THEY’RE COMING TO YOU for information about dentures. Can you give the “matures” all the right answers?
As the U.S. adult population ages, Americans are oftentimes segmented into subgroups based on demographics including age. Those termed “matures” were born between 1909 and 1945 and more than likely are your denture patients. Why is this important? Research indicates that matures often insist upon reliability, consistency, and predictability. They have strong beliefs in institutions and often are intensely brand-loyal. If you think about your practice as a brand, denture wearers can be valuable patients who look to you as a trusted, reliable advisor. As their dentist, you care about their oral health and overall systemic health.
When edentulous patients learn they need complete or partial dentures, they rely on you for more than teeth. Your patients are looking for prostheses that allow them to eat, smile, and speak without difficulty. And, they want to be able to do these things as they always have. This is your opportunity to help patients maintain good oral health and help manage their expectations, thus easing the psychological and physical transition to wearing dentures.
A step back in time
Can you imagine telling your edentulous patients that you are going to make them each a set of complete artificial prostheses out of hippopotamus? Beginning in ancient times, dentures were made of animal products, namely bone and ivory, from elephants and hippopotamuses. Fast-forward to the 1700s and early manuscripts written by Pierre Fouchard, a French dental surgeon. He documented that dentures were made of wood, ivory, metal, and even plaster of Paris. (Contrary to popular belief, George Washington’s dentures were not made of wood.)
Since the 1950s, advances in denture fabrication have resulted from the development of synthetic polymers. Today, the materials used to make dentures - ceramics or acrylic resins - have allowed general dentists and prosthodontists to make esthetically pleasing replacement teeth.
And patients demand it. Today’s denture wearers are increasingly demanding the most natural-looking, well-functioning dentures that can be made. The material used in Washington’s time for fabricating dentures would not meet the needs of today’s denture wearers. It’s up to us to assure patients that the materials used for their dentures will meet their physical and esthetic needs. Equally important is our role in managing patients’ expectations and ensuring that they have successful denture experiences - ones that give them confidence and security in their new smiles.
Navigate the successful denture experience
As edentulous patients’ trusted advisor, you will advise and support patients as they transition into new dentures. You must make them aware of important issues during the transition. According to Dr. David M. Roessler, too many dentists assume that the main reason for dissatisfaction with dentures is a technical issue.1 Studies have found that although technical considerations are important, understanding patients’ needs and wishes and being able to effectively communicate with them are just as important.
Patients’ concerns and fears should be identified and effectively managed before treatment begins. This will help establish realistic expectations for patients and dentists and help avoid disappointment. Following are general patient concerns. Discuss these areas with your patients to navigate through successful denture experiences.
Denture patients must know that they could experience difficulty chewing and swallowing food as they adjust to their new artificial prostheses. The successful denture experience is a learned process. Patients must understand that muscles take time to respond to a new prosthesis and their soft tissues may be affected by it. Dentures are only about 25 percent as efficient as natural teeth. If chewing and swallowing is initially a problem for a patient, start that patient on soft foods - those that are easy to chew - then gradually progress to other foods. Teach patients to distribute food evenly on both sides and chew with the back teeth. A denture adhesive might help improve a patient’s ability to bite, making him or her feel more comfortable and confident in wearing dentures.
Speech and voice can change as a result of the changes in the mouth. Speech problems affect up to 18 percent of patients with removable partial dentures.2 This may have considerable social and psychological impact on patients. In most cases, speech adaptation is one of the most rapid adjustments made by denture patients.
Patients need to understand that their dentures can last between five and 10 years before a reline or replacement is required. In fact, some dentures can last much longer. Communicate that follow-up visits are essential to ensure good oral health. At least once a year, the overall health of the oral cavity tissues should be evaluated.
Daily home care and proper denture maintenance is essential. It is recommended that patients leave dentures out of their mouths at night to allow the oral tissues a chance to rest. If that makes patients uncomfortable, recommend that they leave them out three to five hours during the day. Tell them to place dentures in cool water when not in their mouths. Recommend denture-care products as a complement to professional care. For example, cleaning dentures will help eliminate plaque and food particles that can adhere to dentures and lead to odors, irritations, and possible infections. Brushing can effectively remove loose food particles. Recommend this as a complement to soaking with an effervescent denture cleanser such as Polident® (GlaxoSmithKline) to control odor-causing bacteria and remove plaque that brushing alone may leave behind.
Advances in dentistry and improved techniques have helped dentists fabricate more natural-looking and well-fitting dentures for patients. As more of today’s population ages into the matures category, they will come to you for advice and reassurance, especially if they need complete or partial dentures. Successfully managing this process is as much an art as it is a science. Through effective, ongoing communication - which starts before treatment begins, follows through the fabrication process, and continues after denture delivery - patients can have complete denture success.
1 Roessler DM, Complete Denture Success for Patients and Dentists International Dental Journal 2003; 53, 340-345.
2 Frank RP, Brudvick JS, Leroux B, et al. Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction. J Prosthet Dent 2000 83: 521-527.
Terry Lindquist, DDS
Lindquist joined The University of Iowa College of Dentistry in 1994. She is associate professor in the Department of Prosthodontics. Her teaching includes fixed prosthodontic techniques, removable prosthodontics, and clinical issues. E-mail her at [email protected].