The document describes the process for inserting and evaluating dentures. Key steps include: 1. Inspecting the dentures for imperfections before insertion. 2. During insertion, evaluating the fit using pressure indicating paste and querying the patient about pain. 3. Checking the borders, frenal areas, retention, stability, aesthetics and occlusion. 4. Providing instructions to the patient on insertion, removal, care, eating and other activities.

2.  The following aspects of the denture are inspected before the
insertion appointment :
1.Tissue or fitting surface : For imperfections, nodules, sharp
edges and plaster.
2.Borders : Rounded with no sharp angles.
3.Polished surface : Smooth without scratches and no plaster on
gingival crevices.
DENTURE INSPECTION

3.  During the insertion appointment the completed dentures are
evaluated using a sequence of procedures as follows :
 The adaptation of dentures to the tissues is verified individually.
 The dentures are inserted and the patient is queried for pain and
discomfort during insertion.
 Pressure indicating paste (PIP) is painted onto the tissue surface of
the denture with a stiff-bristled brush, and seated by applying
pressure in first molar areas on either side.
DENTURE INSERTION

5.  It is removed after one minute and the surface is inspected for
the following :
• Complete removal of paste: indicates pressure spots and needs
to be trimmed.
• Brush streaks remaining: no contact, other areas may have
more pressure
• Paste remaining with no streaks: proper contact
 After ensuring adaptation of the dentures individually, the
borders are evaluated and corrected for over extensions.
 The same procedure is adopted using PIP.

7.  The frenal areas are checked for relief and the posterior palatal seal area is
also verified.
 The dentures are checked individually for retention and stability.
 The lower denture will not be as retentive as the upper one.
 Retention can improve after the patient has worn the denture for a few days
due to better soft tissue adaptation.
 In aesthetics midline, anterior plane, shape, size and shape of the teeth, lip
form in profile, amount of tooth visibility and individualization is checked.
 Occlusal harmony is important for complete denture to function efficiently,
be comfortable and to preserve the tissues.

8.  CAUSES OF OCCLUSAL DISCREPANCIES :
 Error in jaw relation
 Error in mounting cast in articulator
 Changes in supporting tissues since impressions were made.
 Difference in tissue adaptation between record bases and processed denture
base.
 OCCLUSAL CORRECTION CAN BE DONE :
 Intraorally: Articulating paper can be used to check the occlusion. It should
be placed bilaterally.
Disadvantage: It will color the tooth ; difficult to place bilaterally ;
 Extraorally (clinical remounting): This involves mounting the processed
denture on an articulator and adjusting the occlusion extraorally.
 Advantages: Permits dentist to view occlusion better ; reduces patient
participation ; absence of saliva

10.  Procedure :
• The clinical remounting is performed using interocclusal check records.
• If the original casts are intact, the dentures are just remounted on the
articulator with the new interocclusal check record and the centric relation
is verified by adjusting the condylar controls.
• If the original casts are destroyed, then remount casts are made.

12.  It consists of instructions regarding :
 Denture insertion and removal
 What to expect from dentures
 How to use dentures
 Care for dentures
 The patient is taught to insert and remove the denture.
 It is usually preferable to wear the upper denture first followed by lower
denture as upper is more retentive and larger.
INSTRUCTIONS TO THE PATIENT

13.  The patient should be instructed that dentures are artificial substitute and
can have limitations. The following are initial normal reactions to a new
denture :
• Awkward feeling in the beginning
• Appearance seems changed
• Speech seems altered
• Feeling of mouth being full
• Excessive salivary flow
• Lower denture may be dislodged during speech and mastication

14.  TONGUE POSITION :
• The tongue position needs to be trained to stabilize the denture, particularly
the mandibular denture.
• The patient must practice mouth opening and closing with tongue in forward
position resting against the inside of denture flange and lower front teeth.
• If the maxillary denture feels loosened, patient should be advised to close the
mouth and swallow which will elevate the tongue and reseat the denture.
 EATING :
• Food should be cut into small pieces, placed on back teeth and chewed
slowly using both side simultaneously.
• They should begin with soft, non sticky food rather than fibrous food.
• Biting with front teeth is avoided till chewing with posterior teeth is
mastered.

16.  SPEECH :
• Patients can expect speech problem initially, due to presence of palatal plate,
initial feeling of bulk and excessive saliva.
 SNEEZING AND COUGHING :
• Patient should be instructed that extreme and sudden movements like
sneezing and coughing can dislodge the denture and cause embarrassment.
 TISSUE REST :
• Patient should be advised to remove the denture at night to provide rest to
the tissues. Failure to this can cause soreness, irritation, increased chances of
candidiasis and bruxism.
 CARE OF DENTURE :
• Patient should be advised to rinse their mouth and denture after every meal,
if possible.

18.  At night, the denture should be brushed gently using a soft brush to remove
plaque. They are soaked in any commercial denture cleansning agent. “Hot
water should never be used as it will distort the denture.”
 First recall : 1-3 days
 Second recall : 1 week after 1st visit
 Third recall : 3-4 months after 2nd visit
 Maintenance : every one year

19.  Definition : A material used to adhere a denture to the oral mucosa. (GPT 8)
 MECHANISM OF ACTION :
 They enhance retention by :
 Increasing the adhesive and cohesive properties and viscosity of the saliva
between the denture base and tissues.
 Eliminating voids between denture base and tissues.
 INDICATIONS :
 Patients with conditions with compromised retention like
 xerostomia
 Neurological disorders like facial paralysis
 Oral dyskinesia
 Resective oral surgery

21.  CONTRAINDICATIONS :
• Improperly fabricated or poorly fitted dentures
• Patients allergic to adhesive
 ADVANTAGES :
• Increased incisal bite
• Decreased frequency of denture dislodgement
• Decreased movement of denture during mastication
 DISADVANTAGES :
• Can increase vertical dimension and occlusal discrepancies with improper use
• Cannot be used as a remedy for pain and discomfort.

22. We work for smile