COMPLETE DENTURE INSERTION AND PATIENT INSTRUCTIONS

By, Adithya Deepa 2007 Batch Al Azhar Dental College

 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 patients 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 denture

-displacement of

EVALUATION OF DENTURE ESTHETICS  Lip support,  cheek support,  vertical height,  low lip line,  high lip line,  smile line are examined.

EVALUATION OF JAW RELATION Jaw 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  Patients appearance with the denture will become more natural with time.  Patients 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 pts 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 wont 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. Its 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

THANK YOU