DENTURES5

Question 1

On the delivery visit what should be done before the patient arrives?

Answer 1

Decontaminate dentures

Check they are correct dentures

Check processing- porosities/inclusion of plaster

Check for sharp and rough prominences- REMOVE

Look for undercut areas which may require adjustment

Question 2

What can porosities cause?

Answer 2

Weakness

Poorer appearance

Question 3

What happens if porosities occur in the anterior and posterior regions?

Answer 3

Ant- affect appearance so may have to repeat some stages

Posterior- inform patient and accept

Question 4

What should be checked upon delivery of the dentures?

Answer 4

Extension

Retention

Stability

Occlusion

Occlusal Planes

OVD, FWS

Appearance

Speech

Question 5

Why must you be careful not to over manipulate the tissues when checking extension?

Answer 5

Can result in functional denture being wrongly seen as not creating a good seal

Question 6

How do you check retention of the dentures?

Answer 6

Pull on upper
central incisors or canines/premolars

*Lower dentures often have poor retention

Question 7

How do you check stability of dentures? (measure of adaptation)

Answer 7

Make denture rock

*If denture places on soft tissue or flabby ridge it may still move

Question 8

How do u check occlusion of dentures?

Answer 8

Use fox’s bite gauge to check occlusal plane

Check changes in OVD/FWS have been done (check assessment and measure with old/new dentures)

Question 9

Why should you worry less about speech at delivery stage?

Answer 9

As patient will require time to acclimatise to dentures

They will commonly have a lisp as upper denture is too thick and the tongue space is limited (adjusted by lab)

Question 10

What aspects on a denture can cause pain when delivering a denture?

Answer 10

Roughness

Large undercuts- usually on insertion and removal (compromise struck with retention)

Over/under extension

Question 11

What can be done to adjust aspects causing discomfort when trying dentures at delivery stage?

Answer 11

Smooth and polish using pumice for chairside adjustments

Lab can be used to make bigger adjustments (disinfect first)

Question 12

Why may the occlusion need to be adjusted at the delivery stage?

Answer 12

Occlusal interferences occur during articulation as result of:

Inaccurate recording of contact position

Limitations of average value articulator

Question 13

How can occlusal interferences at delivery stage be fixed?

Answer 13

Selective grinding

Re-recording of occlusion

Question 14

How is selective grinding done?

BULL RULE

Answer 14

Buccal upper- adjust palatal surface of buccal cusp

Lingual Lower- adjust buccal surface of lingual cusp

*adjust contacting surfaces and not cusp tips

Question 15

How do you identify areas that may require selective grinding?

Answer 15

Use articulating paper to mark high spots

Question 16

How do you re-record the occlusion? (CLINICAL)

Answer 16

Remove lower teeth (if upper is fine)
Replace with wax
Re-Record registration 
Prescribe another wax trial
Give both dentures to lab

Question 17

How do you re-record the occlusion? (LAB)

Answer 17

Remount on articulator

Reset lower teeth

-> RETRIAL (WAX)

Question 18

What should you advise the patient after delivery of denture?

Answer 18

Pain- go back to old dentures until they can return (wear new dentures day before at return appointment)

Speech-returns to normal soon

Eating- start off with softer less challenging food then get gradually harder

Remove at night- prevents thrush

Cleaning

Question 19

If patient has dry mouth what is advised to aid retention of denture?

Answer 19

Putting in dentures moist

Question 20

What is the issue with using toothpaste to clean denture?

Answer 20

They contain abrasives and can damage denture material

Question 21

How should you advise the patient to clean their denture?

Answer 21

Use toothbrush twice daily

Put denture in milton (alkaline hypochlorite) for 30mins 3-4 times per week