Helpful Hints for Optimum Denture Results
Joseph J. Massad, DDS

1. Winning the patient's confidence from the very beginning markedly facilitates prosthetic success.
2. Advise patients to let their oral tissues "rest" before the consultation and examination appointment. Have them leave their dentures out as much as possible the day and night before this appointment and begin a home treatment program (soaking and rinsing the mouth with a warm saline solution three or four times a day). This facilitates a more accurate examination, impression and prognosis.
3. Biting food with anterior teeth will generally create excess pressure on underlying structures and may often cause dislodgement of a denture. To avoid such a problem, show patients how to chew bilaterally. Demonstrate this by having an assistant place a piece of utility wax in the cuspid area and then remove a bite-sized piece of wax using a twisting hand motion. The assistant then places some wax on both posterior occlusal surfaces and demonstrates how an up-and-down bilateral chewing motion may help stabilize dentures with less pressure.
4. An inadequate posterior seal is a common reason for poor maxillary denture retention. To remedy this, place two thicknesses of ¼" adhesive tape approximately 4 to 6 mm from the posterior palatal border. Coat the post dam area with Reline Ink and prepare with acrylic cutting bur to expose fresh plastic surfaces. Coat tape with Reline Screen. Apply reline material to the post dam area. Seat the denture. After curing, remove the tape and excess acrylic from the denture. Feather the new posterior seal into the palatal denture base with an acrylic cutting bur.
5. To detect dimensional change in denture bases, apply thinly mixed alginate to the denture intaglio. Insert the denture into the mouth and seat with normal closing pressure. Remove the denture after the alginate has set (gently introducing some air with an air syringe at the denture borders will facilitate removal without disrupting the alginate). Areas of gross dimensional change will have displaced the alginate. These areas can now be marked with an indelible pencil and relieved. This technique often allows a practitioner to relieve certain discrepancies before they have had a chance to produce trauma to underlying tissues.
6. A good method to accurately locate any denture base area causing a denture sore is to apply a small amount of dye ointment to an irritated area. Seat the denture to allow the dye material to transfer to the denture base, indicating the area to be relieved.
7. To test a patient's degree of gag reflex, move an empty impression tray onto the soft palate. To attempt to program or condition them out if an exaggerated gag reflex; instruct the patient to place a toothbrush handle firmly against the anterior palatal area at two-to-three-minute intervals, three times a day, for two to three days. The patient should then progressively move the toothbrush handle to a more posterior location every two to three days. When a gag reflex is elicited, the handle is moved to a more anterior position for a day, then posteriorly in two-to-three-day intervals until pressure can be tolerated on the soft palate without a gag reflex.
8. A patient will sometimes complain of a whistling or poor "S" sounds while speaking with a new denture. This can be corrected by applying acrylic relining material to the anterior rugae area of the denture. Contour the material with an index finger made wet with monomer until a putty-like consistency is reached. Insert the denture and instruct the patient to swallow and close into occlusion, holding that position for a few seconds. This process causes the tongue to enhance anterior palatal shape, improving "S" sounds and also diminishing or eliminating whistling sounds. Use of Reline Ink will assure fresh acrylic is exposed and Reline Screen will prevent excess acrylic from adhering to teeth by localizing bonding only to the area indicated. Feather the added acrylic, after curing, into the general palatal surface with acrylic cutting burs before polishing.

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