POST-INSERTION INSTRUCTION, PROBLEMS & SOLUTIONS SOLUTIONS PATIENT’S EDUCATION

Outline Post-insertion instruction Patient’s experiences & discomfort Problems occurring following insertion & their solution

POST-INSERTION INSTRUCTION

1.HABITUATION 2.EATING HABITS 3.SPEECH 4.HOME CARE FOR THE DENTURES LIST OF INSTRUCTIONS

1.HABITUATION Initially t he d enture w ill f eel s trange & bulky i n t he m outh & w ill c ause, f ullness o f lips & c heeks. P atient’s a ppearance w ith t he denture w ill b ecome m ore n atural w ith t ime. Patient’s m outh & t ongue h as t o g et a djusted to t he d enture, a lso t here w ill b e increased s alivation, w hich w ill b e reduced s ubsequently.

1. I t m ay b e d ifficult t o a djust a s p atient has b een w ithout t eeth f or a l ong p eriod of t ime. 2. F irst f ew d ays p t i s i nstructed n ot t o chew h ard f ood a void s ticky f ood 3. P t i s a sked t o t ry t o c hew o n b oth s ide with t he b ack t eeth 4. P t i s a sked n ot t o d rink w ater b y l ifting the t umbler b ut d rinking b y s ipping. 2.EATING HABITS

1. Speaking with the dentures normally requires some practise. 2. Patient is asked to read aloud and repeat the words those which are difficult to pronounce. 3. With passage of time pt’s speech with denture will be better than without denture. 3. SPEECH

1. P t i s a sked t o c lean t he denture w ith s oft b rush, specially m ade f or d enture & keep c loth i n t he w ash b asin so, i f d enture w ill f all t han i t won’t b reak. 4. HOME CARE FOR THE DENTURES

2. P t s hould r inse t he mouth & d enture after e very m eal. 3. P t s hould n ever wear d enture a t night & s hould store d enture i n cold w ater. 4. P t s hould n ot w ash the d enture w ith hot w ater.

5. I t’s p referable i f p t p lace d enture i n denture c leanser a t n ight. 6. A fter r emoving t he d enture p t s hould massage t he g ums f or f ew m inutes w ith fingers. 7. P t s hould n ot u se a ny a brasive o r detergents t o c lean t he d entures. 8. P t s hould n ot m ake a ny a djustment o r repair b y h imself.

PATIENT’S EXPERIENCES & DISCOMFORTS

1.FIRST ORAL FEELINGS 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 Different experiences & discomforts

1.FIRST ORAL FEELINGS 1.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. 2.FULLNESS OF THE MOUTH a.Little change in the mouth is perceived as a big change by the pt. b.Also dentist use as much area as possible.

2.RETENTION COMPARISION BETWEEN NATURAL & ARTIFICIAL TEETH NATURAL DENTITION COMPLETE DENTURE MODE OF ACTION Roots ( which have ability to bite tough food) Wet slippery mucosa (which is not able to bite tough food) BITING CAPACITY80 pounds11.7 pounds SENSATIONProprioceptive mechanism No such capacity

3.SALIVA PROBLEMSOLUTION Excess salivation :- As foreign thing enters in the mouth, it’s the normal reaction of the body. Subsides in few weeks, Keep deglutition active.

4.SPEECH PROBLEMSOLUTION  Distortion of speech,  Affected fluency (owing to initial feeling of bulk & the accompanying excessive saliva)  Difficult rapid conversation Quietly read aloud at home (slow reading may not put up the pt’s concentration on how the sound is pronounced.)

5.EATING Pt’s compliance e.g. ability to eat a steak or an apple is a mark of good denture. (Such things result in soreness of the mouth.) Pt’s education  In beginning pt is advised to eat soft/crispy foods, as they are easy to comminuted.( 1 st week)  Avoid fibrous & tough foods in beginning, there is an ample variety of soft food is available so, pt should not compromise with nutrition.  Pt is educated to eat methodically :- Pt is instructed to divide normal forkful of food in half & place each half bilaterally.

6.TONGUE POSITION & PROBLEMS WITH THE LOWER DENTURE IN CONTRAST WITH THE UPPER DENTURE MANDIBULAR DENTUREMAXILLRY DENTURE TONGUE tongue causes lifting of the lower denture No tongue involvement DENTURE BEARING AREAS approx. 14cm 2 Approx. 24 cm 2 Muscle surroundingsBuccal & lingual musclesOnly buccal muscles

Problems occurring following insertion & their solution

SEVERAL PROBLEMS DIRECT SEQUELAE 1.DENTURE STOMATITIS 2.FLABBY RIDGE 3.TRAUMATIC ULCER (sore spots) 4.BURNING MOUTH SYNDROMS 5.RESIDUAL RIDGE RESORPTION 6.DENTURE IRRITATION HYPERPLASIA 7.GAGGING

INDIRECT SEQUELAE 1.ATROPHY OF MASTICATORY MUSCLES 2.NUTRITIONAL DEFICIENCIES