PATIENT EDUCATION (WRITTEN AND ORAL INSTRUCTIONS)

Prosthodontic treatment involves a continuous service that does not terminate with the insertion of prosthesis.  It includes both the initial adjustment phase and the after care phase of treatment.

Oral and written instructions regarding the wearing of complete dentures should be provided for the patient during the active phase of treatment.  Diet recommendations should be included with these instructions.

Forewarn your patient that he or she will experience a feeling of fullness and that this sensation will gradually subside.  Excessive salivation is very common and also will slowly diminish over the first few weeks.

Initially, most patients experience some difficulty in speaking.  Reading aloud will help the patient accommodate more rapidly.

Eating with dentures is a skill that must be learned.  Advise your patient to cut food into small pieces, place it bilaterally on the posterior occluding surfaces of the denture, and chew in an up and down motion.

The mandibular denture depends upon a forward tongue position to maintain the border seal and stability.  Emphasize the importance of this forward position to your patient.

Written instructions concerning the care of completed dentures, including cleaning procedures, should be provided for the patient.

An inexpensive, effective cleaning agent for complete dentures is as follows:

1/2 tsp. sodium hypochlorite (household bleach)
4 oz water

The bleach helps to remove stains and is germicidal.  Since it will corrode metal, bleach should not be used for cleaning complete dentures with metal bases or removable partial dentures. 

Tell your patient to thoroughly brush the denture with a denture brush under running water after soaking to remove the bleach.  Do not recommend the use of toothpaste as it contains abrasive agents harmful to the acrylic.

Daily cleaning of the denture achieves the following:

1. removes bacterial plaque
2. prevents stain and calculus build-up
3. prevents offensive mouth odors

All patients wearing removable prostheses should be examined periodically to evaluate the health of the oral tissues and the condition of the dentures.  The importance of health mucosa and good oral and denture hygiene should be emphasized.

To maintain tissue health, complete dentures should be removed from the mouth for several hours during each 24-hour period, usually while sleeping.

Procedure

1. Explain to the patient the importance of continued oral hygiene.  Brushing the ridges and palate as well as the denture is necessary.

2. Give written and oral instructions in denture care.  A combination of brushing and soaking is recommended.

3. Ask the patient to leave the dentures in the mouth for the first 24 hours in order to check for denture irritation lesions.  You must see the patient in 24 hours when you make this request.

4. Caution the patient against trying to eat hard or difficult to chew foods initially.  Steak, apples, corn on the cob, sandwiches, nuts and lettuce can all a present problems to the denture wearer.  Encourage the patient to eat soft, easy to chew foods initially.  As they accommodate to the denture, harder more difficult to chew foods can be introduced.

5. Allow the patient to ask questions and to look in a large mirror held several feet away from the patient's face

6. Reappoint the patient to be seen in 24 hours.