2a - Treatment planning for complete dentures

Question 1

What history is required to make dentures?

Answer 1

• patient complaints
• denture history
• dental history
• medical history
• social history

Question 2

What could be in involved in patient complaints?

Answer 2

• appearance
• eating (struggling to eat certain foods)
• pain / discomfort
• looseness
• retching
• speech

Question 3

What could be in involved in denture history?

Answer 3

• previous experience ?
• age of dentures
• matched set
• do they wear their most recent set
• when did they first get dentures
• how many sets in how many years

Question 4

What could be in involved in dental history?

Answer 4

• when were teeth lost
• why were teeth lost
• retained roots, swellings
• anxiety, mobility and dental attendance
• any other treatments tried

Question 5

What could be in involved in medical history?

Answer 5

• neuromuscular problems
• tremor
• stroke
• dementia
• epilepsy (choking hazard)
• xerostomia (drug induced, radiotherapy)
• cardiac, diabetes etc
• medications

Question 6

How does Parkinson’s affect denture wearing?

Answer 6

Constant tongue movement can make it difficult to tolerate a lower denture

Question 7

How does cardiac disease impact dentures?

Answer 7

Difficult to tolerate impressions

Question 8

How does diabetes affect denture wearing?

Answer 8

More prone to Candida albicans

Question 9

What could be in involved in social history?

Answer 9

• mobility
• barrier to treatment (ie FTA due to transport)
• alcohol / smoking
• capacity to consent
• any support required

Question 10

What should be examined in the EO?

Answer 10

• signs of TMJ dysfunction (click/tender)
• facial pathology
• facial contours
• appearance of dentures

Question 11

What should be examined in IO?

Answer 11

• mucosal health
• periodontal health (if RR)
• periapical status (if RR)
• caries (if RR)
• support in edentulous areas
• mouth opening
• peri-oral opening (elasticity of tissues)

Question 12

Why is it important to assess mucosal health when designing a denture?

Answer 12

• impressions should be taken on healthy tissues
• denture may exacerbate existing problems

Question 13

How is angular cheilitis related to dentures?

Answer 13

Due to loss of facial height, saliva is able to pool in the corners of the mouth and then becomes infected.

Question 13

How do you manage denture hyperplasia when designing a new denture?

Answer 13

• modify current denture to remove area that sits on the area of hyperplasia
• wait until tissues return to normal before taking impressions

Question 14

Where is the primary support area in an upper denture?

Answer 14

Hard palate

Question 15

Where is the secondary support area in an upper denture?

Answer 15

Ridge crest

Question 16

Where is the non-contributing area in an upper denture?

Answer 16

Sulcus (peripheral seal)

Question 17

Where is the primary support area in a lower denture?

Answer 17

• buccal shelf
• retromolar pads

Question 18

Where is the secondary support area in a lower denture?

Answer 18

• ridge crest
• genial tubercles

Question 19

Where is the relief area in a lower denture?

Answer 19

• lingual ridge incline
• mylohyoid ridge

Question 20

Where is the non-contributing area in a lower denture?

Answer 20

Labial ridge incline

Question 21

What is important to assess when examining the mouth with dentures in?

Answer 21

• occlusal planes
• vertical height
• occlusion recorded correctly
• lip support
• over or under extension
• retention, stability, adaptation

Question 22

How do you assess the occlusal planes of a denture?

Answer 22

Foxes bite plate

Question 23

What causes inadequate freeway space?

Answer 23

Excessive vertical height of dentures

Question 24

What position do you record occlusion in complete dentures?

Answer 24

Retruded contact position (RCP)

Question 25

What is RCP?

Answer 25

• guided occlusal relationship
• most retruded position of the condyles
• most reproducible position

Question 26

What problems can overextension cause?

Answer 26

Ulceration

Question 27

What problems can underextension cause?

Answer 27

Loose dentures

Question 28

What should be assessed on denture out of the mouth?

Answer 28

• base extension
• tooth position
• excessive wear
• alterations
• hygiene

Question 29

What can you use in the pre-treatment phase?

Answer 29

Tissue conditioners (temporary reline material)

Question 30

What are the steps of a denture treatment plan?

Answer 30

• pre-treatment phase
• reassess
• plan denture
• construction of denture
• review