TUT 2 Flashcards
What is retching?
- physiological mechanism
- involuntary contraction of muscles of the soft palate or pharynx
- modified by medulla
What are the different types of retching?
- psychogenic
- somatic
Describe psychogenic retching.
Caused by sight, smell, sound or thought of ______
Describe somatic retching.
Touching of trigger zones causes retching
What are common trigger zones for retching?
- palatoglossal/palatopharyngeal folds
- base of tongue
- palate
- uvula
- posterior pharyngeal wall
How does retching impact prosthodontics?
- impressions
- jaw registration
- tolerating dentures
- denture retention (if extension reduced to accommodate reflex)
How do you manage a patient with a retching problem?
- relaxation (dim light, music, instruments out of sight, deep breathing)
- distraction (wiggle toes, salt on tongue, talking, close eyes)
- desensitisation
How can patients engage with desensitisation?
- brushing of anterior palate and tongue with toothbrush
- swallowing with mouth open
How can you modify the impression stage in a retching patient?
- modify stock trays
- lower trays in upper arch
- modify special tray to have palatal reduction
- rapid setting impression materials
How can the denture design be modified to accommodate a retching patient?
- SDA as an alternative?
- horseshoe palatal
- training plate
- multiple post dams (provide pressure which counteracts retching)
- must be well adapted, acrylic not too thick
What does ulceration in the sulcus indicate?
Overextended
What does poor stability indicate?
- under extended
- occlusal interference
- lack of support
How can you assess if there is enough freeway space?
- ask patient to say numbers 61-69
- ask patient to say days of the week
What key questions should you ask at initial assessment?
- how long ago were your teeth removed
- how many dentures have you had since your teeth were removed
- how old is the last denture you had made
- do you wear your most recent denture
What causes a flabby ridge?
Combination syndrome
