A self-help group for complete denture wearers

Structurofunctional analysis based on postinsertion problems with complete dentures in Moradabad, North India: A cross-sectional study

Background:

Complaints with complete dentures is a common and expected phenomenon. However the type and character of complaint varies between population and is influenced by the socio economic condition, prevalent dental awareness etc. This study attempts to find the most common complaints with complete dentures, their causes and also presents a classification of the same.

Method:

A cross-sectional analytical study was conducted by performing a survey on a sample of population over an 18 month period utilizing a customized questionnaire. The complaints were divided into four categories viz. discomfort, retention, esthetics and miscellaneous. Consequently each denture was evaluated for structural and functional defects. The findings were classified into error in denture base, physiopsychological, error in occlusion and teeth selection. The data was statistically analyzed.

Results:

Error in denture base was the predominant cause of complaints. However physiopsychological and error in occlusion and teeth selection were also important second factors in certain groups of complaints. Highest number of complaints (23.07%) belongs to discomfort in mandibular posterior region. While the least number of complaints are concerned with speech as reported by both males and females (both at 2.02%).

Conclusion:

Discomfort with complete dentures was the largest complaint reported followed by loss of retention with esthetics and miscellaneous complaints. Discomfort in mandibular posterior region was the most frequent complaint reported while speech related complaints were least in number. Most common cause of complaints was error in denture base.

Evaluating denture cleanliness of patients in a regional dental hospital

Aims To evaluate the quality of clinical record keeping and determine quality of denture cleanliness; record baseline denture cleanliness for 60 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping.Methods Analysis of patients' denture hygiene instruction record keeping (n = 60) was undertaken retrospectively. The Denture Cleanliness Index (DCI) was utilised to assess denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered. After one month, patients were reviewed and scored, with record keeping quality analysed.Results At baseline, 11.7% (n = 7) of patients had DCI scores of ≤2, improving to 93.8% (n = 45) after one month, demonstrating short-term improvement in denture cleanliness. Only 63% (n = 38) of patients had evidence of a record of DHI within their notes at baseline, improving to 100% at recall.Conclusions New patient information leaflet and clinical guidelines on denture hygiene have been written and implemented. The results of this study suggest that this may be a relatively straightforward method to achieve a short-term improvement in denture cleanliness. The implementation of a DCI score is helpful in allowing patients to improve denture hygiene and its wider use is supported.

Development of an in vitro denture plaque biofilm to model denture malodour

This study aimed to develop an in vitro denture plaque biofilm to model denture malodour. No previous studies have attempted to characterize the malodour associated with dentures and the effect of Candida spp. (main aetiological agent of denture-related stomatitis) on malodour. Pooled denture plaque microcosms and 'model' denture plaque biofilms (pooled saliva supplemented with additional microbial species) with and without addition of candida were grown aerobically at 37 °C for up to 13 days in a constant depth film fermenter (CDFF) on denture acrylic discs. Sample discs were removed, rinsed in sterile water and placed in phosphate buffered saline (PBS). The discs were vortex mixed to remove the biofilms, diluted in PBS and plated in duplicate onto general and selective media. The composition and stability of the biofilms over time were assessed. CDFF-grown microcosms and 'model' denture plaque biofilms were relatively stable in composition, with streptococci remaining the dominant microbial group. Model denture plaque biofilms were comparable in composition to denture plaque microcosms. This model system has the potential for evaluation of agents that might affect these parameters such as denture cleansers and other oral hygiene treatments.

The effect of a domiciliary denture service on oral health related quality of life: a randomised controlled trial

OBJECTIVES

To assess the effectiveness of a domiciliary denture service on the oral health related quality of life (OHQoL) of older patients requiring complete dentures.

DESIGN

Community based single-blind randomised controlled trial.

SUBJECTS AND METHODS

133 edentate adults aged 65 years and over referred to a community dental service for domiciliary care were assigned to study and control groups using block randomisation. Treatment to provide the study group with complete dentures commenced immediately. Treatment for the control group was deferred to the normal waiting list but in the interim participants received three home visits from the dental team. Follow up data were collected three months after dentures had been fitted in the study group.

OUTCOME MEASURES

Prevalence, extent of impacts and total scores using Oral Impacts on Daily Performance (OIDP).

RESULTS

The study and control groups (n = 65 and 68 respectively) had similar OHQoL at baseline. Two and five participants were lost to the study and control groups respectively. In ANCOVA and intention to treat analysis, the presence of impact, number of impacts and total scores for OIDP at follow up were predicted by group allocation (b = 0.28, b = 0.30, and b = 0.32 respectively. All p <0.001). In all cases the study group showed significantly improved OHQoL compared to the control group.

CONCLUSION

A domiciliary denture service improved oral health related quality of life of housebound edentulous older people.

Perda dentária e seu significado na qualidade de vida de adultos usuários de serviço público de saúde bucal do Centro de Saúde Boa Vista, em Belo Horizonte

Este trabalho objetivou estudar os problemas causados pela perda dentária e a falta de acesso à prótese na vida diária da população adulta, usuária de uma unidade de saúde da Secretaria Municipal de Saúde de Belo Horizonte (SMSBH). Trata-se de uma pesquisa qualitativa, realizada por meio de entrevistas abertas, semi-estruturadas, com 20 pacientes atendidos no Centro de Saúde Boa Vista, pertencente à Regional Leste. Os resultados mostraram que os problemas vivenciados pelos pacientes foram tanto funcionais quanto psicossociais, e os sentimentos relatados com a perda dentária, bastante negativos. Os pacientes apontaram as deficiências do serviço prestado ao adulto, revelando a sua pouca resolutividade, uma vez que só a atenção básica é ofertada, o que tem acarretado a extração de dentes em condições de serem recuperados. Tal situação é agravada pela não oferta da prótese dentária para reabilitação estética e funcional. Concluiu-se que o Programa de Saúde Bucal da Secretaria Municipal de Saúde de Belo Horizonte, realizado no Centro de Saúde Boa Vista, mostrou-se insuficiente e ineficaz para resolver a maioria das necessidades odontológicas que os usuários adultos apresentam.

Patients’ experiences with partial dentures: a qualitative study

OBJECTIVE

The aim of the study was to gain insight into people's experiences of being given and using partial dentures.

METHODS

In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis.

RESULTS

The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free.

CONCLUSIONS

Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers.

Preliminary study of the impact of loss of part of the face and its prosthetic restoration

STATEMENT OF PROBLEM

Loss of a part of the face or having a congenitally missing ear, nose, or eye is likely to have both a social and a psychologic impact on those affected. The nature and extent of this impact has not been explored previously. The provision of facial prostheses is an increasingly viable and beneficial treatment option, but the psychologic and social adjustment to the prosthesis has not been described.

PURPOSE

This study performed a preliminary investigation of patients' responses to loss of part of the face, and their perceptions of the prosthetic restoration of their missing facial part.

METHODS

Nine individuals who had experienced prosthetic replacement of an ear, nose, or eye were interviewed. Interviews were semistructured, each respondent was interviewed individually and the interviewer followed a predetermined interview schedule. Themes emerging in the interviews were identified.

RESULTS

The main themes relating to the loss of the facial part were the importance of the story of the loss, coping through bargaining, and the impact of the loss on relationships. The important themes identified in regard to the prosthesis were issues in the maintenance of the prosthesis and the reactions of other people to the prosthesis.

CONCLUSION

Loss of part of the face requires great adjustment. The reactions of other people were marked. Provision of a facial prosthesis can assist in the process of adjustment.

Construction faults, age, gender, and relative medical health: factors associated with complaints in complete denture patients

STATEMENT OF PROBLEM

Many practitioners will experience a situation, whereby a patient with newly fabricated complete dentures continues to experience difficulty in adapting to them. This can lead to a protracted period of discouraging "adjustment appointments" that may not result in the eventual resolution of the problem. Therefore it is often concluded that there is some patient factor, either age, gender, medical, or psychologic status that is hindering the success of treatment.

PURPOSE

This study examined a group of 100 patients who experienced ongoing difficulties with their new complete dentures, to determine possible underlying causes.

MATERIAL AND METHODS

A retrospective study was conducted with information derived from patient records. All patients were treated by the same prosthodontist after having been referred specifically for their denture problems. Information regarding patient age, gender, medical and psychological histories, and information pertaining to the dentures at the time of presentation was derived from patient records.

RESULTS

Statistical analysis comparing age, gender, and medical and psychologic status with the number or type of patient complaint failed to show any significant relationships. Significant relationships were observed when denture design faults or the condition of a patient's mucosa were compared with patient complaints.

CONCLUSIONS

This study suggests that in most instances, complete denture patients present with complaints only when there is a real design fault or a tissue problem.