1. FRANKIE, CLAIRE, BEN, MEREDITH, PATRICIA, BRITTANY HOW LONG WILL MY NEW DENTURES LAST, DO I NEED TO COME BACK?

2. LONGEVITY Expected to last 5-7 years Tissue changes Bone resorption Wear on the denture material Staining Accidental damages Changes in vertical dimension

3. CARE Yearly denture recall appointments Denture State of denture Repair of denture Ultrasonic cleaning of denture Review home cleaning and care

4. CARE Oral cavity Mucosal health Review mucosal care Screen for oral cancer, Candidasis, ulcers

5. EDUCATION Review Are you removing the denture at night? How are you cleaning the denture? What are you cleaning with? Are you cleaning the mucosa?

6. WHY DO PATIENTS TAKE TIME TO ADAPT SPEECH? Monica Munro Ryan Millet Albert Noujaim Andrew McLeod Nabil Moussa Bobby Nadeau

7. Muscle memory of the Tongue and Soft Tissues Lip Support changes Vertical dimensions changes Palatal and Teeth contour changes Stability of new denture Sensory perception changes WHY DO PATIENTS TAKE TIME TO ADAPT SPEECH?

8. MUSCLE MEMORY OF TONGUE AND SOFT TISSUES Tongue is used to contacting certain areas in the oral cavity to produce certain sounds contact areas may changes due to more “ bulky ” dentures Examples: “ sss ” sounds

9. LIP SUPPORT CHANGES Lips needs to do certain movement to produce certain sounds

10. VERTICAL DIMENSION CHANGES Vertical dimensions of new denture and denture teeth may cause difficulties example: “ ff ” sounds

11. PALATAL AND TEETH CONTOUR New denture = new palatal and teeth contour Patient ’ s tongue needs to get used to contacting new areas in the mouth to produce speech

12. STABILITY OF NEW DENTURES Patient needs to stabilize the denture during speech leading to disturbance in the speech

13. SENSORY PERCEPTION CHANGES The tongue cannot feel the roof of the mouth or the denture teeth This can affect the speech as it takes time for the patient to get used to it

14. LIMITATIONS OF DENTURES! Dr. Raftus’ Group Group members: Victor Quartey Emily Wallace Heather Patry Sara Pinsent Chad Tibbo Joubin Saffary Tom Pastor

15. OVERVIEW Dentures are less efficient of natural teeth Ability to eat all foods is the exception A better ridge equals less problems Minimal ridge denture movement – less chewing efficiency Especially mandibular movement sore spots

16. ORAL AND GENERAL CONDITIONS COMPLICATING USE OF DENTURES Diabetes mellitus Arthritis Anemias Neuromuscular disorders Menopause

17. OTHER COMPLICATIONS Educational factors Appearance Speaking with dentures Tenderness Salivary flow Hygiene and maintenance Removal of denture at night Recall visits and their importance Diet

18. CONCLUSION Close co-operation between the patient, physician and dentist is key to maintaining and ensuring the continued success of a great fitting denture!!!

19. WHY DO PATIENTS TAKE TIME TO ADAPT SPEECH? Monica Munro Ryan Millet Albert Noujaim Andrew McLeod Nabil Moussa Bobby Nadeau

20. Muscle memory of the Tongue and Soft Tissues Lip Support changes Vertical dimensions changes Palatal and Teeth contour changes Stability of new denture Sensory perception changes

21. MUSCLE MEMORY OF TONGUE AND SOFT TISSUES Tongue is used to contacting certain areas in the oral cavity to produce certain sounds contact areas may changes due to more “ bulky ” dentures Examples: “ sss ” sounds

22. LIP SUPPORT CHANGES Lips needs to do certain movement to produce certain sounds

23. VERTICAL DIMENSION CHANGES Vertical dimensions of new denture and denture teeth may cause difficulties example: “ ff ” sounds

24. PALATAL AND TEETH CONTOUR New denture = new palatal and teeth contour Patient ’ s tongue needs to get used to contacting new areas in the mouth to produce speech

25. STABILITY OF NEW DENTURES Patient needs to stabilize the denture during speech leading to disturbance in the speech

26. SENSORY PERCEPTION CHANGES The tongue cannot feel the roof of the mouth or the denture teeth This can affect the speech as it takes time for the patient to get used to it

27. HOW TO CLEAN A DENTURE CAIT FRASER JILL DOIRON LEANNE EASSON TOM DICKSON DONG HO KANG SARAH FAKHRALDEEN KATIE GREENE

28. 1. WHY IS IT IMPORTANT? 2. BRUSHING 3. COMMERCIAL CLEANERS 4. ULTRASONIC CLEANERS 5. MUCOSAL HYGIENE

29. WHY IS IT IMPORTANT? Plaque forms on dentures the same as it does on natural teeth Want to keep the tissues underneath the denture healthy Increases the longevity of the denture Maintains the fit of the denture over time Helps prevent staining and denture odor

30. BRUSHING Most effective and affordable cleaning method Use a soft, long bristled toothbrush Use a non-abrasive cleaning agent Dish soap Denture cleaner Advise patients to brush both sides, and especially along junction of denture teeth and base Brush over a basin of water to avoid dropping and damaging denture

31. COMMERCIAL CLEANERS A good adjunct to brushing Advise patient to soak denture in cleaner overnight – 15- 30 minutes is NOT effective This would also encourage patients to remove their denture overnight! Soaking helps clean out bacteria caught in the pores of the denture that cannot be removed by brushing Combination of brushing and soaking is best

32. ULTRASONIC CLEANERS Effective cleaning method ‘Sonic’ cleaners are not effective without a chemical cleaner Patient should be advised that having the denture cleaned only during dental appointments is not adequate!

33. MUCOSAL HYGIENE Important to educate patients about the necessity of cleaning their mucosal tissues Healthy tissues are essential for a proper fit and comfortable denture Mucosa should be brushed twice daily Brush with a soft bristled brush or washcloth and warm water Massaging tissues will stimulate blood flow and improve the health of the tissues

34. WHAT MAKES A POOR RIDGE? Dr. Lozowski’s Group: Sean, Joey, Angela, Amanda, Katrina, Alicia

35. WHAT MAKES A POOR RIDGE? Decreased height The more height you have, the more retentive the ridge

36. WHAT MAKES A POOR RIDGE? Small size The wider the ridge, the more retentive

37. WHAT MAKES A POOR RIDGE? Boggy tissue Loose tissue will cause movement of the denture Firm, non-compressible tissue (especially in the palate) is ideal

38. WHAT MAKES A POOR RIDGE? Excessive undercuts Surgery may be required to remove excessive undercuts or huge tuberosities that are inhibiting suction A good ridge has no undercuts

39. WHAT MAKES A POOR RIDGE? Large tori Surgery may be required to remove large tori that are inhibiting proper impressions and seating

40. THE IDEAL RIDGE Adequate bone support Bone covered by adequate soft tissue No undercuts or hanging protuberances No sharp ridges Adequate buccal and lingual sulci Satisfactory relationship between maxilla and mandible

41. WHY DO PATIENTS TAKE TIME TO ADAPT TO CHEWING? ALLIE, TATUM, JORDAN, TALAL, DAN AND GURJOT

42. NEW DENTURE PATIENTS Lack of proprioception Loss of vertical dimension Maxillary to mandibular relationship Tooth position Neuromuscular adaptation Tissue adaptation

43. REPLACEMENT DENTURES Changes in occlusion Change in centric relation Change in cuspal inclination Tissue adaptation

44. PATIENTS MAY EXPERIENCE Pain Decreased efficiency Initially cheek or lip biting Discomfort Muscle fatigue Changes in salivary flow

45. WAYS TO DEAL WITH THE ISSUES Placing food towards corners of mouth Cutting food into smaller pieces Initially eating soft foods Avoiding hot foods Encourage wearing dentures to get use to them.

46. NEUROMUSCULAR ADAPTATION Muscles will be hyperactive at first Cheeks, lips, and tongue must be trained to maintain the denture in position during mastication.

47. LIFETIME OF CHEWING!