A denture story, huh?
Honestly, I almost feel like I should write each of my denture stories because making one requires a lot of blood, sweat, and tears (we'll see about that). I had spent most of my free times perfecting it in the lab and to produce and present it to them is a bliss. I might be blessed with kind patient, but the skills developed throughout this journey was not easy to acquire. I have cried multiple times before when things doesn't go my way... a cry baby, ikr, but I enjoy every single one of it and I want to cherish the memories by writing in this blog.
I received my first denture patient after trying for three times (the first two patients had done their denture at a government clinic) and Alhamdulillah he was so compliant and nice and requires no pre prosthetic treatment. His favourite word was 'It is okay to make mistakes as you are still learning) and mine was 'Sorry for being so rough, sir'. The first case is a shared case whereby I'll do the lower arch while my partner do the upper arch. Generally, a denture has two types which are acylic and cobalt chrome and this case is a complete upper and lower acrylic denture.
|cobalt chrome denture|
The examination and diagnosis part is very straightforward as he is fit and healthy and no other problems. Although we did have to take an OPG image to see if there is any retained root as his story is a bit suspicious and there were none found. Oh guess what, he had been edentulous (no teeth) for almost 30 years until he decided to make one with me yeayy. The first visit ended by taking the primary impression of his mouth by using alginate to prepare for the next step.
|cast made from the first impression.|
The second visit involves us trimming the special tray (made by using the previous impression). Once it is done, we use this sticky green wax stick to record the sulcus for better adaptation. You have to repeat this step until a suction sound can be heard when you remove the tray. Once that is done, you will use another material to record the secondary impression which is more accurate. Then, the cast prepared from this will be used to make the bite rims with wax. The function of these impression is to ensure a proper adaptation of the denture to avoid any dislodgement whenever the patient speak/ eat/ cough etc.
|green stick molding and secondary impression of the mouth|
Then, the third visit requires your patient cooperation and patients as it requires putting and removing the bite rims multiple time for adjustment. Wrong measurement can result in future unwanted problems for the patient. You also have to use your eyes to see the centre line, parallelism and aesthetic of the patient. My eyes were so strain by doing this haha and it took us two visit to make it right because you know it's our first time. Fortunately, our lecturers were willing to help us to make it right despite our multiple failing effort.
|adjustment and markings were done after necessary measurement were taken|
Then, the important markings were made and recorded and the patient was asked to pick their desired tooth shade. I always hate it when they say 'you pick for me la, I trust you okey'. I mean like whyyyy and usually we would end up by picking the common shade. The markings made will guide you during the teeth setting. Once that is done, the acrylic teeth were chosen and requested and the painstaking journey of tooth setting begin. Among all of the procedure, this step is my least favourite huhu but the satisfaction you feel when you finish is just incredible hmmm. Plus, what is a denture without teeth, right haha
Once the setting was satisfied, we called him for our fifth visit (the third and fourth is solely for bite rims measurement) and adjustment of the teeth were made whenever necessary and it was kind of smooth sailing if memory serves me right. The patient has no comment regarding the arrangement of the teeth and tooth shade which we were so thankful of. Then, we went to the lab the prepare it for the next step.
After sealing and cleaning the required area, we put the denture in a flask with plaster of paris (POP) to get the negative copy the denture. I had made a mistake by not making the mixture slightly runnier for the top part, hence, there were holes in my flask which was so frustrating causing a breakdown. Luckily, it can be saved and the technician did something to it after I have clean the cast from wax with hot water. After that he also helped me to pack acrylic into the flask for the curing procedure. I prayed so hard for the technique work as I do not want to start from scratch. I was almost at the finishing line huhu.
|puppy eyes trick to ask for help from the technician|
Miracles do happens as the technique works perfectly and there was no porosity seen on the denture. It looks beautiful even though it was ugly with the excess acrylic and stones attached to the denture. Then, a quick rough trimming of the denture was done. My fingers were on fire from the trimmed acrylic and my desk was full with dust (my suction doesn't work but whatever). It was almost like a magical scene with acrylic dust floating over you, even though in reality I look like a mess.
Then, a finer trimming was done to make it look nicer before using the sand paper to make the surface smooth. Once this is done, the denture will undergo further refinement with pumice (remove minute irregularities) and whitening (make it shine bright like a diamond). It is always so satisfying to see the denture shine without any dull surface.
Later, the sixth visit was conducted and after a few trimming was done, the denture was safely issued to the patient and he was satisfied with it. We took some pictures with him and he also claims that he was a bit shy of wearing it because he was used to not having any teeth before. He thanked us and we sighed with relieve after seeing all the hard works being paid off.
|the final product of our labour. Literally our pride and joy|
The seventh visit is done a week later to tend to any complains. He has none, but we did adjust the biting a little bit and dismissed him once done. That was the last time we ever saw him and I'm glad he was happy with the denture issued. Then, we requested another denture case, but this time it was individual. This second complete edentulous patient of mine is an adventurous story on its own, so I'll tell you in another post. In conclusion, making a denture is not an easy process as it requires a lot of time and skills. Not to mention, the risk that each procedure carries.