Full denture prosthetics in the 21st century: acceptance, quality of life, perspectives

Is full denture prosthetics a dying topic, or will it remain relevant in the future? What about the patients, will they continue to accept full dentures? And how can future dentists be inspired by full denture prosthetics? In this interview, find out what a young dentist has to say about the subject.

Interview with Dr Johannes A. Müller (Basel/Switzerland) on the topic of removable prosthetics

Dr Müller, how relevant is removable prosthetics today - and how relevant do you think this topic will be for future generations of dentists?

Dr Müller: In the future, the need for prosthetic restorations will increase, because as we know, life expectancy has risen or will continue to rise in many countries and, thanks to prophylaxis, tooth conservation is possible into old age. Removable restorations are often better for older patients, because they are easier to clean.

What about patient acceptance?

Dr Müller: It has been proven that patients find it easier to get used to a fixed restoration than to a removable restoration. However, it is not always possible to provide patients with fixed dental solutions. This can be due to financial, but also general medical reasons – in cases where it is medically not possible to place implants. Removable reconstructions are therefore still important at this point in time, and provide many patients with good treatment options.

To what extent does the quality of a removable restoration affect a patient's quality of life? Are there differences between standard reconstructions and individual restorations?

Dr Müller: Many patients particularly prefer restorations which allow the palatal region to be either partially or completely free. These reconstructions do not feel like dentures and do not affect the patient’s taste perception. Esthetic solutions are also preferred, where the retentive components – in particular metal clasps – cannot be seen. In summary, patients feel most comfortable with restorations which do not feel like dentures and are not perceived by others as dentures. These high-quality and highly esthetic restorations with concealed retentive components (adhesive attachments, telescopes, root cap) provide a high quality of life for many patients.

In your opinion, what could still be improved in removable denture prosthetics?

Dr Müller: Today, in terms of materials and techniques, we are already very advanced. In future, we will be able to improve the processing techniques further with new manufacturing methods, e.g. metal printing. I believe we need to invest in the training of dentists – so that they are aware of the entire range of possibilities and are able to implement them. So that they are in a position to provide the right care for each case.

I also see potential for improvement in the aftercare service. Aftercare is essential for removable restorations. Its longevity is shortened if it is not properly maintained and cleaned. This is why experienced dentists who offer a wide range of treatments and have a good network of other medical professionals are needed in order to provide comprehensive care to elderly, medically restricted patients. In addition, there is also a need for better training of nurses and private carers. This includes psychological training for the care of dementia patients. In particular the following questions:

• How do I talk to a patient?
• How can I encourage a patient to cooperate?
• How can I guide the patient properly?
• How can I convince them to carry out oral hygiene?

Unfortunately, patients with reduced mobility in nursing homes often lack assistance in these areas.
 

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How do you inspire your students for removable prosthetics? Is this necessary at all or is the interest already there?

Dr Müller: We try to enthuse the students theoretically and practically. On the one hand, we teach them the theoretical knowledge surrounding removable prosthetics. In our lectures, we show them in great detail that there are a variety of possibilities and not just the conventional full dentures and model cast metal dentures.
Phantom courses give students the opportunity to produce removable restorations themselves, including the root cap and chairside anchor. The students enjoy this very much, which can be seen in the results.
In the first and second year of their Master course, the students in the training clinic provide patients with removable restorations. When their work is completed and their patients are happy, this has a very motivating effect.

Do you think that courses should also be offered outside of the university, where dentists are able to practice all steps on the patient?

Dr Müller: In principle, it would be good for all dentists to be able to visit courses with practical tutorials or involving actual patients.
 

Personal information:
Dr Johannes A. Müller is a Dentist in the department for Reconstructive Dentistry at the University Centre of Dentistry (Universitären Zentrum für Zahnmedizin, UZB) in Basel, Switzerland.