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Clinical Lecturer (Restorative), School of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol BS1 2LY, UK (James.Puryer@bristol.ac.uk)
Patients with complete dentures will often present to a clinician complaining that their dentures are loose. A careful history, clinical examination and denture examination is needed so that the cause of their loose dentures can be determined. Only once a suitable diagnosis has been reached can an appropriate treatment plan be developed. This paper aims to guide readers through this history and examination process to help them formulate a suitable diagnosis before embarking on any potential treatment options.
CPD/Clinical Relevance: The paper provides a guide as to how to assess an edentulous patient presenting with loose complete dentures.
Article
The proportion of the UK population that is edentulous has fallen over recent years from 30% in 1978 to 6% in 2009.1 Despite this encouraging trend, the UK still has many edentulous patients who are generally older, more medically compromised and more of a challenge to treat than previously. To treat these patients successfully, clinicians are therefore in need of greater levels of experience, clinical skills and management of patient expectations.
Patients naturally expect their dentures to fulfil certain basic criteria in that they want them to be:
Failure to achieve any of these criteria can lead to patient dissatisfaction, and one of the most common ‘post-insertion’ complaints is one of loose dentures.2,3,4 Before embarking upon remedial treatment, a thorough structured patient history needs to be taken, along with careful examination of the patient's oral cavity and existing dentures. Without this, a differential diagnosis as to the cause of the loose dentures is unlikely to be established nor a suitable treatment plan formulated.5 The aim of this paper is to guide readers through this history and examination process so that an appropriate diagnosis and treatment plan can be made.
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