Tutorial 1 - Patient assesment Flashcards
You are seeing a patient for the first time who requests new dentures.
What information, examinations, tests and investigations do you require prior to starting treatment?
- Medical history updated at every appointment
- Other histories
- What the patient is complaining of - are they currently wearing dentures and if so do they have any complaints about them?
Other things to examine with other dentures are:
fit - are they too loose?
appearance - is the tooth shade off? what is the anatomy of the tooth positions like? are the metal components visible
function - are they able to use them to chew and talk? is the occlusion correct?
support - what type of support do they have?
When looking at all these factors, we need to esbalish if creating a new denture would even improve these issues or not.
- Intra-oral examination
soft tissues, teeth/roots present, position of the teeth, condition pf the teeth (perio/endo/caries, mobility, overeruption, tooth wear), occlusion, oral hygeine
state of the ridges of alveolar bone - is the resorption too bad?
any further tests needed - eg radiographs and vitality testing? - Pre-denture steps:
There are a minimum number of visits required (7 for an acrylic, 8 for a metal based denture). These may be 2 weeks apart, and this should be explained to the patient.
What are the stages to creating dentures? there are 8
Primary Impressions
Preliminary Jaw Registration
Secondary Impressions
Metal Framework Try (metal dentures only)
Definitive Jaw Registration
Wax Try In
Insertion
Review
What are some of the effects of the losses of some or all teeth?
self confidence - mental health and psychological stress
eating
speaking
shifting/drifting of the reamining teeth
facial changes - skip may appear more saggy or older.
Briefly list the advantages of partial dentures on the long term oral health
- Restores Function – Improves chewing and speech.
- Prevents Teeth Shifting – Maintains alignment of remaining teeth.
- Aesthetic Improvement – Enhances appearance and confidence.
- Affordable Option – Less costly than implants.
Briefly list the disadvantages of partial dentures on the long term oral health
- Bone Loss – Does not prevent jawbone shrinkage.
- Increased Plaque Buildup – Can lead to gum disease if not cleaned properly.
- Potential Discomfort – May cause irritation or soreness over time.
- Wear on Adjacent Teeth – Can put stress on natural teeth used for support.
What do you need to note when doing your intra-oral examination for a patient who wears DENTURES? (Without the denture in-situ)
Soft tissues - are they healthy? Is there any denture-related stomatitis?
Teeth/roots present
Position of the teeth - kennedy classification
Conditoon of the teeth - perio, caries, mobility, overeruption, tooth wear
Occlusion
Oral hygiene
Degree of resorption on the ridges
Further tests required? inc vitality and radiographs
If the patient is currently wearing dentures, what information can you obtain by examining these dentures?
Are they clean?
Are they stable?
Are they retentive?
What type of support do they have?
Is the occlusion correct?
Are the teeth worn?
If a patient comes in wanting a new denture because they don’t like the old one, what is one of the main things to consider and discuss with the patient?
You will need to find out WHY the patient doesn’t like their denture, and whether this is something which can be overcome by making a new one. This way, we will have a better idea of whether a new denture can meet their expectations.
If you are to proceed with making new dentures, what information do you need to tell the patient before starting? 2 things
Main informed consent
Tell the patient that they will need a minimum of 8 appointments for metal and 7 for acrylic!!
