Post Insertion Instructions

Ankita Reddy

Contents

Introduction Nature of Complete Dentures First Oral Feelings Problem of Excessive Saliva Speech Accommodation Eating Tongue Position Tissue Health Cleaning of Complete Dentures Warnings about over the counter Denture Products Danger of do-it-yourself dentistry

Introduction

It is not unusual for patients to have unrealistically high expectations at

the beginning of complete denture treatment. Patient education should

help create a positive attitude by informing the patient of special problems associated with wearing complete dentures, advising the patient on ways to overcome or compensate for these problems informing the patient of proper oral and denture hygiene, and warning the patients of drug store denture products.

Educating patients to the limitations of dentures as mechanical substitutes for living tissues must be a continuing process from initial patient contact until the adjustments are completed.

1. Nature of complete dentures

To understand some problems related with complete dentures, the patients should have a fundamental understanding of nature of denture foundation. Models or diagrams of natural dentitions ,masticatory system and mechanical denture system are helpful aids

Retention. The dentist should point out that natural teeth have roots surrounded by bone, cohere as a denture sits on wet, slippery mucosa. Natural teeth form an effective arrangement for the mastication of tough foods, a denture rests on bone with delicate layer of mucosa between the denture base and bone. It should be explained to patients that teeth have acute proprioceptive system that detect minute variations in movements, size location and nature unlike denture patients who have lost their tooth guidance mechanism. The dentist must stress that these problems are not insurmountable but can be overcome with patience, determination and skill.

First Oral Feelings

As

soon as the dentures are inserted,the patients should be allowed to view themselves. They must be forewarned that they will experience a temporary feeling of fullness

 There

are two reasons for this fullness justly the dentist wants to take advantage of much tissue area as possible to aid in stabilization, retention and distribution of chewing forces, thus new dentures are always larger than the older denture secondly, small changes in denture is perceived by mouth as bulk or excess.

Excessive Saliva
New

dentures are often interpreted as foreign objects by oral system which leads to a stimulation of salivary glands to produce saliva. Excessive flowFloating dentures The patient should be reassured that this is a normal reaction to new dentures and will gradually decreased over time.

Speech

Initial Feelings of Bulk & Excessive SalivaDistorted Speech Speaking with dentures requires practice. Patients should be advised to read aloud and repeat words or phrases that are difficult to pronounce. Reading restores patients speech and removes the intense concentration on how they sound to themselves speech with reading practice quickly assumes natural tone and fluency.

Eating

Patients must be advised that chewing is not random but an intentional and selective activity. The eating skills must be slowly developed and refined. Initially patient should limit themselves to soft foods and avoid tough fibrous foods that will overtax the capacity of their residual ridges. Basically chewing with dentures is more methodical than with natural teeth. Patients must be instructed to divide the normal spoonful of food into half and place each half posteriorly and bilaterally

Placing the food posteriorly in the area of first molar increases the power of the masticatory stroke and places the occlusal load over the denture bearing area. The chewing stroke itself should be up and down motion to minimize lateral stresses and to stabilize the mandibular denture. Mastication may be additionally impaired because of excess flow of saliva for first few days after placement of new dentures. However in relatively short time the salivary glands accommodate to presence of dentures and production of saliva returns to normal.

5.Tongue position

Area of mandibular basal seat is 1/3 that of maxillary basal seat. The mandibular denture is surrounded lingually as well as buccally by muscles all of which disrupt the denture base. - The mandibular denture depends on proper tongue position to maintain adequate peripheral seal and stability

The most common complaint of complete denture patient is loose mandibular dentures. patients should be educated about three basic handicaps of mandibular denture. They are

In order to determine whether the patient has normal tongue position or an abnormal retracted tongue position, ask the patient to open just wide enough to accept food and observe the dorsal surface of tongue and occlusal surfaces of the teeth. The tongue is in contact with lingual surface of denture and floor of mouth is at normal level. The mandibular denture should be stable and able to resist a gentle push on mandibular incisors. If not, the denture will be unstable and easily dislodged.

 Thus

the patient should be aware of importance of tongue position, demonstrate proper tongue positions and subsequent increase in denture retention and stability. The patient must practice opening and closing while tongue assumes normal position.

7.Maintaining health tissue

There are three factors involved in the maintenance of healthy edentulous oral tissue.

Adequate tissue rest Proper denture hygiene Cleansing of oral tissues.

Chemical cleaning agents

There are many safe and effective commercial cleaning solutions available to complete denture wearer. The state university of New York at Buffalo School of Dental Medicine has been recommending the following inexpensive, safe and effective cleaning solution. This solution should be used for complete acrylic dentures with resin or porcelain teeth. It contains 1tbs-sodium hypochlorite (house bleach) 1tsp- calgon water softener, detergent 4 ounces- water To effectively remove calculus, overnight soaking with 4 ounce white vinegar is recommended.

Mechanical cleaning
The use of brush soap or denture cleaning paste and water is very popular method of cleaning complete dentures. Unfortunately, this mode of cleaning can lead to damaging abrasion if too stiff a brush or too harsh a cleaner is used. sonic cleaners; They are relatively new denture accessory. They should not be confused with laboratory type of ultrasonic cleaners. The sonic cleaners employ vibratory energy not ultrasonic energy to clean dentures. Their effectiveness is investigated by Myers and Krol.

Cleaning soft lining materials

It is evident from studies that soft temporary conditioning lining changes with use of commercial products; changes colour , loss of resiliency, internal porosities,

surface roughness
were seen in conditioning materials after two weeks of normal daily soaking in commercial cleaners.

 The

recommended cleaning procedure is gentle washing under cold running water with soft cotton. The external surface may be brushed in the normal manner. If denture is to be left out overnight, it should be stored in plain water with teeth down. The denture should rest on the teeth and not on denture border so that the weight of denture does not distort the living material

c.Often-neglected facets of complete Tissue hygiene and massage

denture care is tissue cleaning and massage. gentle brushing or rubbing of residual ridges with washcloth removes plaque and food debris, which can cause or exacerbate area of local irritation. Tissue brushing helps control the tissue inflammation commonly seen under complete dentures, while denture brushing is not as effective as reducing the level of inflammation.

8.All too often patients will come into the dental office after Over the counter denture products
having prolonged wearing of an ill fitting denture by Home relining Home repairing Excessive use of an adhesive powder or paste Dentists views these claims as absurd, but the uninformed patients sees a thread of hope in such advertisements.

Dentists must assume the responsibility of educating their patients to the dangers of do it yourself dentistry.