77328628 Complete Denture Insertion and Patient Instructions
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Transcript of 77328628 Complete Denture Insertion and Patient Instructions
During insertion phase,the operator appraises the accuracy of all the preceeding steps
CAUSES OF DENTURE ERRORS
Errors may be incorporated into the denture from 3 sources
a)Clinical errors by the dentist
b)Technical errors from the laboratory
c)inherent deficiencies' in the material
DENTURE INSERTION AND EVALUATION PROCEDURE
1) Evaluation of processing
2) Evaluation of polished surfaces
3) Evaluation of tissue fit and comfort
4) Evaluation of retention, stability
and support
5) Evaluation of jaw relations
6) Evaluation of occlusion
7) Evaluation of esthetics
8) Evaluation of speech function
CHECKING FOR THE FIT OF PROSTHESIS
Examining the dentures
Feel the borders of the denture to check for
sharp projections
Examine for the presence of voids or nodules
Examining the patient’s mouth, oral mucosa
is thoroughly examined
CHECKING FOR ADAPTATION
Checked at the posterior palatal seal using mouth mirror- there should be no space.
Patient is asked to say ‘Ah’ in unexaggerated short bursts
CHECKING FOR BORDER EXTENSION
Cheeks are elevated and borders are examined.
Buccal and labial mucosa are stretched to check for denture displacement
CHECKING FOR FRENAL RELIEF
1. Labial frenum is very thin and
require a deeep notch
2. A shallow relief should be given
for buccal frena -
displacement of denture
EVALUATION OF DENTURE ESTHETICS
Lip support, cheek support, vertical height, low lip line, high lip line, smile line are examined.
EVALUATION OF JAW RELATIONJaw relations are once again verified 1) Centric relation is verified 2) Vertical dimension is verified.
CHECKING FOR DENTURE FUNCTION
1) Evaluating the retention and stability of denture
Posterior palatal seal is checked by gently
pressing the anterior teeth perpendicular to
the path of insertion,if adequate we can feel
the resistance.
Anterior seal is checked by pulling against the
path of insertion.
2) Speech
The patient is asked to speak or read
aloud.
If there is any error in the denture,
patient will have difficulty in
pronounciation of certain words.
3) Occlusal Harmony
Using interocclusal records
Materials like ZnOE are placed in between
the teeth and asked to bite and high points are
detected by the presence of perforations.
Using articulating paper
Paper is placed in between
the teeth and dragged slowly- if it
does not slide away it indicates the
presence of high point.
PATIENT INSTRUCTIONS
LIST OF INSTRUCTIONS
1)HABITUATION
2)EATING HABITS
3)SPEECH
4)HOME CARE FOR THE DENTURES
HABITUATION
Initially the denture will feel strange & bulky in the mouth
Patient’s appearance with the denture will become more natural with time.
Patient’s mouth & tongue has to get adjusted to the denture,
also there will be increased salivation, which will be reduced subsequently
EATING HABITS
1)It may be difficult to adjust as patient has been without teeth for a long period of time.
2)First few days pt is instructed not to chew hard food avoid sticky food
3)Pt is asked to try to chew on both side with the back teeth
4)Pt is asked not to drink water by lifting the tumbler but drinking by sipping.
SPEECH
Speaking with the dentures normally requires some practice.
Patient is asked to read aloud and repeat the words those which are difficult to pronounce.
With passage of time pt’s speech with denture will be better than without denture.
HOME CARE FOR THE DENTURES
Pt is asked to clean the denture with soft brush, specially made for denture & keep cloth in the wash basin so, if denture will fall than it won’t break.
Pt should rinse the mouth & denture after every meal.
Pt should never wear denture at night & should store denture in cold water.
Pt should not wash the denture with hot water.
Patient should not use any abrasive or detergents to clean the dentures.
Pt should not make any adjustment or repair by himself.
It’s preferable if patient place denture in denture cleanser at night.
After removing the denture pt should massage the gums for few minutes with fingers
DENTURE HYGIENE
Poor denture hygiene can result in
1) Mucosal irritation
2) Inflammatory papillary hyperplasia
3) Denture stomatitis
4) Chronic candidiasis
5) Stain retention
6) Halitosis
Chemical denture cleansers
Commercial preparations• Most preparations contain
sodium hypochlorite• Tablets are also there which
effervesce when dropped in water releasing bubbles
• Dentures are left for 15 mins or even night
Formula for home made cleanser• Sodium hypochlorite- 1 Tbsp• Calgon ( detergent softens and
loosens food deposits) - 1tsp
• Water -114 cc
Boucher recommended that a 30 min soaking is
sufficient to remove stains
Caution- Na hypochlorite not indicated in
dentures containing chrome cobalt or other
metals
Removal of calculus
Occasional overnight soaking in white vinegar
is effective in removing calculus
Sonic cleansers
• Use vibratory energy to clean the
dentures
• Very effective in removing calculus
as well as cigarette and coffee
stains
Manual cleansing
• Used with a mild detergent or a denture paste and water.
• Use of regular paste is contraindicated – abrasives can cause wear of denture
Caution
1)Stiff bristles can cause
severe abrasion
2) Impression surface should
not be brushed too
aggressively