COMPLETE DENTURES



20. CORRECTING THE OCCLUSION
Patient Instructions (wearing) (cleaning)

Patients should first learn to wear and speak with the dentures. I tell the patient we are now only interested in problems of wearing. Chewing problems will come later. Take out one of the dentures when eating, or wear the old dentures. Only if you feel comfortable should you wear the new dentures when eating, and then only with nonchewing foods such as soup, soft boiled eggs, a banana, etc. The idea is to get used to having food and the dentures in your mouth at the same time.

Speaking with dentures is usually not a problem for most patients. Others will speak as if they had a house in their mouth. I usually compliment the patient if they can speak well while wearing the dentures. With those that have difficulty, I suggest they practice speaking when they are alone at home.

Initially when you put the denture(s) in the mouth, the brain assumes that it is food so you start to salivate. Later on the brain will understand the signals from the denture and you will salivate normally.

Patients should be aware that food will get under the denture no matter how well they are made.

If the upper denture is hard to remove, coughing (or a large yawn) will help get it loose by breaking the seal. Air will be forced under the denture. Another way to loosen a maxillary denture is to push the centrals forward. This causes the posterior border to rotate downward, thus breaking the seal.

Sleep with them the night before the first adjustment only if you can and then never again. Your gums are not designed to support the dentures for long periods of time, so always take them out at night and give your gums a rest. You can also take them out during the daytime if you are home alone.

What do you say to a woman who has had two heart attacks and is afraid to take the dentures out at night because she might have another heart attack and people will see her without her teeth. (She should be aware that the hospital personnel will take the dentures out of her mouth and then may very well lose them.)

Dentures have to be kept wet. At night (or daytime) keep them in cool water away from children and pets.

They should be kept clean. Soap and water with a soft cloth is all you need. (Should the patient develop an oral infection then soap and water will not be enough. Microscopic defects in the denture and possibly the container will serve as a reservoir of the pathogens. The denture and the container must be sanitized to prevent reinfection.) Keep some water in the sink so they won't break if you drop them. You can buy any denture soak if you want to. Do not use anything abrasive to clean the dentures. Even a toothbrush will eventually put scratches on the denture. Food will get under the denture and on the denture. Try to rinse them with water after each meal.

The denture containers are a good source of bacterial growth. Some food, bacteria, water, provide a good growth media. Clean the container every day.

The first adjustment will be the next day. That is why you don't deliver on a Friday.

Before the patient leaves make sure they can remove and insert the dentures.
1981 Board Question

During the first few days of the postinsertion period for complete dentures, the patient should expect

(a) to leave dentures in the mouth continuously
(b) noticeable improvement in speech
(c) excessive salivation
(d) some difficulty in masticating most foods

1. (a) and (b)
2. (a) and (c)
3. (a) and (d)
4. (b) and (c)
5. (b) and (d)
6. (c) and (d)
7. all of the above

Click for the Answer

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©1999 by Julius Rosen, D.D.S.