular pain

-Test with disclosing wax/PIP

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8
Q

Non-specific pain reported by a patient with a new denture may be caused by

A
  • pressure over the zygomatic process

- Distobuccal border of maxillary denture base is too wide

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9
Q

How can you check to see if the issue is that the distobuccal boarder of the maxillary denture is too wide

A

Place finger on anterior teeth of maxillary denture
Have patient protrude mandible and move side to side
feel for movement of maxillary denture

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10
Q

Thick flange in the retrozygomal area can result in

A

coronoid interference with the maxillary denture

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11
Q

If there is coronoid interference what will happen to the upper denture when the patient opens

A

dislodges

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12
Q

Causes of generalized soreness after repeated adjustments may be

A
  • Clenching/bruxing
  • Inadequate freeway space
  • Errors in occlusion
  • Post menopausal endocrine changes
  • Nutritional deficiency
  • Low tissue tolerance
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13
Q

How do you fix inadequate freeway space

A

use rest position and phonetics

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14
Q

Signs a patient is clenching clinically

A

wear facets in denture teeth

patient awareness

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15
Q

What is an alternative method to doing a remount

A

Coble-Balancer

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16
Q

Role of Coble Balancer is

A

Detects occlusal prematurities that are tough to see

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17
Q

What diseases should be ruled out with someone with low tissue tolerance

A

diabetes and pemphigus vulgaris

18
Q

Cheek biting with a denture can be caused by

A
  • Insufficienct HO of posterior teeth
  • Insufficient clearance between dentures distal to the last tooth
  • Sharp buccal cusps
19
Q

How can you correct for insufficient HO in the posterior teeth

A
  • Round the buccal cusps of the mandibular molars

- If cross-bite round the buccal cusps of the maxillary molars

20
Q

_-_mm clearance should be between denture bases distal to last tooth

A

3-4

21
Q

Burning sensation upper lip/side of nose may be caused by

A

impingement of nasopalatine nerves in incisive foramen (relieve)

22
Q

Sore throat may be caused by

A
  • Over extension and ulceration of soft palate
  • Over extension hamular notch
  • Distobuccal of maxillary denture
  • Distolingual of mandibular denture
  • Denture on pterygomandibular raphe above retromolar pad
23
Q

What is the first thing you should do when a pateint complains that their denture is loose

A

ask them to show how it loosens

24
Q

What is one reason as to why a maxillary denture may lack retention

A

incorrect posterior palatal seal (wrong position, not deep enough, doesn’t extend to the hamular notch)

25
Q

If the denture extends too far posteriorly the boarder will be on (movable/non-movable) tissue

A

movable

26
Q

How will PIP look if the denture boarders are short? Long?

A 
Short= streaks 
Long= burn-through
27
Q

If the denture boarders are over-extended they will be retentive until

A

patient speaks

28
Q

A tight _ can cause a maxillary denture to loosen

A

pterygomandibular raphe

29
Q

What may be the cause for when a maxillary denture lacks retention on insertion and how should you look clinically to determine if this is the cause

A
  • Tissue/fluid contours changed since impression (bite on 2 cotton rolls for 5 minutes and re-eval)
  • Inadequate clearance for buccal and labial frenum (pull the lip down and look for dislodgement or frenal ulceration)
  • Incorrect posterior palatal seal
30
Q

Poor posterior palatal seal is detected clinically by

A

placing fingers on the lingual of the maxillary anterior teeth. If the posterior denture drops –> bad seal

31
Q

The upper denture base can also be loose when the periphery terminates on bony structures such as

A
  • Hard palate
  • Zygoma
  • External oblique ridge
  • Before retromolar pad
32
Q

Causes for the maxillary denture comming loose during speaking

A
  • Inadequate post palatale seal
  • Coronoid interference
  • Post boarder is too long/short
  • Short labial flange or excessive notch for labial frenum
  • Notch for buccal frenum too thick or insufficient
33
Q

Reasons the mandibular denture lacks retention on insertion

A 
Change in contours or fluid balance 
boarders too wide or too long 
Buccal flanges underextended 
Labial flange is underextended 
Overextended lingual boarders 
Inadequate notch for lingual frenum
34
Q

Clinically how can you determine there is an inadequate notch for lingual frenum

A

check for lifting when patient touches tongue to posterior palate

35
Q

Causes for why a denture loosens at different times of day

A
  • Heavy salivary secretions (ropey)

- Excessively dry

36
Q

Perpetually loose maxillary denture may be atributed to

A

anterior interferences
tuberosity mucosa grows into space
space develops under midline of denture base

37
Q

Lingually displaced mandibular denture caused by

A

incisors too far labial

Inclined ridge with no resistance

38
Q

Tilting of jiggling caused by

A

-Contacts not centered over the ridge

contacts on inclined portion of ridge

39
Q

Causes for lisping

A
  • Too much overjet
  • Triangular spaces between embrasures of maxillary and mand teeth
  • palatal contour is too constricted
  • INsufficient tongue space
40
Q

If you can’t determine the problem what should you do

A
  • Tell patient
  • Don’t adjust
  • Refer
41
Q

Why should you never pretend to adjust a denture

A

reinforce maladaptive behavior harder for next dentist

42
Q

-% patients are satisfied

A

80-85% (most patients aren’t problem patients)

Geriatrics (11 decks)

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