Dental CPD Australia

Denture Difficulties in the Edentulous Elderly Patient - Patient Attitude

It is a common attitude of the elderly that they do not adapt as well or as willingly to the new, be it in the environment, society, in their home, and in particular, their own body. It therefore can be a challenge for the practitioner to provide an elderly patient with a new set of dentures that the patient will instantly adjust to. Patients who have been wearing the same set of dentures for many years, will be used to the feel and fit, making the new dentures difficult to accept. Some patients may also request the practitioner copy their

old set of dentures because they feel like it fits them perfectly. As professionals we have all encountered this at some time and will need to explain to the patient that their mouth has altered and the denture no longer fits, and show them how the teeth have worn so they are no longer effective for their needs. The old dentures will have decreased vertical dimension and probable incorrect occlusion when true centric relation is sought. Although it is common for adjustments to be made after initial completion of the denture, the practitioner may encounter patients that return frequently for adjustments because they claim to still feel discomfort or pain.

Patients with microstomia have a limited mouth opening that make conventional methods for fabricating a denture become difficult and challenging, making it inevitable to use modifying techniques. Some recommended techniques for modifying the standard impression include the use of stock trays or custom-made trays for each half of the arch. This creates sectional impressions that are connected extra orally after impression taking. Another method is the use of flexible impression trays made of silicone putty that can be bent during insertion and removal from the mouth, enabling the tray to pass through the mouth opening with ease for both practitioner and patient.

In dealing with the flabby or fleshy type of mucosa, custom trays can be made for selective pressure impression taking. This simply means modifying the impression tray so more pressure can be is applied to areas that can withstand. A modification that can also be implemented is the placement of holes in selected areas of the tray to relieve the pressure applied on the tissues in that particular area.

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