We have talked to many patients who have suffered ongoing denture problems which a new set of dentures (or even multiple sets) have failed to solve. One of the most common questions we are asked is “what should I be asking the dentist making my dentures to ensure I get the best result possible”? To help patients with this particular dilemma, we have put together a checklist of questions that will help patients gauge if a dentist takes a particular interest in this area of dentistry. While the vast majority of dentists do their absolute best to provide a high level of treatment to all their patients, it is sometimes the case that a general dentist’s expertise may not lie in the area of denture construction.
We have provided both a good answer (the answer you should expect from a good dentist) as well as the answer you can expect from our team of denture construction specialists here at The Denture and Implant Clinic (TDIC).
Do you make a lot of dentures each year?
GOOD ANSWER: Yes. There are few dentists that specialise in making dentures and sometimes avoid taking on denture cases altogether. However, there are still some dentists, like our practice, that make large numbers of dentures each year (50 plus). Naturally, the more dentures a dentist makes the better the dentist is likely to be at that treatment.
TDIC ANSWER: Yes, we pretty much exclusively treat denture and implant patients. All our patients require denture or implant treatment; this is very unusual for dentists. We specifically set up our clinic to run this way as there is a huge need for high quality dentures and replacing missing teeth.
Will I get to meet the denture technician directly?
GOOD ANSWER: No. However, the dentist will have a long discussion with the denture technician about each case and may take photographs of the patient at the bite and try-in stage, so the technician can get the optimum cosmetic
TDIC ANSWER: Yes. You will meet the denture technicians direct; in fact, they will move the teeth in wax in front of you to ensure you get the best possible result. We will only finish the denture when you, the dentist, and the denture technician is happy with the result. We feel it is vital that the technician sees you before they make your dentures. Every patient is different, and these differences affect the type of dentures we make you. Some of the important things our technician will look at is:
- Skin tone
- Lips – volume, shape, symmetry
- Cheek volume
- Bone ridges
- Width of arches
- Distance from upper and lower arches at rest
These are just some of the things we consider and as you can see, it is impossible for the dentist to communicate this back to the technician if they are not on site.
How close is the dental laboratory to the clinic?
GOOD ANSWER: Close by. Ideally this allows the patient to pop into the laboratory so the technician can be more involved with the treatment. Also, if anything of an urgent nature was to arise in the future, it allows for the patient to be able to see both the dentist and technician on the same day e.g. for a repair of any kind.
TDIC ANSWER: Our laboratory is on the same site as the dental practice. This has many advantages; it allows the denture technicians to be involved in every stage of the process, and if there is an emergency, we can resolve the issue much faster than a general practice. If needed, a denture can be repaired within an hour. A normal dentist will usually post it to the laboratory, or delivery it at the end of the day, and then expect it back a few days later. As you can imagine, a lot of people are not very keen on giving someone their teeth for a few days!
Impressions tend to distort, what do you do to prevent this?
GOOD ANSWER: There are some very good impression materials, that if sent to the laboratories straight away distort less. Ideally the laboratory will be close-by so the impression will not have to lie around for too long.
TDIC ANSWER: We cast the denture impression straight away as we have the laboratory on site. We believe this provides the most accurate results. We also border mould the impressions which makes for better impressions and therefore a better fitting denture.
The bite on a denture can be difficult to record, how do you do this?
GOOD ANSWER: Most dentists will manipulate the lower jaw back into a relaxed position. For someone taking a special interest in dentures we would expect them to say this may need to be repeated at the next appointment also i.e., the try-in visit.
TDIC ANSWER: We use an Intra-Oral Gothic Arch Tracing. This is arguably the most reliable way of getting the bite correct and has a big impact on enjoyable eating. Less than 1 in 100 dentists use this method as it requires a lot more time.
How do you ensure that the appearance of the denture is life-like?
GOOD ANSWER: The dentist may say that it can take two or three wax try-ins to get this right. This is normally a good sign as it shows they are willing to work with you to get the best appearance.
TDIC ANSWER: Rather than sending the work backwards and forwards to the technician, the denture technician will move the teeth with the patient in the chair. This can take some time, but it ensures the patient is 100% happy with the appearance. This is one of the main advantages of seeing our team at The Denture & Implant Clinic. Before we finish a patients’ dentures, we try them in to check the cosmetics/bite etc. If there is something that doesn’t look right, we make the required changes and then check again. We repeat this process until we are all happy. This means you know exactly what you are getting before the denture is finished.
If the finished dentures need adjustment, how is this done?
GOOD ANSWER: If the dentist does not use pressure indicating paste, we would expect him to explain that adjustments should be carefully done with a minimal amount of adjustment i.e., it is better for you to come back two or three times than have too much taken of the denture in one go.
TDIC ANSWER: We use a special paste, imported from the USA, to highlight any high spots. Minimal adjustment is very important to ensure the strength and maintain the fit of the denture. We have tried every single method and product involved in denture adjustment and the one we use is the absolute best. It allows us to fine-tune adjustments with great precision.
Can you provide denture implant treatment if I require it?
GOOD ANSWER: Yes, we can provide basic implant treatment for simple cases. We would refer a patient for more complex cases.
TDIC ANSWER: It is important to offer all treatment options to patients in a non-pressured manner. We are able to provide all denture and all implant treatment, from the very simple cases to the most complex cases. We also provide mini dental implants which is a cost-effective way of anchoring the denture into place. We do full mouth implants and have many dentists referring to us for complex work.
Can you provide 3D dentures?
GOOD ANSWER: Even a good dentist is unlikely to provide this as The Denture and Implant Clinic was the first to bring this technology over from the US!
TDIC ANSWER: We are proud that we were the first clinic to bring this technology to the UK. 3D denture impressions are not just impressions of the gums but are impressions of the way the tongue lies on the denture on the inside and the way the cheeks lie on the denture on the outside. Taking these detailed impressions allows the denture to feel naturally integrated into your mouth, more so than a traditional denture. It also improves the fit.
When we take a look back at the history of dentures and how things have changed, we think it’s safe to say that dentures have come an extremely long way. We hope you find these questions helpful when discussing your treatment with your dentist. If the dentist is willing to spend time answering these questions and is knowledgeable about the answers, it is more likely that he/she will spend more time with you to obtain the best results possible. If you are in any doubt, we offer a free consultation with no obligation, you are more than welcome to come along and get another opinion.