If a patient wants or needs a prosthesis solution, there are a few good options available.
Although many would prefer a non removable denture solution, sometimes medical history, time and / or clinical conditions and of course expense can work against that option.
When patients consider a denture solution, it is usually with limited information as to the hows and whys of such a procedure.
For example most consider a denture solution to be a one-time mattter which is not true. A removable prosthesis must be relined periodically, which can mean they will have to live without it while this is being done.
Prior to treatment planning, you need a complete review of dental records and the patient’s medical history to date.
The design of your removable prosthesis will start with which type of material should be used, such as acrylic resin, vulcanite, polystyrene, metal, or flexible material. The guide planes and the height of contour of abutment teeth are other important factors.
Whether it is a full or partial denture, the goal is to reduce or eliminate lateral forces and attempt to transmit forces parallel to the long axis of teeth. When designing your prosthesis, consider the necessary support, retention, stability, and esthetic requirements.
When creating treatment plans for full dentures, please make sure you review with your patients the fact that they will need denture adhesive for a more secure fit. The advantage here is if they do not need it, you look good. If they do, they will not be surprised.
I recommend informing patients that ideally, they would benefit from two to six implants on the upper or lower arch or both arches for the best and most secure fit. Mention that the placement of implants reduces the need for relines and in many cases reduces the bone loss caused by resorption due to disuse atrophy.
This is an important concept for your patients to understand: in the time without dental implants, they will have more and more bone loss causing their dentures to fit poorly, causing many problems as well as discomfort.
A word of caution regarding patients who come to you and only want a reline: once you do a reline on a patient who has had dentures for a long time, you will be irreversibly changing his or her denture, which can cause problems.
I strongly recommend that you consider a new prosthesis first so you never touch his or her original denture. I find that patients who have had dentures for a long time develop a feel for them, much like an old pair of blue jeans.
To learn more about helping customers transition to prosthetics and more customer-focussed approaches to dental care, please contact me.
And he knows that once you “get it right,” it’s not a great leap to replicate that success over and over again.
Today, in addition to his work as an actual dentist, Dr. Coughlin coaches, consults and speaks to dentists across the country on how to build the practice of their dreams – based on proven processes and procedures.
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