Assessment of the Completely Edentulous Pt

Question 1

Steps to assessing the completely edentulous pt?

Answer 1

History exam
Clinical exam
Denture assessment
Diagnosis and prognosis
Tx strategy and outcome

Question 2

History taking steps?

Answer 2

Presenting complaint (loose lower denture most common, pain, function, nausea, aesthetics, intolerance)
Additional observations

Relevant dental history:

• How long been edentulous?
• No of sets of dentures
• Successful or unsuccessful sets?
• Challenges?

Med history:

• Meds - xerostomia (antihistamines, antidepressants)
• Mobility issues
• Motor-neurone disease

Social history: gender, age, occupation
Access problems - pt able to attend any time/day, preferred days and times, transportation, care requirements

Question 3

Clinical examination steps?

Answer 3

Intraoral access: if limited - why?
Dental arches: edentulous, partially dentate, ridges
Ulceration, denture candidosis, granuloma, angular cheilitis, dry mouth, hyperplasia, tori (lumps on lingual surface of mandible), flabby ridge, retained roots/teeth

Ridges:
- Well formed, fibrous, atrophic

Teeth present - plan for dental clearance for CD?
BPE
PPD>6mm

Question 4

Denture assessment steps?

Answer 4

Type of current dentures:

• Upper/lower
• Complete/partial
• Acrylic/Co/Cr
• How old they are

Retention: good, fair, poor
Stability
Aesthetics
General condition: good, worn, damaged, unhygienic

Able to speak and eat with dentures
OVD: Too big/little
Approx FWS
Lip support and general aesthetic issues
Mould and shade

Jaw relationship:
Skeletal or postural

Diagnosis (of current denture) and prognosis (different for U and L)
Pt expectations: high, moderate, low