There are three main areas that need attention when designing complete denture prostheses. When these three things are not accomplished, it can lead to misfits and patient dissatisfaction. I see it all the time.
Having a unified practice vision is essential for implementing complete dentistry. As doctors, we need to have a clear picture or vision of the type of practice we want to have. What type of dentistry do we want to offer? What level of service do we want to deliver to our patients? What does the office look and feel like? What is the reputation we want to have? And what is the personality or culture of our practice?
Occlusal equilibration is a treatment modality that we can use to increase patient satisfaction and comfort. Prior to my training and education at The Dawson Academy, equilibration was the least understood and therefore the most underutilized procedure of all the things that I did.
When patients come to us with existing maxillary dentures and want to transition to afixed implant supported prosthesis, sometimes the treatment planning process can be a little confusing and a little challenging.
And we tend to maybe let the patient drive that decision and we end up doing a fixed prosthesis. But really the question is, is that the best prosthesis for them?
Performing a complete exam on a new patient is our greatest opportunity to differentiate our practice, and if done the way Pete teaches us, it can be a huge practice builder. However, getting our team on board and getting them trained in the concepts of complete dentistry can often be our greatest barrier to implementation. There are three steps that I recommend for getting our team trained.
Mandibular denture stability is often times a difficult challenge for us and also for patients.
For them to feel that a lower denture is stable and comfortable is very challenging, especially with ridges that are severely atrophic. One of the things that I have learned over my career is using HydroCast, which is a functional impression material. It is made by Sultan.
Cement-retained implant crowns are very, very popular and have been for the past 10 or 15 years.
But one of the challenges we see with cement-retained implant crowns is the lack of retrievability, especially since most of these have been put on with permanent cement.
Even the temporary cement sometimes is very difficult to remove.
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When we are restoring patients with complete dentures, and they come in with, sometimes, a bag of many sets of dentures that have not been functional, we often wonder why would our set be any different.
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Rehabilitating the completely edentulous patient is one of the most challenging tasks we face in restorative dentistry, and for me, the most rewarding. The majority of the patients I see with an existing set of complete dentures are suffering from pain under the denture bases, poor retention, difficulty with mastication and unnatural esthetics (Figure 1). I feel our society has come to accept the fact that this is what you get when you lose all of your teeth, that this is how dentures are supposed to feel because they are dentures! The psychological effects that accompany the loss of teeth often lead patients to insecurities, social isolation, and even depression. The physical effects of pain, weight loss, and poor nutrition can be even more debilitating.
Combining what we have learned from Pete’s Concept of Complete DentistrySM, classic removable prosthodontic principles, and the latest technologies in implant dentistry, we have the ability to impact our patients’ lives in a way they never knew was possible.
To me: INTEGRITY
My grandmother once told me "Integrity is the key to a good life." Perhaps that is why so many of us are drawn to The Dawson Academy and its teachings about Complete Dentistry. The Dawson Academy has had the most profound influence on me, both personally and professionally, than any other dental institution.
Dr. Dawson’s time tested principles teach us how to solve our patients’ problems with confidence, predictability and success. He helps us to understand that if the teeth are not in harmony with the joints, something is likely to breakdown. We learn how to identify signs of instability before symptoms develop, which leads to better care and stability for our patients.
Complete Dentistry IS Integrity - you cannot have one without the other! Complete Dentistry is about doing the right thing for people who need our help.