This document discusses clinical problems related to complete dentures and their solutions. It covers topics like pain and instability, lack of saliva, and modifying denture surfaces. Common issues include soreness, loose dentures, and an dry mouth. Solutions may involve adjusting the denture design, addressing parafunctional habits, improving saliva flow, using adhesives, and focusing on denture and oral hygiene. Close collaboration between dentists and physicians is often needed to properly manage patient issues and care for the edentulous.
This document discusses clinical problems related to complete dentures and their solutions. It covers topics like pain and instability, lack of saliva, and modifying denture surfaces. Common issues include soreness, loose dentures, and an dry mouth. Solutions may involve adjusting the denture design, addressing parafunctional habits, improving saliva flow, using adhesives, and focusing on denture and oral hygiene. Close collaboration between dentists and physicians is often needed to properly manage patient issues and care for the edentulous.
This document discusses clinical problems related to complete dentures and their solutions. It covers topics like pain and instability, lack of saliva, and modifying denture surfaces. Common issues include soreness, loose dentures, and an dry mouth. Solutions may involve adjusting the denture design, addressing parafunctional habits, improving saliva flow, using adhesives, and focusing on denture and oral hygiene. Close collaboration between dentists and physicians is often needed to properly manage patient issues and care for the edentulous.
This document discusses clinical problems related to complete dentures and their solutions. It covers topics like pain and instability, lack of saliva, and modifying denture surfaces. Common issues include soreness, loose dentures, and an dry mouth. Solutions may involve adjusting the denture design, addressing parafunctional habits, improving saliva flow, using adhesives, and focusing on denture and oral hygiene. Close collaboration between dentists and physicians is often needed to properly manage patient issues and care for the edentulous.
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Cara perawatan gigi tiruan lepasan
2. Masalah-masalah dan penyakit yg ditimbulkan gigi tiruan yg tidak dirawat dan perawatannya Some Clinical Problems and Solutions The topics that will be covered in this chapter are: Pain and instability Lack of saliva Hard and soft materials for modifying the impression surface of dentures Implant-retained prostheses The fl abby ridge Midline fracture Debonding of teeth Retching The burning mouth syndrome Disturbance of speech. Pain and instability The most common problems associated with complete dentures are pain and instability of the dentures (Lechner et al. 1995). Many of the causes have been described in earlier chapters but to give a simplifi ed picture they are summarised in Table 16.1. The most likely main complaints have been indicated in each case. However, it should be remembered that there is considerable overlap between the two columns, as any cause of instability may additionally give rise to a complaint of pain. It should also be stressed that there may be more than one cause of a complaint. Persistent pain This problem is more often seen in the lower jaw where the area available for distribution of the occlusal load is relatively small. As noted in Table 16.1 there are many possible causes of this complaint, which may be attributed to the denture design and to the patient. Discomfort can arise from overloading of the mucosa as a result of clenching or grinding the teeth. These occlusal habits are caused by increased activity of the masticatory muscles produced during stressful situations. Clues to such a diagnosis come from the absence of errors in denture design together with evidence of shiny wear facets on the occlusal surface of the teeth. It is helpful to ask the patient, When you are not eating are your upper and lower teeth normally in contact or out of contact? It is not unusual for such patients to reply that their teeth are usually together and for them to assume that this is quite normal. In treating parafunction, the patient must be made aware of the problem and should be told that teeth should be out of contact for most of the time. It is important to reassure the patient, describe the link between stress, parafunction and pain under dentures and point out that there is no sinister change in the oral mucosa. The importance of conscious relaxation should be emphasised and the patient should be strongly encouraged to leave both dentures, or at least the lower denture, out at night. Lack of saliva Functions of saliva Saliva possesses the following functions in the edentulous patient: It is responsible for the physical retention of complete dentures It prepares food for swallowing and facilitates the sense of taste It lubricates and protects the oral mucosa It helps to preserve a normal balance of the oral fl ora It promotes clear speech. Problems of reduced salivary fl ow A reduction, or absence of saliva (xerostomia), is likely to cause problems with all the functions listed above so that a general, and signifi cant, reduction in the quality of life results. Reduced retention of dentures is a particular problem for edentulous patients. There may also be an increased susceptibility to denture trauma resulting in complaints of pain and in some case the burning mouth syndrome, discussed later in this chapter. Aetiology of reduced salivary fl ow Old age per se does not result in reduced salivary fl ow rates (Scott & Baum 1990). However, the condition is relatively common in middle-aged and older people, the main candidates for complete dentures, with between 12% and 16% complaining of a dry mouth (Locker 1995; Field et al. 2001). The commonest causes of dry mouth (Niedermeier et al. 2000; Field et al. 2001) are: Drugs, e.g. tricyclic antidepressants, beta-blockers Depression and chronic anxiety Dehydration Mouth breathing Sjgrens syndrome Head and neck radiotherapy Poorly controlled diabetes Smoking. A complaint of dry mouth can occur in the absence of the clinical signs of dryness (symptomatic xerostomia) Under such circumstances the physical retention of the dentures would not be expected to be diminished. In clinical xerostomia there are intra-oral signs of dryness such as a dry, atrophic mucosa and lack of saliva pooling in the fl oor of the mouth. The dentist can check the dryness of the buccal mucosa simply and quickly during the examination of the patient by carrying out the mirror test. For this the dentist lightly presses the face of the mirror against the buccal mucosa and then tries to remove it. If the mirror comes away easily the mucosa is still covered by a substantial fi lm of saliva; if the mucosa adheres to the mirror then it is dry. Management of dry mouth Close collaboration with the patients general medical practitioner or with a specialist in oral medicine is often necessary. It might be possible, for example, to change an existing xerostomic drug to one less liable to reduce salivary fl ow. As there is a defi nite relationship between fl uid intake and secretory performance it is essential that the patient is kept well hydrated. Chewing and energetic exercise improve salivary fl ow, possibly because of improved blood circulation to the glands (Niedermeier et al. 2000). Where some functional salivary tissue remains the problem may be alleviated by sialogogues such as sugar-free chewing gum or ascorbic acid. In cases where fl ow rate cannot be improved limited relief may sometimes be obtained by the use of artifi cial saliva. It is very important for a denture patient with a dry mouth to maintain an excellent level of denture hygiene. The likelihood of proliferation of Candida albicans is increased in xerostomia and therefore unless denture hygiene is maintained at a high level the denture is likely to be rapidly colonised by the micro-organism, resulting in denture stomatitis. Motivation and instruction of the patient, followed by monitoring the quality of denture hygiene are essential. In cases where an intractable dry mouth gives rise to a persistent problem of loose dentures a denture adhesive will usually provide some improvement in denture function. Prosthetic Treatment of the Edentulous Patient, Fourth Edition R.M. Basker J.C. Davenport Blackwell
3. Edukasi pasien 4. Hubungan kebersihan gigi tiruan dg jaringan di rongga mulut