Dentaltown April 2024 - 49

upcoming dentures. Consider a scenario where
an edentulous patient anticipates eating a hamburger
wearing tissue-supported prostheses as
effortlessly as they did in their teenage years with
healthy natural teeth. Such elevated expectations
may lead to dissatisfaction with new dentures.
The dentist and patient must recognize that
dentures are prostheses with differences from
natural teeth and gums, and the patient must
adapt to changes in speech, function and feel.
Active listening
The preexamination interview with the patient
should occur before the visual clinical examination.
A good opening for the dentist with a new
patient is asking, " How can I help you? " and then
listening attentively. Ask the patient to assess
and describe the conditions with their existing
dentures (e.g., aesthetics, comfort, retention,
function) and discuss their likes and dislikes
with present and past dentures. Also, inquire
about the patient's wants and expectations with
new dentures. Listen with the intent to understand
the patient.
The preexamination consultation is a time
to understand the patient, rather than educate
them about dentures. Education should occur
after the clinical examination to inform the
patient about restoring their conditions and
needs in relation to their wants and expectations.
At the preexamination consultation, the
dentist should take the time to actively listen to
the patient's concerns and expectations. Many
patients seeking new complete dentures may
have had negative experiences or fears associated
with dental procedures. By empathetically
listening, the dentist can gather valuable information
and establish trust, a crucial factor in the
success of any dental treatment.
THE COMPREHENSIVE
CLINICAL ORAL EXAMINATION
The clinical examination begins only after
completion of the preexamination consultation,
where the patient has discussed their wants
and expectations and the dentist has listened
Fig. 1a
Fig. 1b
and spoken briefly in general terms. After
understanding the patient's wants and expectations
and the conditions and restorative needs
learned at the oral examination, the dentist
will discuss their findings, impressions, options
and recommendations at the postexamination
consultation.
A thorough oral examination of the edentulous
patient is a cornerstone of successful complete
denture treatment. Beyond assessing the
patient's oral health, it provides insights into the
anatomical and physiological factors that may
affect the success of dentures.
For predictability and success with complete
dentures, it's essential to treat patients who have
stable (not changing) stomatognathic systems;
this includes stable (noninflamed) denturesupporting
tissues and temporomandibular
joints (TMJs). If final impressions are made of
unstable inflamed, swollen tissues (Fig. 1a), the
denture will not fit well to the healed, unswollen
tissues (Fig. 1b). Other conditions that can lead to
unpredictability include the absence of retromolar
pads, hypertrophied maxillary tuberosities,
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Dentaltown April 2024

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