2. INTRODUCTION
COMPLETE EDENTULISM
DENTURES
ASSOCIATED PROBLEMS WITH NEW DENTURE WEAR
GERONDONTOLOGY
ASSOCIATED PROBLEMS WITH AGING IN COMPLETE EDENTULISM
ASSOCIATED PROBLEMS WITH AGING IN COMPLETE DENTURE WEAR
PROBLEM MANAGEMENT
CONCLUSION.
TABLE OF CONTENT
3. Edentulism (partial or total) is an indicator of the oral health of a
population (Brodeur, et al 1996). It may also be a reflection of
the success or preventive and treatment modalities put in place by
the health care delivery system (Otuyemi, Ndukwe 1997) since it
has being described as the “final marker of disease burden for
oral heath (journal of dental research, 2007)
Complete edentulism can be defined as the physical state of the
jaw(s) following removal of all erupted teeth and the condition of
the supporting structures available for reconstructive or
replacement therapies (Garry, Skiba, et al, 1999).
INTRODUCTION
5. Edentulism has being described as irreversible (journal of dental
research, 2007) and a major form of management is DENTURE
WEAR.
Dentures, also known as false teeth, are prosthetic devices
constructed to replace missing teeth; they are supported by the
surrounding soft and hard tissues of the oral cavity.
Conventional dentures are removable. However, there are many
different denture designs, some of which rely on bonding or
clasping onto teeth or dental implants
DENTURES
9. Complete denture can either be conventional or immediate.
It is estimated that the need for complete dentures will have
increased from approximately 54 million in 1991 to approximately 61
million in 2020 (US estimate, Douglass, et al, 2002).
Although the rate of edentulism will have decreased, the aging
population will bring with it an increase in number of teeth loss (US
estimate, Feine, Carlsson 2003).
In a study carried out in Nigeria (ile-ife and Lagos), the demand for
complete denture increased with age (Esan et al, 2004)
COMPLETE DENTURE:
PREVALENCE
10. The advent of denture has helped with lots of complications
associated with the edentulous state, the image below explains a lot:
COMPLETE DENTURE:
COMPLICATIONS MANAGED
11. Among the complications associated with edentulism complete
denture has helped with include:
Mastication
Aesthetics
Pronunciation
Self-esteem
However, denture wear has not come without its own related
problems.
COMPLETE DENTURE:
COMPLICATIONS MANAGED
12. Apart from problem associated normally with a well fixed complete
denture, McCord and Grant, 2000 in the British Dental Journal
grouped factors causing complete denture problem into:
Adverse intraoral anatomical factors e.g. atrophic mucosa
Clinical factors e.g. poor denture stability
Technical factors e.g. failure to preserve the peripheral roll on a
master cast.
Patient adaptational factors
COMPLETE DENTURE:
ASSOCIATED PROBLEM CAUSES
13. Excessive Salivation: In the first 12 to 24 hours of wearing denture,
the patient face the problem of excessive salivation as the brain
misinterprets it to be food.
Sore spots as they compress the denture bearing soft tissue (mucosa)
may also arise
Eating and speaking difficulty
With adaptation and few denture adjustments in the days following
insertion of the dentures can take care of this problems
NEW COMPLETE DENTURE:
PROBLEMS ASSOCIATED
14. Gerondontology: is the branch of dentistry that deals with the oral
health problems of the old people. one of the problems of aging is
that some of the bodily functions do not maintain their efficiency.
There are lots of oral health problems associated with aging,
edentulous or not ranging from root caries, Gingivitis,
Periodontitis, xerostomia, candidiasis to list a few.
Complete edentulism only aggravate some and in some cases,
introduce new ones.
While the use of denture help manage some of the problems
introduced by the edentulism, with aging it also aggravate some
oral health problem, modify some and might introduce new ones
The focus of this slide is however the last two cases.
GERONDONTOLOGY
15. EXTRA-ORAL CHANGES
Skin
skin becomes thin, wrinkled
and dried
Lip
age reduces the concavity and
pout of the upper lip
PROBLEMS ASSOCIATED WITH AGING IN
COMPLETE EDENTULOUS PEOPLE
16. Naso-labial groove
Naso-labial groove deepens, which produce a sagging look to
the middle third of the face.
Fat pads
atrophy at subcutaneous end buccal pads of fat hollows the
cheeks
due to loss of fat, support for the pre symphysial pad of fat
disappears and upper lip droops over maxillary teeth
EXTRA ORAL CHANGES
17. Oral mucosa becomes thin, easily abraded, and frequently reacts
unfavorably to the pressure of dentures.
Mandibular ridge resorption: a Clinical Evaluation of Mandibular
Ridge Height In Relation To Aging and Length of Edentulism
performed by Dr.Mandya et al published in journal of Dental and
Medical Sciences, 2013 concluded from the study result that:
The reduction in mandibular height has a linear relationship to age.
The Early mean % reduction in mandibular height was followed by
slower mean resorption as the period of edentulism increased in
both age groups.
INTRA ORAL CHANGES
18. In older age groups, the progression of mandibular resorption in
relationship to edentulism period was faster than in the younger age
groups.
A constant % reduction of mandibular height occurs as length of
edentulism period increases.
A non-significant comparison between the two age groups i.e.
mandibular ridge height reduction was constant between the aging and
length of edentulism .
It is based on this (showing severity difference) that complete edentulism was
divided into four classes
INTRA ORAL CHANGES
23. EXTRA ORAL CHANGES
Wrinkles above/ around lips or at corners of mouth: Denture has
moved back and no longer supports the lips. This may be due to
bone loss/ loss of skin elasticity
PROBLEMS ASSOCIATED WITH
COMPLETE DENTURE WEAR
WITH AGING
24. Angular cheilitis: loss of vertical support for the denture (bone
loss) can cause mouth to over close. This can change the way the
leaps seal together and cause saliva to pool at the corners of the
mouth. The excess moisture in this area may cause the skin to
become irritated and man increase fungi infection.
EXTRA-ORAL CHANGES
25. becomes thin, easily abraded, and
frequently reacts unfavorably to the
pressure of dentures sometimes
leading to sore spot in the mouth
stomatitis and other mild
inflammations are the mucosal
lesions encountered most frequently
in older edentulous mouths,
especially of older men who wear
dentures, smoke tobaccos and drink
alcohol excessively
ORAL MUCOSA
26. oral cancer or precancerous lesions are
unusual in western countries, although they
are the most common forms of cancer on the
Indian subcontinent and in other parts of
Asia
external carcinogens such as nicotine and
alcohol could be more damaging to the oral
mucosa in old age because of atrophy,
increase mitosis with slow turnover of cells,
and increased number of elastic fibers.
therefore it is likely that there is risk of oral
cancer is increased among edentulous denture
wears.
ORAL MUCOSA
27. Poor-fitted dentures: the fitness of the denture to the oral mucosa decrease
with the wearer’s lifetime. This is due to bone resorption, edentulous jaw
ridges tend to resorb with aging, especially the alveolar ridge of the lower
jaw. Mucosa also reacts to being chronically rubbed by dentures.
Poor fitted dentures is further associated with problems as:
Increase in bone resorption rate
Gagging
Pain
Denture slipping and moving
Epulis fissuratum among others
BONE RESORPTION AND
DENTURE FITTING
29. Journal of clinical and diagnostic research in 2014 published a study on
problems faced by complete denture wearing elderly people living in
Jammu District (singh et al). The problems were classified into 4 classes:
Physical problem
Social problem
Psychological problem
Clinical observation
The following tables summarises their findings among the male
respondents, this is just to point out that most of the problems does
not occur in all the people together
PROBLEM PREVALENCE
30.
31.
32.
33.
34. BY THE DENTIST
Fixing Denture Discomfort
No matter what the cause, Ill-fitting dentures can be fixed by a
dentist. Three techniques are typically used, which are:
Relining. A liquid acrylic molds the denture closely to shape of the
gums.
Recasting: The dentures can be re-made to get a better fit.
Mini-implants. This procedure is becoming more routine, and it is
extremely effective. Mini implants are inserted
into the bone, to stabilize dentures. This minimally invasive
procedure can typically be accomplished in one visit.
MANAGEMENT OF PROBLEMS ASSOCIATED
WITH COMPLETE DENTURES
35. Taking Care of Dentures
False teeth require just as much as care as natural teeth. The
following tips are recommended for denture wearers:
Clean and brush dentures every day. Plaque and tarter can still
build up just like on natural teeth.
Use a toothpaste and toothbrush specially designed for dentures.
Regular toothpaste and brushes are abrasive enough to scratch the
surface of dentures.
Soak dentures at night. Dentures may lose their shape if they are
allowed to dry out. Remove the dentures, clean them and soak
them in denture cleanser overnight.
MANAGEMENT BY PATIENT
36. Visit your dentist for regular hygiene checkups. Even people who
have no natural teeth and wear full dentures should have their
mouth examined annually for signs of gum disease and oral
cancer, and also for proper denture fit.
Store dentures in a safe place. Dentures are delicate and may
break if dropped even a few inches. When not wearing dentures,
store them away from children and pets.
CONCLUSION
