Dentaltown December 2019 - 42

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Need Serious Guidance ...
Extremely Unhappy Denture Patient
This Townie has gone back and forth trying to create the 'perfect' denture.
Is it time to give it up and send the problematic patient packing?

MountainsandBeach
Member Since: 06/08/05
Post: 1 of 86

I have a patient who presented with wanting a brand-new denture to look exactly like her
old denture. (I know what you're thinking already. In retrospect, maybe I should have seen this
coming.) In any event, I did give her my usual spiel that new dentures are like having a new pair
of shoes and they take getting used to. I also listened very carefully to her and what she wanted,
took photos of everything and impressions of her current dentures and sent that to the lab. After
a disturbing amount of visits to have the lab guy give her the look she wanted, we sent to finish.
Unfortunately, while now she likes the way they look, she hates them so much she cries and
claims that she can't even wear her old dentures anymore because they're now not fitting right.
Her bite, while not perfect (there is some interocclusal space around #10-11), is fairly decent and
she doesn't have any pain with them. But, she hears a clicking (which I hear, too) and she feels
like they're rocking and she's getting food trapped. We even did a rebasing, and that didn't work
and now I'm out of options.
I feel awful; I even told her husband that I can refund their money. They can see a prosthodontist, I can try to rebase again, I really don't know what to do. The whole experience has
been frustrating (for both me and her, with the lab who couldn't seem to follow my guidelines
in addition to her not being happy).
I know you can make the best denture and they'll hate it and you can also make the worst
denture and they'll love it. But the fact remains I have a very unhappy patient who cries every
day. All thoughts welcome. Sorry for the novel. ■
8/21/2019

B2_DMD
Member Since: 05/03/11
Post: 2 of 86

We've all been here. It sucks, and yes, hindsight is always 20/20. I would tell her that you've
done all that you can to meet her expectations, then hand her a check for the amount of money
she has given you and then ask for the denture you made back. Then refer her to a prosthodontist
and have them handle it. At this point, you are better off buying the denture back and moving
on. I wouldn't offer her anything else treatment-wise and I sure wouldn't offer to pay for the
denture and let her keep it. ■
8/21/2019

CheckRaise
Member Since: 09/01/14
Post: 3 of 86

Oftentimes, you must be certain that the dentures were done perfectly before you give up.
Whether you want to give up now is up to you. Let me give you a few pointers.
1. Do the wash impression of the old dentures to use as your final impression, if possible.
Make sure borders are covered passively and fully. Check to see if vibrating line is marked
on the impression.
2. Verify the centric and vertical at the same time to ensure you are not simply copying the
wrong occlusal scheme.
3. Try in. This is your cosmetic approval. (Which you have done, I'm sure.)

DECEMBER 2019 // dentaltown.com

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