Dentaltown December 2019 - 44

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rundoc
Member Since: 07/05/10
Post: 24 of 86

Here is what I would do, and did. We all have these cases if you do a lot of dentures-I did.
Some of this repeats above advice of course.
1. Check vertical. Could be over-opened. Measure from spot on nose tip to under chin with a
straight edge. Compare to old set; should be close. If close, adjust teeth a little. If not, well,
remake or reset teeth and rebase.
2. Check fit. In this case, I would reline both chairside with some Lynal. Let it set awhile-
maybe 10 minutes. Come back, trim and send home. Next day, see how she's doing. Any
improvement? Check the borders. Any show-through areas? If so, adjust them. If a lot,
adjust all of them (mark with pencil) and then Lynal again. Repeat until no show-through.
If at that point the patient reports they are great, then process with the Lynal reline after
one day of wearing. (Other stuff works, too, of course.) It's surprising how often this
worked on the lowers.
3. The above takes time, lab fees (out of pocket) and hassle/patience. If you don't want to
do that, then refund the money. Send to specialist. They won't go, usually, but will go to
a denturist who will probably make them happy. Sucks, I know. I did not take their new
dentures. If the denturist can work with them and make them work, what do I care? I
think I refunded maybe five times in 29 years. It's powerful to have that option in your
pocket and use it, like insurance. It was far less than 1%. Huge stress reliever, though. If
you aren't willing to refund on occasion, don't do dentures.
4. The old denture not fitting. Tell her it's because tissues are like putty. They change shape.
Wear them for a day and the tissue will adapt. Give her some adhesive to use during the
"adaptation phase." Don't take responsibility for that. That's her panicking.
5. Sometimes with dentures, you need to listen a lot and be humble and willing to play
with them a lot. They can be a huge practice-builder, in my experience, if you handle the
patients correctly. Some of our biggest fans and referrers were denture patients-some of
them only moderately happy with their dentures! I did adjustments for free. Everyone does
it differently. That's how we did it.
6. Your case, I would probably refund. It's the crying part. Sometimes you gotta know when
to fold 'em and walk away. ■
8/22/2019

TonyCannoli
Member Since: 06/29/06
Post: 28 of 86

Dentures at PPO fees are difficult. We can't be expected to always reproduce the form and
function of 28 body parts for what the insurance companies pay. The patient needs to know
this. I don't want to hijack or take away from those offering great tips, but speaking only of that
occasional unhappy denture patient.
This is what has helped that patient come to acceptance. Have the patient sign an informed
refusal and initial declining each option and accepting one of them. It goes something like this.
Hybrid All-on-4: The highest level of fit, retention and cost. Decline ____ Accept ____
Denture with four implants: Less expensive than hybrid; provides mostly good retention.
Decline ____ Accept ____
Denture with two implants: Less expensive than four implants, provides mostly good retention but less than with four implants. Decline ____ Accept ____
Basic traditional denture: Provides teeth, but the least retention and chewing ability. The
low-cost option. Decline ____ Accept ____ ■
8/22/2019

DECEMBER 2019 // dentaltown.com

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Dentaltown December 2019

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