Complete Denture: Usage and Upkeep

Patient Education Related to Complete Denture

• Prosthodontic service provides information and instructions to complete denture patients on the usage and upkeep of their prosthesis.

Limitations of Dentures

• These limitations should be discussed with the patient before delivering the denture.
• Dentures are not as effective as natural teeth for chewing and biting food.
• Some individuals can eat all foods with dentures, but this is not typical.
• Patients who have minimal ridges should know that the denture, particularly the mandibular one, will likely move and not work as well as those with well-formed ridges.
• Patients with minimal ridges are more likely to develop sore spots.
• Continuous follow-up and treatments will be needed for dentures, including occlusal adjustments, relining, rebasing, and remaking.

Nature of the Denture Foundation

• Oral tissues are placed in an unnatural position when dentures are put in the mouth.
• Mucosa is pressed between the bone and the denture base.
• Excessive compressive forces may cause bone loss, overgrowth of soft tissues, and denture movement.
• Healthy supporting tissues depend on proper nutrition and good general health.

Oral and General Conditions Complicating Denture Use

• Patients for whom pre-prosthetic surgery is contraindicated are not ideal candidates.
• Patients who have both vertical and horizontal bone loss are not ideal candidates.
• Patients who don't accept responsibility for excellent prosthodontic care are not ideal candidates.
• Patients with adverse mental attitude are not ideal candidates.
• Geriatric patients with diminished mental capacity struggle to adjust to, care for, and maintain dentures.

Denture Adjustment Period Problems

• Patients may bite their cheek or lip at first.
• Adaptability is reduced because the proprioceptors of the periodontal ligament have been lost and large areas of mucosal proprioceptors are covered in acrylic.
• It may take 6–8 weeks to adjust to the prostheses.
• More saliva may be produced briefly at first.
• Soreness and discomfort may be experienced.
• Sensation of fullness and crowding of the tongue may be experienced..
• Speech is affected by tooth position, tongue space, and palatal contours.
• Tongue is adaptable, so initial speaking issues are usually temporary.

Adaptability factors

• Length of time without wearing dentures affects adaptability.
• Amount of residual ridge remaining affects adaptability.
• Individual variation affects adaptability, patients with more acute oral sensory perception have more difficulty adapting

Adjustment Visit

• It may take more than one appointment is required during the first couple of weeks after denture insertion.
• A patient should never try adjust the denture on their own.
• In some people, appearance may change due to changes in vertical size.
• Improved lip support may occur (does not help with wrinkles).
• These changes usually are beneficial, but patients may need reassurance while getting used to their look.

Learning to Correctly Use Dentures

• Patients must persevere as their neuromusculature adapts to new prostheses.
• Patients should be trained to place and hold dentures in place.
• Hold the denture in place.
• Hold the tongue on the lingual flanges of the lower denture.
• Lips and cheeks should be relaxed.
• Eat soft foods at first, then gradually add more firm foods in tiny amounts, cut food into smaller pieces, and place food towards the corners of the mouth.
• DO NOT EAT STICKY FOODS.

Resting the Supporting Structures

• The denture should be left out of the mouth for six to eight hours each day to allow supporting tissues to recover, usually done before going to bed.

Oral and Denture Hygiene (Denture)

• Brushing has been proven to be the most effective technique for plaque removal.
• Use a non-abrasive cleanser (like commercial pastes or dish detergent, not traditional toothpaste).
• Use a soft brush with long bristles (for less wear).
• All inner and outer surfaces must be cleaned.
• Brush over a filled basin or face cloth to prevent fracture if dropped.
• Brush after every meal and before bed.
• Chemical cleaners are more effective overnight (15–30 minutes is insufficient).
• Brushing is more effective than soaking for plaque reduction.
• Combine brushing with soaking.

Oral and Denture Hygiene (Mucosa)

• Remove dentures at night
• With a gentle toothbrush and warm tap water, brush the mucosa and massage the tissue to improve health.
• This will stimulate tissues.

Denture Care and Maintenance Guidelines

• Removing bacterial biofilm every day is very important for preventing denture stomatitis and for good oral and general health.
• Clean dentures every day by soaking and brushing with an effective, nonabrasive cleanser.
• Denture cleansers should only be used to clean dentures away from the mouth.
• After soaking and brushing, dentures should always be fully rinsed before being reinserted into the mouth.
• Always follow the product usage guidelines.
• Dentures should be cleaned annually by a dentist or dental professional using ultrasonic cleansers to minimize biofilm accumulation over time.
• Dentures should never be put in boiling water
• For longer than 10 minutes, dentures should not be soaked in sodium hypochlorite bleach or products containing sodium hypochlorite, as it can cause damage.
• Store dentures submerged in water after cleaning to avoid distortion.
• Denture adhesives, when used properly, can help seal out food debris beneath the dentures and improve well-fitting dentures' retention and stability.

Denture Adhesive Concerns

• Zinc-containing denture adhesives' may possess negative adverse systemic effects.
• It is best to avoid zinc-containing denture adhesives.
• Only use enough denture adhesive in sufficient amounts, three or four pea-sized dollops, on each denture to provide sufficient support.
• Denture adhesives should be taken out from the prosthesis in the oral cavity daily.

Importance of Recall Visits

• Yearly denture recall visits (ideally every 6 months) are not scheduled by many patients and dentists.
• Undesirable situations can be observed during recall visits, and problems like wear, fractures, resorption, and reinforce hygiene can be fixed more easily.
• Dentures last 5–7 years, but if the tissues change, they may need to be remade sooner
• It’s preferable for denture-bearing tissues to wear out over dentures.

Importance of Good Diet

• Diet and nutrition are important for all edentulous patients, especially geriatric ones.
• As people get older, they become less active, which lowers caloric needs.
• As muscle activity declines, caloric requirements decrease and more protein, fewer carbs and starches are needed.
• Appetite loss and malnutrition can result from a loss of taste sensibility.
• Collaboration with the prosthodontist and dietitian will help the patient.
• Vitamin therapy is important as a dietary supplement.
• Consuming too many refined carbohydrates results in obesity.