Complete dentures - Delivery

Question 1

What checks must you do before placing the denture in the patients mouth? (4)

Answer 1

Ensure denture matches the design and the patient
ensure when placed on the cast the pin is on the table
ensure it is of good quality - remove sharp/rough areas with an acrylic bur and ensure no porosities

place in perform 10 mins

Question 2

what checks do we do once the denture is in the patients mouth?

Answer 2

same as wax trial

Extension - upper = vibrating line, maxillary tuberosities and frenal relief, lower = 2/3rd retromolar pads, retromylohyoid space

Retention - pull down on central incisors, hold tissues out of the way, manipulate tissues

Stability - rock occlusal surface of premolars side to side

Occlusion - incisor plane parallel to inter pupillary line, occlusal plane parallel to ala-tragal line, even occlusal contacts, assess OVD

Appearance - canine line, midline, nasiolabial angle = 90, corners of the mouth are supported, appropriate tooth colour.
& speech - 60, 70 and fictive words

Ensure the patient is comfortable and is happy with the appearance!

Question 3

what is the aim of a delivery stage?

Answer 3

That the complaints from the first visit have been addressed

Question 4

What do you inform the patient that they might experience? (5)

Answer 4

Pain:
Like breaking in new shoes - may get sore patches and ulcers for a few days
If unbearable, remove new denture and use the old one however use the denture 1 day before new appointment so that the problem areas are highlighted.

Eating:
Eat as normal with dentures in
whilst mouth getting used to the dentures cut food into smaller pieces and stick to soft foods
Ensure chewing on both sides to prevent tipping

Dry mouth:
Ensure mouth kept moist to help with keeping the denture comfortable in the mouth

Excess salivation:
Normal response whilst the mouth is getting used to the denture, will resolve naturally

speech:
Lisping normal - will resolve naturally

Question 5

What patient instruction do you provide? (3)

Answer 5

Cleaning - DONT USE BOILING WATER
Clean dentures out of the mouth 2x day morning and night for 3 mins over a basin of cool water
Use a denture brush or soft bristled tooth brush
Use denture cream or non-perfumed soap
Always rinse dentures after

Soaking:
Once a day in steradent or Milton for 10 mins
- don’t oversoak as it can cause damage and discolouration to the denture
Thoroughly rinse after soaking
Soak in water overnight

Removal at night:
Allows tissues to breathe and reduces oral thrush
Soak in water

Instruct them on insertion and removal

Question 6

When should patients clean their dentures? (2)

Answer 6

Clean 2x daily - morning and night

clean after every meal

Question 7

what denture cleansers should be avoided with a temporary soft lined denture?

Answer 7

effervescent peroxides i.e. steradent

Question 8

what denture cleansers should be avoided in a denture with a metal base?

Answer 8

Alkaline hypochlorites e.g. milton

Question 9

If we identify areas of acrylic that need adjusting how do we do that?

Answer 9

use an acrylic bur and a straight handpiece at chairside

Question 10

What are the advantages of using a denture cleaner?

Answer 10

Removes the microorganisms and the biofilm

Question 11

What are the limitations of only using mechanical action i.e. a toothbrush?

Answer 11

only removes debris doesn’t remove the biofilm