A Philosophy Of Full Denture Service: Mouths & People Are Different
by Dr. McBride | Date Published: 2017-03-07 | Download PDF
In dental school, our clinical learning experience in large part consisted of filling and replacing teeth. We worked on models of teeth, repairing simulated decays and making tooth replacements to develop our dexterity. In fact, our being selected into dental school was largely based on our ability to perform these tasks. One of our senior year requirements was the making fully removable dentures for three patients. I excelled in this area of my training and thought that I would be very successful in dental practice based upon these learned skills. When I started practicing dentistry, I quickly realized that I needed to continue my education and that dental school had just been the beginning of my learning process. I found that people and their mouths varied immensely and that I surely didn’t “know it all”. Another thing I learned was that full denture service was completely different from other types of restorative dentistry such as fillings, fixed bridgework or implant dentistry. When a dentist places a filling or a fixed bridge, if the color match is good and the fit and “bite” is right, the patient is happy and they’re off to a predictable future. With full denture care, it is not the same in that there are numerous individual differences that will influence their success. These differences have to do in part with the nature and size of the remaining ridges (gum and supporting bone). Dentures have hard, unyielding undersides that are placed over thin gum tissue that covers the bone; therefore the success of the dentures is quite reliant upon the relative quality of these ridges. People also can vary considerably in their general health, their oral dexterity and attitude. A large number of dentists have discontinued and many new dentists do not offer full denture services due to the degree of difference between the predictability of “fixed” services as compared to removable denture services.
A TEAM APPROACH
As indicated, with a filling or fixed bridge, the treatment usually ends the day of placement. Denture treatment actually commences the day they are placed. Whether the dentures are the first ones or a replacement of old ones, they are always a completely different and new experience for the patient, and it usually takes time to get them “finely tuned”. It may involve a course of denture adjustments and modifications that are based on a mutual commitment and excellent communication between the dentist and patient – a true teamwork approach. In order to have a successful course of treatment, a dentist must allocate time which would be inclusive of an in depth medical and dental history, an oral examination and a consultation prior to the start of denture fabrication ‑ usually two separate appointments. This allows the dentist to develop a treatment plan based upon information gained from the initial appointment and perhaps from the patient’s physician. The second appointment lets the patient be informed of the nature of the treatment and his/her relative success possibilities. My services are based on a realization that each person has individual and unique qualities, which require differing methods of time and treatment. The service includes any and all adjustments or modifications required along the way after initial placement of the dentures until the patient is able to realize the projected expectations.
WHAT ARE WE PURCHASING?
Many dentists “sell” their “product” with a separate fee for the upper and the lower dentures, as if they were commodities to be dispensed. Many patients believe the same, as they have been “trained” by these types of dentists, and also insurance companies who list fees per denture with no consideration for individual patient differences, which vary with denture patients more than with all other branches of dentistry. Our fees are based upon the value of the service taking into consideration these individual differences. It is an interesting fact that the materials used in the making of dentures cost essentially the same, no matter what the viewpoint is of the dentist or the age of the patient. Treatment results are determined by the interest, skill, care and experience rendered by the dentist based upon his/her philosophy of care. Also important is the commitment of both the dentist and patient to the prescribed care. A tenet of the The Academy of Prosthodontic Research in which I have participated for many years is a realization that full denture service is one of the more difficult, unique and specialized aspects of dentistry. Each member realizes that we offer a complex service, its goal being the resolution of our patient’s problems rather than “selling teeth.”
We are committed to providing the finest in full denture service which includes having the denture patient fully understand all his/her individual needs, and giving our full support from the beginning through the completion of treatment.©2020 Robert P. McBride DDS, Inc. All Rights Reserved.