6. Delivery and Aftercare of Denture

Question 1

What do we do before the patient arrives for denture delivery?

Answer 1

Decontaminate denture in perform for 10 minutes

Question 2

How long do we decontaminate denture for and what in?

Answer 2

10 minutes in perform

Question 3

After decontaminating denture what do we do before pt comes? 4

Answer 3

1. Check this is the correct denture for the patient
2. Check denture has been processed properly - is there POROSITY - porosity can weaken the denture and affect appearance - if posterior can show pt and explain
3. Check for sharp/rough/uneven edges that can cause pain on insertion - we may need to do alterations to smooth off
4. Check for undercuts that may need adjusted - BUT DONT DO THIS UNTIL PT COMES IN

Question 4

When pt comes in for delivery stage how do we explain it?

Answer 4

Today we are going to try in the completed denture and make sure everything is okay - if needed we can make changes

Question 5

What do we check in patient when we insert the denture? 5

Answer 5

EXTENSION 
RETENTION
STABILITY 
AESTHETICS 
OCCLUSION

Question 6

Which way do we put denture in?

Answer 6

Upper in first - then lower - MAKE SURE DENTURE IS MOIST BEFORE INSERTING.

Question 7

How do we assess denture extension?

Answer 7

Insert upper denture and look at the sulcus to assess if it has correct extension or under/over extended

Question 8

How do we know if denture is under-extended?

Answer 8

The denture will be short of the buccal sulcus - wont extend far enough and will also drop out - have very poor retention

Question 9

How do we know if a denture is overextended?

Answer 9

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

Question 10

What is retention?

Answer 10

resistance to displacement forces

Question 11

How do we assess retention?

Answer 11

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

Question 12

How do we assess stability of denture?

Answer 12

Place finger on occlusal surface and see if the denture rocks - remember if flabby ridge then will be some movement

Question 13

How do we assess occlusion?

Answer 13

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

Question 14

How do we check anterior occlusal plane?

Answer 14

We use foxes guide plane and see if occlusal plane is parallel to inter pupillary line

Question 15

How do we check posterior occlusal plane?

Answer 15

posterior occlusal plane parallel to ala tragus line

Question 16

How do we determine the FWS?

Answer 16

OVD-RVD

Question 17

What is OVD?

Answer 17

This is measurement from point on nose to point on chin when pt is biting together

Question 18

What is RVD?

Answer 18

This is measurement from point on nose to point on chin using willis bite gauge when pt is relaxed - get pt to say m

Question 19

How do we assess denture appearance?

Answer 19

Ask if pt is happy with the appearance of the denture

Question 20

How do we assess speech?

Answer 20

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

Question 21

What if pt has a very bad lisp with denture in?

Answer 21

Then we may need to reduce bulk of upper denture as it may be impinging the tongue space

Question 22

What must we do if we make any adjustments?

Answer 22

Polish denture with pumic and whitting

Question 23

How can we do occlusal adjustments?

Answer 23

We can do this by SELECTIVE GRINDING or RE-RECORDING THE OCCLUSION

Question 24

How do we carry out selective grinding?

Answer 24

use articulating paper to mark high spots - anything on occlusal surface = too high

Question 25

What is BULL rule?

Answer 25

Buccal upper (palatal surface of buccal cusp) and Lingual lower (buccal surface of lingual cusp)

Question 26

How do we re-record occlusion?

Answer 26

We:

1. remove lower teeth
2. replace with wax
3. re record reg
4. prescribe another wax trial
5. give both dentures to lab

Question 27

What 6 things must we tell pt about in terms of aftercare?

Answer 27

1. pain
2. speech
3. eating
4. night removal
5. dry mouth
6. cleaning

Question 28

What do we tell pt about PAIN?

Answer 28

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

Question 29

What do we tell pt about SPEECH?

Answer 29

Can take time to acclimatise to new denture - this is completely normal - may have small lisp - keep speaking and should get used to denture

Question 30

What do we tell the pt about EATING?

Answer 30

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

Question 31

What do we tell pt about NIGHT REMOVAL?

Answer 31

Take denture out at night and leave in water - this prevents any infection such as thrush and allows tissues to breathe

Question 32

What do we tell the pt about DRY MOUTH?

Answer 32

Always put denture in moist - if dry it can affect retention

Question 33

What do we tell pt about DENTURE CLEANING?

Answer 33

Several methods:

1. soft toothbrush and soap
2. strident - effervescent tablets from supermarket
3. milton - 30 mins 3-4 times a week