As a prosthodontist, many people really have no idea what I do. However, when I say that I am a dentist, then they know that I look at teeth. But what I really like to tell them is that I change peoples’ life by giving them back their smile, by restoring their self-esteem and allowing them to have a better quality of life again. To me, my job is to use whatever means appropriate to restore my patients’ smile by replacing their missing teeth and their supporting structures. This can be achieved by using crowns, bridges and dentures or a combination of, using my patients’ existing teeth, or by using dental implants in strategic locations.
Over the years, I have restored many peoples’ smiles using a combination of treatment options. However, the really memorable ones that brought tears to my patients’ face are often ones when I just made a set simple dentures for them. These are people who had suffered from years of missing teeth, defective bite, failed surgical attempts. The nature of their oral handicap has affected their quality of life to the extent that there seems to be no more hope left for them. I see them when all they want is just a simple denture so they can smile again. At that point, it is amazing how much they can adapt to a set of ill-fitting dentures. It becomes a matter of survival so they can at least interact with others in a social setting. I remember someone referring these dentures as the “oral wigs” as they are truly their security blankets.
Despite the positive influence of a set of properly made acrylic dentures to patient’s life, learning to make them well is not always easy. In fact, removable prosthodontics is not often seen as the glamorous part of dental education. I remember that as a dental student, I found both the didactic aspect and the clinical aspect of denture curriculum very confusing. Many of my dental colleagues commented to me how they hated making dentures.
But very early on during my dental education, I also realized that if I can make a good set of dentures from scratch, then learning how to reconstruct someone’s mouth with bridges or using fancier dentistry would really be no different. After all, one must know how to set denture teeth in order to start diagnosing a case. These were always my beliefs. As a result, as boring and confusing the denture curriculum was, I was so drawn to reading every literature out there to learn about making a set of good dentures. Yes I am a denture nerd.
Also after years of practice, I realized I am trained to look at every prosthodontic case using my denture background. Where is my incisal position? How much is incisal display? What is the state of the occlusal plane? What is the current vertical dimension of occlusion? Knowing how to evaluate these clinical parameters comes with experience. And there is no such thing as one size fits all in dentistry. Not every patient has to be treatment planned to the ideal incisal position but one must start with this in mind.
As much as denture prosthetics may not be the most exciting material in dental education, I really think the knowledge and the skill sets behind denture making are critical when one wants to look at doing full mouth reconstruction or considering larger prosthetic cases. It will force you to not just focus on the edentulous areas but also whether the existing dentition requires treatment or modification. This takes the clinician away from the tooth to tooth approach to one that is a whole mouth approach. I hope I have convinced some of you to go back to your notes on denture prosthetics or at least have some respect for this material as this is the foundation to all prosthetic dentistry.
Please check out my other posts too. Thanks for reading!