SlideShare. Present yourself.

Upload

Login or Signup

Go Pro

pateint istruction, prob, solution-complete denture insertion

10 months ago

Email

Favorite

Download

Embed

Loading…

Flash Player 9 (or above) is needed to view presentations.

We have detected that you do not have it on your computer. To install it, go here.

No comments yet

Embed Video Subscribe to comments

Post Comment

Edit your comment

Cancel

Speaker Notes on slide 1

pateint istruction, prob, solution-complete denture insertion - Presentation Transcript

GOOD AFTERNOON

POST-INSERTION INSTRUCTION,PROBLEMS & SOLUTIONS

SOLUTIONS

PATIENT’S EDUCATION

COMPLIED BY:-NIKUNJ PATEL

Outline

Post-insertion instruction

Patient’s experiences & discomfort

Problems occurring following insertion & their solution

POST-INSERTIONINSTRUCTION

LIST OF INSTRUCTIONS

HABITUATION

EATING HABITS

SPEECH

HOME CARE FOR THE DENTURES

1.HABITUATION

Initially the denture will feel strange & bulky in the mouth & will cause, fullness of lips & cheeks. Patient’s appearance with the denture will become more natural with time. Patient’s mouth & tongue has to get adjusted to the denture, also there will be increased salivation, which will be reduced subsequently.

2.EATING HABITS

It may be difficult to adjust as patient has been without teeth for a long period of time.

First few days pt is instructed not to chew hard food avoid sticky food

Pt is asked to try to chew on both side with the back teeth

Pt is asked not to drink water by lifting the tumbler but drinking by sipping.

3. SPEECH

Speaking with the dentures normally requires some practise.

Patient is asked to read aloud and repeat the words those which are difficult to pronounce.

With passage of time pt’s speech with denture will be better than without denture.

4. HOME CARE FOR THE DENTURES

Pt is asked to clean the denture with soft brush, specially made for denture & keep cloth in the wash basin so, if denture will fall than it won’t break.

Pt should rinse the mouth & denture after every meal.

Pt should never wear denture at night & should store denture in cold water.

Pt should not wash the denture with hot water.

It’s preferable if pt place denture in denture cleanser at night.

After removing the denture pt should massage the gums for few minutes with fingers.

Pt should not use any abrasive or detergents to clean the dentures.

Pt should not make any adjustment or repair by himself.

PATIENT’S EXPERIENCES& DISCOMFORTS

ZARB BOLENDER STATES,….

“Explanations provided after problems develop often are interpreted as excuses by the dentist for dentures that function less than satisfactorily.”

Different experiences & discomforts

FIRST ORAL FEELINGS

RETENTION COMPARISION BETWEEN NATURAL & ARTIFICIAL TEETH

SALIVA

SPEECH

EATING

TONGUE POSITION & PROBLEMS WITH THE LOWER DENTURE IN CONTRAST WITH THE UPPER DENTURE

1.FIRST ORAL FEELINGS

NATURE OF THE COMPLETE DENTURE

General introduction about the denture by the mean of diagrams or models can be used to show the pt that what he wears in his mouth.

FULLNESS OF THE MOUTH

Little change in the mouth is perceived as a big change by the pt.

Also dentist use as much area as possible.

2.RETENTION COMPARISION BETWEEN NATURAL & ARTIFICIAL TEETH

3.SALIVA

4.SPEECH

5.EATING

6. TONGUE POSITION & PROBLEMS WITH THE LOWER DENTURE IN CONTRAST WITH THE UPPER DENTURE

Problems occurring following insertion & their solution

SEVERAL PROBLEMS

DIRECT SEQUELAE

DENTURE STOMATITIS

FLABBY RIDGE

TRAUMATIC ULCER (sore spots)

BURNING MOUTH SYNDROMS

RESIDUAL RIDGE RESORPTION

DENTURE IRRITATION HYPERPLASIA

GAGGING

INDIRECT SEQUELAE

ATROPHY OF MASTICATORY MUSCLES

NUTRITIONAL DEFICIENCIES

DIRECT SEQUELAE

1.DENTURE STOMATITIS

DENTURE STOMATITIS - SYNONYMS

Denture induced stomatitis

Denture sore mouth,

Inflammatory hyperplasia,

Chronic atrophic candiasis

CLASSIFICATION

Type-I (Localized simple infection)

Type-II (erythematous type)- generalized type

Type-III granular type

ETIOLOGIC FACTORS

systemic factors

old age

diabetes mellitus

nutritional deficiency:- iron, folate, vit.12 etc.

Local factors

dentures

environmental factors

night wear of the dentures

denture cleanliness

xerostomia

high carbohydrate diets:- causes increased plaque accumulation

MANAGEMENT

SUPPORTIVE MEASURES

cleanliness of the denture

denture & the mucosa should be cleaned after the meals.

Store the denture in the 0.2-2% chlorhexidine during the night time.

Polishing of the denture routinely.

Not to wear the denture during night time.

DRUG THERAPY

after the infection is conformed to be occurring because of the candida the topical anti-fungals are given,,, e.g. nystatin, amphotericin B, micronidazole,

SURGICAL THERAPY

necessary in the type-III.

2.FLABBY RIDGE

DESCRIPTION

Alveolar ridge may become mobile & extremely resilient due to replacement of the bone by the fibrous tissue.

TREATMENT

Surgical correction & relining of the denture base accordingly for re-adaptation of the tissue surface.

3.TRAUMATIC ULCER (sore spots)

DESCRIPTION

It develops with 1- days after placement of new denture.

They are small, painful lesions covered with a grey necrotic membrane surrounded by inflammatory halo with firm, elevated borders.

ETIOLOGY

over extension of the denture

unbalanced occlusion.

TREATMENT

In normal pts, these ulcers heal within few days after correcting the dentures. If treatment is not administered, it may progress to denture irritation hyperplasia.

4.BURNING MOUTH SYNDROMES

ETIOLOGY

local factors

systemic factors

psychological factors

LOCAL FACTORS

mechanical irritation by ill-fitting dentures

prolonged masticatory muscle activity

constant parafunctional movements of the tongue

constant excessive friction on the mucosa

SYSTEMIC FACTORS

vitamin or iron deficiency

menopause

xerostomia

diabetes

PSYCHOLOGICAL FACTORS

anxiety

depression

CLINICAL FEATURES

does not show any overt clinical features.

Mainly pain starts in the morning & aggrivates during the days.

Burning sensation is usually accompanied with dry mouth & persistent altered taste sensation.

Asso. Symptoms include head ache, insomnia, decreased libido, irritability, depression.

TREATMENT

removal of local factors

compensation for systemic deficiency except for menopose.

Psychologic counselling

5.RESIDUAL RIDGE RESORPTION

ETIOPATHOGENESIS

Wherever there is pressure, bone resorbs due to activation of osteoclast.

It’s a constant sequel after extraction & continues even after inserting the complete denture.

PATTERN OF RESORPTION

More rapidly in first 6 months and slows in later 6 months.

It’s more rapid in females than in males.

It’s precipitated by certain systemic diseases & ill-fitting dentures.

RATE OF RRR

MANDIBLE

initially=4-5mm

Later=0.1-0.2mm

MAXILLA

Initially=2-3mm,

Later=four times lesser than mandi.

CLINICAL FEATURES

The depth & width of the sulcus is reduced.

Decreased vertical dimension at occlusion.

Reduction of the lower facial height.

Increased relative prognathism.

MAXILLAE

Resorption is centripetal

(toward centre)

MANDIBLE

Resorption is centrifugal

(away from centre)

6.DENTURE IRRITATION HYPERPLASIA

It is a hyperplastic reaction of the mucosa occurring along the borders of the denture. These lesions result from trauma due to unstable denture flanges.

The lesions usually subside after surgical excision of the tissues & correction of the dentures.

Symptoms are very mild with single or numerous lesions showing flaps of hyperplastic connective tissue. Deep ulceration, fissuring & inflammation may occur at the depth of the sulcus.

7.GAGGING

The gag reflex is a normal defence mechanism, which functions to prevent foreign bodies from entering the trachea.

It may occur due to over extension of the denture borders at posterior palatal seal of the maxillary dentures & disto-lingual part of the mandibular dentures.

In such cases it needs the correction.

INDIRECT SEQUELAE

1.ATROPHY OF MASTICATORY MUSCLES

Usually with age biting efficiency decreases with age.

Any part of the body which is out of function goes under atrophy.

2.NUTRITIONAL DEFICIENCIES

As masticatory muscles go under atrophy & also for any person masticatory muscles go under atrophy along with age their nutrition status also goes down.

CONCLUSION

Patient’s education only on a right time will lead to a successful denture.

If the annoying sequelae of denture wearing are not solved than they will lead to failure of treatment outcome.

Patient should be educated & problems complained by them should be solved without FRUSTRATING them.

The denture fabricated even with all the normal criteria may lead to discomfort to the patient.

A WISH:- EVERYONE COULD INSERT FOUR OF THE DENTURES

REFERENCES

ZARB BOLENDER

WINKLER

ANY DOUBT..,

THANK YOU

nikunj999 + Follow

972 views, 0 favs, 0 embeds more

Related

Section 35 - Masticatory Efficiency 240 views

Section 18 - Pre-Prosthetic Surgery.doc.doc 336 views

Chronic candidiasis 133 views

About dentures 297 views

PROSTHODONTICS.ppt [Read-Only] 1021 views

PROS MIDTERM STUDY QUESTIONS 324 views

Complete denture impressions 30101 views

effect of aging on edentulous state 2199 views

Prosthetic Dentistry 833 views

FEBRUARY 26 - MARCH 1, 2009 McCORMICK PLACE, CHICAGO 180 views

CURRICULUM AND SCHEME OF EXAMINATION FOR P.G.DIPLOMA COURS… 112 views

DENTURES AND QUALITY OF LIFE – A LONGITUDINAL ANALYSIS 66 views

PROSTHODONTICS 609 views

Word 63 views

Section 23 - Treatment Planning - RPD's 219 views

Handout 137 views

4-page article: word version with pics (5.7 Mbytes) 67 views

About this presentation

Usage Rights

© All Rights Reserved

Stats

0 Favorites

0 Comments

92 Downloads

972 Views on

SlideShare

0 Views on

Embeds

972 Total Views

Accessibility

View text version

Additional Details

Uploaded via SlideShare

Uploaded as Microsoft PowerPoint

Flagged as inappropriate Flag as inappropriate

File a copyright complaint

1

3

0

Learn About Us

About

Careers

Our Blog

Press

Contact us

Help & Support

Using SlideShare

SlideShare 101

Terms of Use

Privacy Policy

Copyright & DMCA

Community Guidelines

SlideShare Outside

SlideShare Mobile New

Facebook App

LinkedIn App

Widgets for your blog

Pro & more

Go PRO

Business Solutions

Developers & API

Developers Section

Developers Group

Engineering Blog

SlideShare is the world's largest community for sharing presentations. Upload and share on blogs, Twitter, Facebook or LinkedIn. Over 60 million people use SlideShare every month for research, sharing ideas, connecting with others, and generating business leads. SlideShare also supports documents, PDFs, and videos. Get an account.