ClassifIcation of complete denture patients/ hands on courses in dentistry

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ClassifIcation of complete denture patients/ hands on courses in dentistry

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Do we need to categorize our complete edentulous patients Guidance: Dr. M. Vasanthakumar (Prof. & HOD) Dr. B. Muthukumar (Prof.) Presenter: Dr. G. Uday Raghav Reddy Post Graduate www.indiandentalacademy.com
  3. 3. www.indiandentalacademy.com
  4. 4. EDENTULISM; the state of being edentulous ,without natural teeth. www.indiandentalacademy.com
  5. 5. Our patients can be First timers with no knowkedege of our treatment procedures or patients who have undergone much treatment. www.indiandentalacademy.com
  6. 6. They can be rich…or poor www.indiandentalacademy.com
  7. 7. Highly educated or uneducated www.indiandentalacademy.com
  8. 8. Highly co-operative /non-co-operative… www.indiandentalacademy.com
  9. 9. Patients who may sue us if there is any professional negligence www.indiandentalacademy.com
  10. 10. So don’t you think we should treat each one in a different manner www.indiandentalacademy.com
  11. 11. An earlier concept states patients can be classified as per their attitudes. www.indiandentalacademy.com
  12. 12. Philosophical   They anticipate the need for  treatment with complete dentures and   are willing to rely on dentists advice for  diagnosis and treatment. a.   .  www.indiandentalacademy.com
  13. 13. Exacting Poor oral health a seriously concerned about appearance and efficiency of artificial dentures, Reluctant to accept the advice of the physician and are unwilling to submit to the removal of their natural teeth. They doubts the ability of the operator and insists on a written guarantee or expects the dentist to make repeated attempts to please them. www.indiandentalacademy.com
  14. 14. Hysterical   Bad oral health with neglected mouth conditions and had come to the dentist as a last resort. Have attempted to wear artificial dentures but failed. They are of a hysterical,nervous &exacting type and will demand efficiency . www.indiandentalacademy.com
  15. 15. Indifferent          They are unconcerned about their appearance feel  very  little  or  no  necessity  for  teeth  for  mastication.  They  have very little appreciation for the dentist.                     This classification helps the dentist to understand patient’s attitudes & helps in assessing the ways in which they may react to the dentist. www.indiandentalacademy.com
  16. 16. A new classification is proposed. Based on 2 factors: 1. The level and quality of the engagement or involvement of the patient toward the dentist 2. The level of willingness to submit (trust) to the dentist www.indiandentalacademy.com
  17. 17. Ideal Reasonably ENGAGED(+++) and reasonably WILLING to submit (trust) (+++) to the dentist. They seek explanations to understand the situation and arrive at a final decision regarding treatment. Neither overly suspicious nor blindly accepting of the dentist’s recommendations. www.indiandentalacademy.com
  18. 18. Submitter ++++ Engagement ++++ willingness to submit (trust). They lack discrimination and tend to idealize the dentist, which results in a high degree of engagement and utter surrender. Therefore he/she cannot be an active partner in the treatment www.indiandentalacademy.com
  19. 19. Reluctant This patient rates ++ on engagement and ++ on willingness to submit (trust). They are often leery of the dentist and skeptical of the treatment plan. www.indiandentalacademy.com
  20. 20. Indifferent This patient rates + on engagement and + on willingness to submit(trust). Usually forced into seeing the dentist by a concerned family member or friend. This patient is minimally engaged and indifferent to the dentist to the extent ,that willingness to submit (trust) is not an issue. www.indiandentalacademy.com
  21. 21. Resistant This patient is paradoxically, very engaged with the dentist but in an adverse way. Rather than being dependent , they challenge the dentist and there is no trust. This patient rates ++++ on engagement and + on willingness to submit (trust). www.indiandentalacademy.com
  22. 22. Patients with medical problems; Uncontrolled diabetes www.indiandentalacademy.com
  23. 23. Diabetes Should be controlled by medical treatment. Impression technique must be physiologically compatible. Masticatory load to the supporting tissues should be controlled. Careful occlusal correction to remove interferences. Food table should be small. www.indiandentalacademy.com
  24. 24. Arthritis Limited movement of the mandible – necessitates modification of trays and technique during impression making. DDifficult to get proper jaw relation registrations. OOcclusal corrections must be made often because of arthritic changes in the TMJ. www.indiandentalacademy.com
  25. 25. Bells palsy Retention difficult to achieve – denture adhesives necessary Paralyzed musculature – affects both function & aesthetics – explain to the patient. Patient education on mastication and oral hygiene www.indiandentalacademy.com
  26. 26. Parkinsonism Control of patient movement during denture fabrication accomplished with sedatives. Retention is difficult – adhesive is necessary. To eliminate denture swallowing – remove dentures when not in use. www.indiandentalacademy.com
  27. 27. Radiation necrosis Dentures to be used only after 2 years from the radiotherapy treatment. Abrasion and irritation avoided, because an open lesion may provoke Osteoradionecrosis. www.indiandentalacademy.com
  28. 28. Pagets disease   Is a chronic osseous disturbance Continued  enlargement  and  change  in  form  of  the  supporting  structures  especially  the  maxillary  tuberosities,  necessitates  frequent  re-fabrication  and  adjustments of the denture.    www.indiandentalacademy.com
  29. 29. Hypothyroidism Decreases  salivary  flow  and  increases  mucosal  inflammation. Treated systemically. Salivary substitutes  www.indiandentalacademy.com
  30. 30. Hyperthyroidism Increase the rate of resorption Treated systemically Denture base should take advantage of the maximum  basal seat coverage. www.indiandentalacademy.com
  31. 31. Acromegaly Condition necessitates a periodic  check up of the prosthesis to determine  whether  the  denture  requires  changes  due  to  continued  growth  of  the  mandible and the maxilla.   www.indiandentalacademy.com
  32. 32. CONCLUSION As we have seen that our patients can be from different economic classes, different education levels, different psychological attitudes, and present different clinical picture we have to carefully asses them and categorize them according to the above mentioned conditions before treating them there by rendering better service. www.indiandentalacademy.com
  33. 33. OUR MOTTO SHOULD BE SERVICE TO HUMANITY. AS SERVICE TO MAN IS EQUAL TO SERVICE TO GOD www.indiandentalacademy.com
  34. 34. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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