Patient Education Related to Complete Denture PDF

1 Patient Education Related to Complete Denture By Dr. Hana.I.Mahgob 2 Lecturer at removable prosthodontic department /Benghazi university BDS (2001 ) Benghazi university MDS (2011) Cairo university PHD (2019) Ain Shams university  3 It is the prosthodontic service that refers to providing...

1 Patient Education Related to Complete Denture By Dr. Hana.I.Mahgob 2 Lecturer at removable prosthodontic department /Benghazi university BDS (2001 ) Benghazi university MDS (2011) Cairo university PHD (2019) Ain Shams university  3 It is the prosthodontic service that refers to providing information and instructions to a complete denture patient regarding use and maintenance of prosthesis. 1. Limitations of Dentures - These limitations should be explained to the patient prior to the denture delivery - Dentures are less efficient in mastication and incising food than natural teeth. - Some people can eat all foods easily, but these are the exception. - Patients with minimal ridges should be advised that their dentures will likely move (specially the mandibular) and their efficiency will be less than those with well_formed ridges. - Patients with minimal ridges will likely encounter more sore spots than others. - Denture needs continuous follow up and further treatments such as occlusal adjustments, relining, rebasing, remaking…..etc. - 2. Nature of the denture foundation  Placement of dentures in the mouth provides unnatural environment to oral tissues.  Mucosa is compressed between the bone and the denture base.  Compressive forces with excessive limits will lead to bone loss and over growth of soft tissues leading to excessive movement of the denture.  Adequate nutrition and maintaining a good general health will help keep supporting tissues in healthy conditions. 3. Oral and general conditions complicating the use of the denture 6  Patients for whom pre-prosthetic surgery is contraindicated.  Patients with both vertical and horizontal bone loss.  Patients who do not care and do not accept their responsibility despite of good prosthodontic service provided to them.  Patients with adverse mental attitude.  Lack of mental capacity (geriatric patients) to get adjusted, care for, and maintain dentures.  4. Problems of the adjustment period  Patients may experience initial cheek or lip biting.  Adaptability is reduced in complete denture wearers because proprioceptors of the periodontal ligament have been lost and large areas of mucosal proprioceptors are covered in acrylic.  It may take 6 to 8 weeks for patients to become optimally adapted to the prostheses (explain to patients)  Adaptation may be accompanied by an initial, transitory increase in saliva.  Soreness and discomfort.  Crowding of tongue and the sensation of fullness.  Speaking may be affected by tooth position (specially anteriors), tongue space (particularly if patients have been without dentures for some time), and palatal contours.  Initial speaking problems are usually transitory, since the tongue is very adaptable.  Adaptability is affected by:  Length of time without wearing dentures.  Amount of residual ridge remaining.  Individual variation (e.g. patients with more acute oral sensory perception have more difficulty adapting)  May be more than one adjustment visit is required during the first couple of weeks after denture insertion.  Patient should not attempt to adjust his denture by himself.  Appearance may be changed in some individuals. These changes are usually due to: Changes in vertical dimension Improved lip support (not help with wrinkles)  In most instances these changes in appearance will be beneficial and not of concern to the patient. However, patients may require reassurance during the period of adjustment to their new appearance. 10 5. Learning to use dentures correctly  Patients should be advised of the need to persevere while their neuromusculature adapts to the new prostheses.  Patient should be trained to perform certain exercises: ❑ Hold his/her denture in place. ❑ Hold his/her tongue on the lingual flanges of lower denture. ❑ Lips and cheeks should be relaxed.  Initially eating soft foods, increasing to hard foods in small quantity, cutting food into smaller pieces, and placing food towards the corners of the mouth. DO NOT EAT STICKY FOOD. 6. Resting the supporting structures 12  Denture should be left out of the mouth at least for 6-8 hours each day. This will allow the recovery of supporting structures (usually before going to bed). 7. Oral and denture hygiene 13 Oral and denture hygiene (A. Denture): - Brushing has been shown to be most effective method to remove plaque: - Use non-abrasive cleanser (commercial pastes, dish detergents, not regular toothpaste). - Use soft brush with long bristles (less wear). - Inner and outer surfaces must be cleaned. - Brush over a filled basin or face cloth (protection against fracture or damage if dropped). - Brush after every meal and before bed.  Chemical cleaners must be used overnight to be effective (15-30 minutes is not sufficient) - Brushing is more effective (60-80% vs 20-30% plaque removal compared to soaking alone)  Combine brushing with soaking for more efficiency Oral and denture hygiene (B. Mucosa): - Remove dentures at night. - Brush mucosa with a soft tooth brush and warm tap water, massage all of the tissue - this will improve health for the next denture - Stimulates tissue.  Guidelines for the care and maintenance of dentures  Careful daily removal of the bacterial biofilm present in the oral cavity and on complete dentures is of paramount importance to minimize denture stomatitis and to help contribute to good oral and general health.  Dentures should be cleaned daily by soaking and brushing with an effective, nonabrasive denture cleanser.  Denture cleansers should ONLY be used to clean dentures outside of the mouth.  Dentures should always be thoroughly rinsed after soaking and brushing with denture-cleansing solutions prior to reinsertion into the oral cavity.  Always follow the product usage instructions.  Dentures should be cleaned annually by a dentist or dental professional 18 using ultrasonic cleansers to minimize biofilm accumulation over time.  Dentures should never be placed in boiling water.  Dentures should not be soaked in sodium hypochlorite bleach, or in products containing sodium hypochlorite, for periods that exceed 10 minutes. Placement of dentures in sodium hypochlorite solutions for periods longer than 10 minutes may damage dentures.  Dentures should be stored immersed in water after cleaning, when not replaced in the oral cavity, to avoid warping.  Denture adhesives, when properly used, can improve the retention and stability of dentures and help seal out the accumulation of food particles beneath the dentures, even in well-fitting dentures.  Improper use of zinc-containing denture adhesives may have adverse systemic effects. Therefore, as a precautionary measure, zinc-containing denture adhesives should be avoided.  Denture adhesive should only be used in sufficient quantities (three or four pea-sized dollops) on each denture to provide sufficient added retention and stability to the prostheses.  Denture adhesives should be completely removed from the prosthesis and the oral cavity on a daily basis.  9. Importance of recall visits - Most patients and many dentists don't schedule at least yearly denture recall appointments (ideally every 6 months). - Recall visits will allow the dentist to observe the development of undesirable situations and it is more easier to correct problems in early stages like wear, fractures, resorption, reinforce hygiene, etc. - Denture life expectancy is 5-7 years, but if tissues change, remakes may be required sooner. - It is better for dentures to wear out rather than the denture bearing tissues. 10. Importance of good diet  Nutrition and diet are important factors with all edentulous patients, but particularly with geriatric persons.  As the aging process advances, people become less active. Since muscle activity is limited, caloric requirement is lower. The time for more proteins and fewer carbohydrates and starches has come. Decline in sensibility to taste can result in appetite loss and malnutrition.  Cooperation between patient, prosthodontist, and dietitian will end up providing greater service to the patient.  Vitamin therapy, so essential as a diet supplement.  Obesity can result from an excessive intake of refined carbohydrates.