NMDA Journal Summer 2018

13 nmdental.org By Charles Tatlock, DDS, MPH; Steve Wagner, DDS, FACP; and Jon Wagner, MD, DDS, FACS —Photos courtesy of the Wagner Denture Group The completion of a successful denture prosthesis is not pre-determined by an exact scientific process. Rather, a number of clinical judgments come in to play in order to achieve a satisfactory and predictable result. We would like to share some thoughts we consider both critical and helpful in the “calculus” of making a successful denture. Selecting the Proper Denture Patient It cannot be stressed enough that your selection of an ideal denture patient is crucial to the ultimate success of the case. The American College of Prosthodontists (ACP) has developed a classification system designed for use by dental professionals in the diagnosis and treatment of completely edentulous patients ( https://www.prosthodontics.org/assets/1/7/PDI_Partially_ Edentulous_Checklist.pdf ). This classification is the first in a series and is similar to the classifications for the completely dentate patient and partial edentulism developed by the ACP. These guidelines are intended to aid practitioners in the systematic diagnosis of each patient which, in turn, should lead to appropriate treatment or referral. The ACP classification is quite simple to use and is presented in a simple graphic form. However, as we all know, this is just a component of proper patient selection. During our dental training, our professors regularly taught that the key to a successful result was the proper selection of the patient. Unfortunately for most of us, these lessons are instantaneously forgotten the moment we begin to practice. Experience has forced the importance of these lessons back on us. As a service to younger dentists, and a reminder to the rest, here are a few specific thoughts. Some candidates are physically well constituted for complete dentures but show unrealistic expectations. They have only a vague conception of what denture wearing entails. They tend to be oblivious to any attempt on the doctor's part to inject some reality into the conversation. The demanding patient often brings to the consultation a portfolio of photographs, some with penciled modifications and measurements that they expect you to reproduce. They must be made to understand that the majority of issues can be controlled, the final appearance and function is a result of many factors, not the least of which may be the genes they inherited. It is crucial that this information is understood before you proceed with treatment. After delivery of the dentures, any such explanations are interpreted as simply an excuse. continues on next page  for the Successful Denture