7a - Denture insertion and review

Question 1

How should you assess the dentures prior to insertion?

Answer 1

Check all surfaces for acrylic flash, blebs, sharp edges and quality of polish

Question 2

What may cause pain the insertion stage?

Answer 2

• roughness
• extension into undercuts
• overextension
• occlusion

Question 3

What problems may present at insertion with retention and stability?

Answer 3

• lower is never as retentive as the upper
• retching may indicate that the palate needs reduced
• muscle imbalance (eg labial frenum impinged by denture)

Question 4

What problems may present at insertion with LIMBO?

Answer 4

• very few changes can be made at this stage
• lip support can be adjusted by minor labial flange reduction

Question 5

What problems may present at insertion with occlusion?

Answer 5

• minor adjustment is common at insertion
• selective grinding used in most cases
• if major error, some teeth may need stripped off for a wax rim and re-reg

Question 6

What problems may present at insertion with speech and aesthetics?

Answer 6

• manage patient’s expectations of new denture, may lisp to begin with but will improve over time
• patient must view new dentures in the mirror and approve
• warn that friends may notice change, may take time to adjust to muscles
• some patients have smileorexia and never be pleased

Question 7

What problems may present at insertion with discomfort?

Answer 7

• undercut areas are common sites for discomfort (eg tuberosity, anterior labial flange or tori)
• areas with poor support (mylohyoid ridge etc)
• ask patient to be specific and record (PIP useful)

Question 8

How should you assess insertion and removal?

Answer 8

• insert lower first then upper
• demonstrate with mirror to patient and/or carer

Question 9

What wear and care instructions should you provide with the new denture?

Answer 9

• remind patients that it may take time to become accustomed to wearing new dentures and to persevere
• some discomfort is normal (like new shoes)
• eating may be difficult to start
• arrange review appointment and encourage patient to wear dentures if there are issues in the days before appointment to highlight issues
• give written advice

Question 10

What happens when the patient accepts the new dentures?

Answer 10

• must tick accepted on prescription
• hand one copy of prescription to patient, one in the notes and one to the lab (with finished written across the page)