6. Delivery and Aftercare of Denture Flashcards
What do we do before the patient arrives for denture delivery?
Decontaminate denture in perform for 10 minutes
How long do we decontaminate denture for and what in?
10 minutes in perform
After decontaminating denture what do we do before pt comes? 4
- Check this is the correct denture for the patient
- Check denture has been processed properly - is there POROSITY - porosity can weaken the denture and affect appearance - if posterior can show pt and explain
- Check for sharp/rough/uneven edges that can cause pain on insertion - we may need to do alterations to smooth off
- Check for undercuts that may need adjusted - BUT DONT DO THIS UNTIL PT COMES IN
When pt comes in for delivery stage how do we explain it?
Today we are going to try in the completed denture and make sure everything is okay - if needed we can make changes
What do we check in patient when we insert the denture? 5
EXTENSION RETENTION STABILITY AESTHETICS OCCLUSION
Which way do we put denture in?
Upper in first - then lower - MAKE SURE DENTURE IS MOIST BEFORE INSERTING.
How do we assess denture extension?
Insert upper denture and look at the sulcus to assess if it has correct extension or under/over extended
How do we know if denture is under-extended?
The denture will be short of the buccal sulcus - wont extend far enough and will also drop out - have very poor retention
How do we know if a denture is overextended?
Clinically look - the denture will extend too far into the sulcus and also due to overextension it will sit on muscle attachment and soft tissues so when we manipulate the tissues and muscles the denture will drop/rock
What is retention?
resistance to displacement forces
How do we assess retention?
We assess the dentures ability to resist displacement forces in direction away from the tissues - we do this by pulling on upper centrals or canines and PULL DOWN to assess how well retained denture is
How do we assess stability of denture?
Place finger on occlusal surface and see if the denture rocks - remember if flabby ridge then will be some movement
How do we assess occlusion?
This is where we use foxes guide plane to check anterior and posterior occlusion
ANTERIOR - inter pupillary line must be parallel to occlusal plane
POSTERIOR - ala-tragus line must be parallel to occlusal plane
How do we check anterior occlusal plane?
We use foxes guide plane and see if occlusal plane is parallel to inter pupillary line
How do we check posterior occlusal plane?
posterior occlusal plane parallel to ala tragus line
How do we determine the FWS?
OVD-RVD
What is OVD?
This is measurement from point on nose to point on chin when pt is biting together
What is RVD?
This is measurement from point on nose to point on chin using willis bite gauge when pt is relaxed - get pt to say m
How do we assess denture appearance?
Ask if pt is happy with the appearance of the denture
How do we assess speech?
Ask pt to say the days of the week
Tell pt that it can take time to acclimatise to new denture - this is okay and may have a lisp for a few days - keep speaking to get used to it
What if pt has a very bad lisp with denture in?
Then we may need to reduce bulk of upper denture as it may be impinging the tongue space
What must we do if we make any adjustments?
Polish denture with pumic and whitting
How can we do occlusal adjustments?
We can do this by SELECTIVE GRINDING or RE-RECORDING THE OCCLUSION
How do we carry out selective grinding?
use articulating paper to mark high spots - anything on occlusal surface = too high
What is BULL rule?
Buccal upper (palatal surface of buccal cusp) and Lingual lower (buccal surface of lingual cusp)
How do we re-record occlusion?
We:
- remove lower teeth
- replace with wax
- re record reg
- prescribe another wax trial
- give both dentures to lab
What 6 things must we tell pt about in terms of aftercare?
- pain
- speech
- eating
- night removal
- dry mouth
- cleaning
What do we tell pt about PAIN?
If denture pain gets too much then take out and put old dentures back in - if poss on day u come to see us put new dentures in so we can see if there are any areas rubbing/find cause of pain
What do we tell pt about SPEECH?
Can take time to acclimatise to new denture - this is completely normal - may have small lisp - keep speaking and should get used to denture
What do we tell the pt about EATING?
This also takes time to get used to - start with soft foods nothing too hard - dont expect to eat fully with old dentures as it takes time to adjust again
What do we tell pt about NIGHT REMOVAL?
Take denture out at night and leave in water - this prevents any infection such as thrush and allows tissues to breathe
What do we tell the pt about DRY MOUTH?
Always put denture in moist - if dry it can affect retention
What do we tell pt about DENTURE CLEANING?
Several methods:
- soft toothbrush and soap
- strident - effervescent tablets from supermarket
- milton - 30 mins 3-4 times a week
