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

THANK YOU…………