care of removable prostheses Flashcards

1
Q

define edentulous - fully and partially

A
  • Being without teeth or lacking teeth
  • Fully edentulous: No teeth
  • Partially edentulous: 2 quadrants with 4 teeth missing/quadrant OR 3 quadrants with 3 teeth missing per quadrant
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2
Q

define prosthesis

A

A fixed or removable appliance that is functionally and cosmetically designed to replace a missing natural tooth or teeth

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3
Q

DEMOGRAPHICS OF TOOTH LOSS

Changing patterns in __________, professional care, and attitudes toward healthcare have __________ the number of completely _______ people

~__% of American adults are edentulous

1 out of 5 adults aged ___ years or older are completely edentulous

Dental hygienists are likely to see edentulous
patients in practice due to ______ life spans and
growing “older adult” population

A

Changing patterns in ORAL DISEASE, professional care, and attitudes toward healthcare have DECREASED the number of completely EDENTULOUS people

~5% of American adults are edentulous

1 out of 5 adults aged 65 years or older are completely edentulous

Dental hygienists are likely to see edentulous
patients in practice due to LONGER life spans and a growing “older adult” population

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4
Q

what major risk factors contribute to a persons edentulous status (8)

A
  1. dental caries
  2. periodontal diseases
  3. oral cancer and treatment for it
  4. oral injury
  5. low socioeconomic status
  6. inadequate access to professional oral care
  7. low frequency of professional oral care
  8. poor daily oral hygiene
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5
Q

what are psychologic factors and physiologic factors

A

PSYCHologic factors: attitudes and values, insecurity, loss of self esteem, unrealistic expectations, fear of aging

PHYSIologic factors: residual ridge and alveolar bone resorption (4x faster/greater in the mandible), oral mucous membrane remodeling, loss of orofacial muscle tone

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6
Q

what human needs deficit is tooth loss associated with when it leads to loss of self esteem and insecurity

A

wholesome facial image

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7
Q

what other factors are associated with tooth loss

A
  • mesial drift
  • extrusion
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8
Q

what are the 4 types of prostheses

A

removable dentures: can be removed by the patient

fixed dentures: cannot be removed

partial dentures: replace some teeth

complete dentures: replaces the entire dentition

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9
Q

what are removable implant-supported overdentures

A

removable complete dentures designed to fit over implant fixtures

can be snapped onto implants using attachments or retained by magnets

increased stability and retention compared to traditional dentures

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10
Q

what is an obturator?

what could the opening be caused by?

A

obturator: a prosthesis that closes an opening between the nasal and oral cavity

the opening could’ve been caused by:
-oral cancer removal
-an accident
-congenital anomaly (cleft palate)

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11
Q

what 3 challenges are associated with the replacement of missing teeth

A
  • physical appearance
  • speech disturbance
  • masticatory efficiency
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12
Q

when replacing missing teeth, how is physical appearance a challenge

A
  • alveolar bone resorption
  • judged most critically by the patient themselves
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12
Q

when replacing missing teeth, how is speech a challange

A
  • if a speech disturbance lasts longer than a few weeks, the prosthesis may be ill-fitted and need to be reevaluated by a dentist
  • encourage pt. to read/speak aloud in front of a mirror
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13
Q

when replacing missing teeth, how is masticatory efficiency a problem

A
  • reduction in efficiency with the use of prosthesis due to a loss of periodontal support and stability as well as periodontal proprioception
  • instruct pt. to increase chewing time, consume smaller pieces of food, and distribute the food evenly when chewing
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14
Q

what factors affect the oral mucosa of denture wearing individuals (5)

A
  • systemic diseases/conditions
  • xerostomia
  • denture occlusion and fit
  • oral hygiene; biofilm control
  • continuous wear of dentures; should be removed overnight (or at least 6 hours/day)
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15
Q

the longevity of removable appliances depends on the:

the health of the natural teeth depend on:

A

The longevity of the removable appliance depends on the health of the supporting teeth

The health of the natural teeth depends on the cleanliness of the prosthesis

16
Q

prostheses induced oral lesions

what are 2 examples of traumatic/reactive lesions

A

denture-induced fibrous hyperplasia - an abnormal increase in the volume of tissue as a result of irritation

ulcers

17
Q

prostheses induced oral lesions

what are 2 examples of infectious lesions

A

denture stomatitis - inflammation under the dentures characterized by redness, pain, and swelling

angular cheilitis - fissures at the corners of the mouth with cracks, ulcerations, and redness

18
Q

prostheses induced oral lesions

what is an example of mixed lesions

A

papillary hyperplasia - trauma and infection are causative factors, cobblestone appearance

19
Q

DENTAL CARIES PREVENTION

__________ teeth are at increased risk for caries and periodontal disease.

________, _________, __________ may need modification to reduce caries risk

Caries and periodontal involvement involving any abutment tooth can lead to ___________ and the patient may have more limited options for __________

A

ABUTMENT teeth are at increased risk for caries and periodontal disease.

DAILY ORAL CARE, TOPICAL FLUORIDE USE, AND DIET may need modification to reduce caries risk

Caries and periodontal involvement involving any abutment tooth can lead to TOOTH LOSS and the patient may have more limited options for REPLACEMENT

20
Q

What are the 3 types of dentures

A

interim - a denture for esthetics/function for a LIMITED time, them it should be replaced by a definitive prothesis

immediate - placed immediately following the removal of teeth

conventional

21
Q

4 examples of denture deposits

A
  • food debris
  • pellicle and biofilm
  • calculus
  • stain
22
Q

CARE OF DENTURES

removal of the denture:

professional cleaning of the denture:

A

removal: done by the patient

professional cleaning: place denture in a bag with tartar and stain remover, place bag in the ultrasonic for 5-10 minutes depending on calc/stain; rinse and brush with denture brush; scale calc from the teeth avoiding the soft tissue

23
Q

how to prepare for the cleaning

A

rinse, remove any adhesive, brush exposed mucosa with soft denture brush or with a soft cloth

24
Q

what are the advantages to cleaning by immersion

A
  • solution reaches all areas of the denture
  • prevents unnecessary handling
  • attractive for caregivers (they don’t wanna do that shit)
25
Q

ALKALINE HYPOCHLORITE

  • mechanism of action
  • advantages
  • disadvantages
A

mechanism of action: dissolves mucins and organic substances from prostheses biofilm matrix

advantages: bactericidal cleanser, fungicidal cleanser, bleaches stains, may inhibit calc formation

disadvantages: CORRODES METALS (never clean partials with), odor and taste, may bleach the acrylic

26
Q

ALKALINE PEROXIDE

  • mechanism of action
  • advantages
  • disadvantages
A

Mechanism of action: mechanical cleansing effect is caused by the release of oxygen (bubbling)

advantages: antibacterial effect, removes stains

disadvantages: harmful to soft liners, not effective at removing calc

27
Q

CHLORHEXIDINE GLUCONATE SOLUTION

  • mechanism of action
  • advantages
  • disadvantages
A

mechanism of action: antimicrobial action caused by chemical agent

advantages: antibacterial cleanser, antifungal cleanser

disadvantages: provides temporary relief of denture stomatitis symptoms, stains denture teeth

28
Q

ULTRASONIC CLEANSING DEVICE

  • mechanism of action
  • advantages
  • disadvantages
A

mechanism of action: ultrasonic sound wave action creates a vibrating/bubbling effect

advantages: removes biofilm, enhances the effectiveness of chemical cleansers

disadvantages: commonly an in-office procedure, efficiency of the ultrasonic is uncertain

29
Q

MICROWAVE RADIATION (IN OFFICE ONLY)

  • mechanism of action
  • advantages
  • disadvantages
A

mechanism of action: electromagnetic waves kill microorganisms

advantages: bacterial cleanser, minimal negative effect on resilient liners

disadvantages: high temperatures can affect dimensional stability of a denture

30
Q

which products are chemical and which are antimicrobial

A

CHEMICAL: alkaline hypochlorite and alkaline peroxide

ANTIMICROBIAL: chlorhexidine gluconate, ultrasonic cleansing, and microwave radiation

31
Q

why is it important to maintain regular professional care (4)

A
  • assess oral tissues
  • denture irritation may be a cocarcinogenic factor in predisposed individuals
  • oral tissue changes may go unnoticed by the patient
  • loss of retention, stability, and support must also be assessed
32
Q

what factors should we teach the patient (5)

A
  • how to self-exam their tissues
  • how to handle/clean the prosthesis (don’t assume they know how to)
  • risks when missing teeth aren’t replaced
  • need for a professional evaluation of existing prostheses
  • review wearing/removing habits
33
Q

how to clean the prosthesis

A
  1. fill sink with water and line with paper towel to prevent breakage if dropped
  2. use denture brush with denture cleaning creams/pastes
    - creams/pastes are for EXTRAORAL use only
    - do not use traditional toothpaste on the denture
  3. soak in denture cleanser overnight or for 6-8 hours PER DAY
34
Q

what nutritional considerations must we take into account for individuals with dentures

  • lack of ___________ magnifies tissue irritability and diminishes repair potential
  • ill-fitting dentures may result in _______ difficulties
  • _________ can affect food choices by causing clients to shy away from foods that require a lot of chewing; this results from the increase in denture _______ or the rubbing of the denture in a dry mouth as well as the lack of _______ to moisten the food to soften it and make it easier to chew
A
  • lack of essential nutrients magnifies tissue irritability and diminishes repair potential
  • ill-fitting dentures may result in chewing difficulties
  • Xerostomia can affect food choices by causing clients to shy away from foods that require a lot of chewing; this results from the increase in denture friction or the rubbing of the denture in a dry mouth as well as the lack of saliva to moisten the food to soften it and make it easier to chew
35
Q

what to document for a client with dentures (5)

A
  • chief complaint
  • stability
  • intraoral findings
  • oral hygiene instructions
  • cleaning of prosthesis if provided