One of the procedures I have come to love in my practice is making traditional dentures. There is no question that many dentists hate this procedure. The reason for this, I believe, is twofold.
One, patient’s expectations often do not equal the reality of a denture.
And second, the process of making a denture is, technically, a difficult procedure to do correctly.
First, I clearly explain to patients that dentures are not a replacement for teeth, but a replacement for NO TEETH. Without implants (see implant section), the best denture in the world…. STILL MOVES. And, as long as patients understand this, I have found denture outcomes to be very positive.
Like most dentists, the technical side of making dentures used to frustrate me. Then, I decided to attend a continuing education course highlighting a specific method in making dentures called “The Massad Technique”. This technique changed my attitude in making dentures 180 degrees.
Dolores, my patient above, loved her new set of “Massad Technique” complete dentures! (The technical stuff…)
The Massad technique involves taking multiple “incremental”impressions (using the same tray), using different viscosities (thickness) of impression material. Each viscosity is specific to the particular area (softness or hardness) of the mouth impressed. In a nut shell, this is a much more detailed way to take an impression. And, the final result is a much more intimately fitting denture.
In addition, as each area is impressed, I have the patient go through a series of movements (ie. smile, fish face, open, close, jaw wag, extreme tongue movements, etc.) This way, the shape of the impression replicates the extreme movements a person might go though in a day. This greatly reduces the number of sore spots and post delivery adjustments.
The other key in making dentures, I believe, is TIME. I require four (sometimes 5) separate appointments to make a denture. It takes me about a month and a half (sometimes 2 months on a tough case) to fabricate a denture from start to finish.
The reason for this is that I like to try the denture in at various stages in the denture fabrication process, each evaluating specific aspects of the denture such as fit, speech, occlusion (bite), and aesthetics. This is done using WAX so the patient can see and feel how the denture is going to look and function BEFORE the final denture is fabricated. ALL of my patients know exactly what they are getting before they get it. And if there is something that doesn’t look right, feel right, or function right (to me OR to the patient), then I go back a step and make sure that issue is corrected.
Please know that it takes this amount of time to fabricate a denture CORRECTLY. I could probably make a denture in one, possibly two days (And, I know some dentists advertise this and brag about this!) But, you’ll get a denture that feels AND LOOKS like it was made in a day.
To someone who already has a denture that doesn’t fit well or looks bad, this one and a half month time amount may not be that bad. This denture is something you will have for many years into your lifetime. It is something that determines what you look like, how you talk, how you eat, how you feel, and who you are.
Overall, I have found denture fabrication to be somewhat fun (believe it or not!). It is fun for myself as well as the patient.
With the methods I have adopted, it is an interactive process that involves input and discussion over specific desires and expectations of the patient.
I still firmly believe that nothing beats an implant retained denture. But, many people can’t do this due to financial constraints, medical issues, lack of bone, or simple fear of “implants”. The traditional denture, when done correctly, is the next best thing.
A well made denture can improve someone’s appearance, self esteem, eating habits, health, and overall outlook on life!