22. ADDENDUM Questions and Answers Question: What is the euphemism for slaughterhouse and toilet?

(See Section 6. Talking to Your Patient, "How to Speak to the Patient") Answer: Abattoir and powder room. Question: Why does a patient with an oral infection have to clean their dentures differently? Answer: In the polymerization of methyl-methacrylate, the release of gases causes microscopic pores and cracks. The pathogens reside in these invisible imperfections and serve as a reservoir for reinfection. Keeping the denture looking perfectly clean by using soap and water is not enough. Question: For complete denture construction, why do you make a primary model? Answer: We want to make a custom (personalized) tray that will fit accurately on this particular patient. Question: A faculty member saw a student in the clinic putting rubber base adhesive on the secondary tray with a brush that was attached to the cap of the bottle of adhesive. The instructor removed the brush and told the student to use a Q-tip. Why? Answer: When the brush touches the tray, the brush is now contaminated with the patient's bacteria. When the brush is returned to the bottle, then the entire bottle is contaminated. It is best to pour some adhesive on the tray then spread it with a Q-tip. The Q-tip will never touch the bottle. (Did you know that the "Q" in Q-tip stands for quality?) Question:

Knowing that the impression material for secondary edentulous impressions should be 1/2 to 1mm thick, the student placed a thin sheet of wax over the primary model before making the impression tray. Was this a good idea and why? Answer: It was an extraordinarily bad idea. Because the tray is now so inexact, the student cannot correctly seat the tray in the patient's mouth. (Because of the "wax space" there is no seat.) Thus the borders of the tray cannot be shortened correctly. If the tray is properly made on the primary model, and firmly seated, the viscosity of the impression material will allow for 1/2 to 1mm thickness. (To be sure in other techniques there will be a need for relief under the tray. There will also be a need for tissue stops. ) Question: What type of impression material did you use to take the edentulous secondary impression? Answer: You used rubber base impression material. Question: What are the two basic physical differences between a secondary tray and a recording base? Answer: A recording base does not have a handle. The borders of the recording base simulate that of the final denture. They are not purposely shortened. Question: What is the purpose of shortening the borders of the secondary impression tray (in complete denture construction)? Answer: You want to perfect the borders of the tray on the patient. Softened compound is added to the tray to capture the mucobuccal and mucolingual folds. It is easy to remove and add compound so the procedure can be repeated until the borders are correctly captured. Question: What temperature do you set your compound heater to anneal the compound? Answer:

140 degrees Fahrenheit. (60 degrees Centigrade) Look under Section 11. Secondary Impression, "Using the Compound Heater" to get a more detailed answer. Question: How long should you leave the rubber base impression material to set in the mouth? on a typodent? Answer: In the mouth you need 6 to 7 minutes. If it is on a typodent you will need 10 minutes. Body heat makes the material set faster. Question: When pouring up an impression why is it permissible to invert a primary impression on a mound of stone or plaster, while you are not permitted to invert the secondary impression? Answer: The primary impression is not as important. So if changes occur while inverting then the secondary tray will change slightly. This error will be corrected in the final impression. We want the secondary model to be as accurate as possible. If you invert the secondary impression, the stone may pull away from the impression due to gravity resulting in a distortion. Then the final denture will be distorted. Question: Give two reason why you should bead and box secondary complete denture impressions. Answer: When you bead and box you can pour a base on the secondary impression without inverting. Inverting can sometimes cause the stone in the impression to move. Beading and boxing helps you define the useful portions of your impression. It ensures that you will capture the mucobuccal and mucolingual borders of your impression. When you vibrate the stone into your impression the heavier particles fall to the bottom. This means the tissue surface of your model will be stronger. The more watery mix will now be on the base of your cast which is now up top. You can trim down the base after the stone hardens. Question: What is the optimal height of the base of the master cast? Answer: One half inch or 12.5 millimeters. Question:

Show by an equation the relationship between rest vertical dimension, occlusal vertical dimension, and free way space. Answer: RVD=OVD + FWS Q. What is a prosthodontist? A. A prosthodontist is a specialist in the restoration and replacement of broken and missing teeth. Their training lasts an additional three years after four years of dental school. During that time, a prosthodontist is taught in greater detail about both removable and fixed prosthodontics. Removable prosthodontics includes replacing missing teeth with appliances that the patients themselves can take in and out of their mouth, such as dentures and partial dentures. Fixed prosthodontics includes replacing missing and/or broken teeth with restorations that the patient cannot take in and out, such as veneers, crowns, bridges, and implants. Q. What are dentures? A. Dentures are removable prosthetic devices designed to replace missing teeth. Q. What are complete dentures? A. Complete dentures are dentures that replace a complete set of missing teeth. Q. What is the difference between conventional dentures and immediate dentures? A. Conventional dentures are dentures that are made and placed after the remaining teeth are removed and the tissues have healed. Immediate dentures are dentures that are placed immediately after the removal of the remaining teeth. Q. What is an over-denture? A. An over-denture is a denture that fits over a small number of remaining natural teeth or implants. Q. What do dentures feel like? A. For a few weeks, new dentures will feel awkward until you become accustomed to them. They might feel loose until the cheek and tongue muscles learn to hold them in position. It is not unusual to feel minor irritation or soreness. The patient needs to see his or her dentist or prosthodontist for regular fit adjustments to relieve any sore areas. Q. Are you able to eat with dentures? A. Eating with dentures will take a little practice. You should start with soft foods that are cut into small pieces. As you become used to chewing, you can return to your normal diet.

Q. Are there foods you should avoid if you wear dentures? A. There are only a few eating restrictions for denture wearers. Avoid biting down directly on crunchy or hard foods, like whole apples, hard pretzels, crusty bread, or large sandwiches. They can break because of the angle where the denture comes into contact with the hard surface. Biting is limited only by the stability of the dentures themselves. Insufficient bone structure (shrunken bone ridges covered by gum tissue), old or worn dentures, and a dry mouth decrease stability. Q. If you wear dentures, are dental adhesives necessary? A. Today's dentures have been significantly improved through advances in both dental and materials technologies. As a result, dentures that fit properly usually do not require adhesives to secure the dentures. When you are just getting used to dentures, adhesives may be advised, but otherwise should not be necessary. A loose denture is a sign that it doesn't fit your mouth correctly. When first getting used to dentures, you may notice them slipping when you laugh, smile, or cough, which is caused by air getting under the base and moving it. The more you wear dentures, the better you will be able to control their movements in these situations. If your mouth has insufficient bone structure, dentures will be more difficult to retain. Your dentist or prosthodontist may advise the placement of implants. These are placed in the bone and retain the denture with small, precision attachments.

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