insertion Flashcards

1
Q

before the pt arrives for insertion appointment

A
  • Decontaminate dentures
  • Are they the correct dentures? (can put identifying plate or mark on palate esp in care home to minimise risk of mix up)
  • Have they been processed properly – porosity, inclusions of plaster in the denture
    • Slight reduce strength (depends on where they are)
      • Anterior – appearance
      • Posterior – ask pt if they are ok with them
  • Any sharp, rough, prominences which should be removed prior to insertion?
    • Do before pt comes in
  • Look for undercut areas that may need adjusted
    • Wait for pt to try in before adjusting if needed as usually provide retention
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2
Q

when pt arrives for insertion appointment inform them

A

may make some adjustments, very common

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3
Q

what to check when insert denture (6)

A
  • Extension – if moves on manipulation, want seal on function (don’t be excessive)
  • Retention – pull anterior region
  • Stability – measure of adaptation, rock, minimal movement ok
  • Occlusion
    • Occlusal Planes
    • OVD, FWS (measure old and new and check if changes done)
  • Appearance
  • Speech
    • Will change slightly as pt needs to acclimatise to the new dentures, in a few days will get used to them
      • Most common is lisp – denture is thick and not sufficient space for tongue – ask lab to reduce thickness down as much as possible
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4
Q

what to do to aid insertion of denture

A

moisten them and leave to settle for a moment before checking

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5
Q

how to check extension

A
  • if moves on manipulation, want seal on function (don’t be excessive)
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6
Q

how to check retention

A
  • – pull anterior region
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7
Q

how to check stability

A

measure of adaptation, rock, minimal movement ok

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8
Q

how to check occlusion

A
  • Occlusal Planes
  • OVD, FWS (measure old and new and check if changes done)
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9
Q

appearance check

A

ask pt if happy

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10
Q

speech assessment

A
  • Will change slightly as pt needs to acclimatise to the new dentures, in a few days will get used to them
    • Most common is lisp – denture is thick and not sufficient space for tongue – ask lab to reduce thickness down as much as possible
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11
Q

should you assess a C/C with both dentures or individually initially

A

individually

check stability, retention and extention

then together for occlusion, speech and appearance

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12
Q

adjustments of final dentures

A
  • Roughness can cause pain
  • Extension into Undercuts can be painful
  • Over and under-extension may cause pain/looseness
  • Occlusion may require adjustment

Smooth & polish if necessary (e.g. pumice & whiting). We have a small lab on level 6

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13
Q

why would occlusion need adjusted

A
  • Occlusal interferences occur at delivery
  • Inaccuracy of recording retruded contact position due to limitations of articulator
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14
Q

how to adjust occlusion in final dentures (2)

A
  • Selective grinding
  • Re-record occlusion
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15
Q

selective grinding

A

to adjust occlusion

  • Use articulating paper (mark high spots)
  • Remember bases are unstable and denture moves slightly
    • Never as solid as natural teeth
  • Adjust carefully
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16
Q

BULL rule for adjusting occlusion

A
  • Buccal upper (Palatal surface of buccal cusp) and
  • Lingual lower (buccal surface of lingual cusp).

Adjust the contacting surfaces rather than the tips of the cusps (avoid changing appearance)

17
Q

how to re-record occlusion

A

check with member of staff before doing as lengthens tx plan

clinic

  1. Remove the lower teeth (if upper is fine)
  2. Replace with wax
  3. Re-Record the registration
  4. Prescribe another wax trial
  5. Give both dentures to the lab

laboratory

  • Laboratory remount on articulator
  • Reset lower teeth

clinic

  • Retrial of wax try in
18
Q

advice for pt (5)

A

Pain

  • Too sore, take out and go back to old dentures but wear the new ones the day before appointment so can highlight areas of rubbing

Speech

  • will adapt to in a few days

Eating

  • Not eat anything too hard or challenging initially, eggs -> fish -> chicken
  • Do not expect be able to eat fully until used to new dentures

Removal at night

  • Lets tissue breathe
  • Reduce thrush risk
  • Wouldn’t wear shoes in bed

Dry mouth?

  • Affect retention – always place in moist
19
Q

denture cleaning

A
  • Toothbrush twice daily and toothpaste
    • Cheap and easy
    • Trauma to denture material? ensure not abrasive as damage denture material
  • Chemical cleaners
    • Effervescent Peroxides (steradent)
    • Alkaline Hypochlorites (Milton – 30mins 3-4 times a week)
    • Acids
    • Disinfectants
    • Enzymes

leaflet given