Perfect Dentures

What are patients expecting in dentures and what are they getting?

- Sundru Moodley

In every day practice the denture practitioner has to meet various criteria in order to provide satisfactory dentures to the patient. All these factors need to be concurrent for the patient to enjoy the best dentures.

In my international demonstrations, we simplify the making and fitting of dentures using the innovative technique called the “Moodley Principle”. This three-step technique is very accurate for achieving beautiful, comfortable dentures with the highest level of chewing efficiency for all types of food. These teeth are also an alternative to implants. Linear occlusion with a cutting edge or cutting edge with a curve of spee appear to work very well.

Patients want comfort and beauty that aid in the effort to look younger. This is especially true today as patients live longer and the population ages as a whole. In my 30 years of practice as a denturist, I have manufactured from start to finish over 12,000 sets of dentures with a success rate of over 98% - due mainly to a high level of quality control. Patients today are willing to pay for better work, but are unable to obtain it because of the lack of well trained denture technicians throughout the world. Many technicians/dentists have opted for crown and bridge work for better remuneration. Over the next five years, intense training programs for technicians will be absolutely necessary if dentures are to remain a viable alternative.

Dentures not only have to look good, they have to feel good and allow the wearer to talk naturally. "There is many a slip betwixed cup and lip". From the time the impression leaves the dental office and undergoes manufacturing, several mistakes can occur since laboratories have to work on many cases on a production basis. Work has to be completed as fast as possible greatly increasing the chance of error. This is why dentists that want to offer quality dentures and denture services to their patients have to spend more time and attention to the details of fitting dentures. It is very important to work very closely with their technicians and highly personable labs to achieve better communication which will in turn result in better work for the patient. Key elements for superior dentures and fitting are as follows:

1. The anterior teeth should be the appropriate size, color and shape to enhance the patient’s personality. More and more patients prefer whiter teeth even if they look a little unnatural as they enjoy the younger look of brighter teeth. Anterior teeth should also have the proper natural profile and should show the correct amount of teeth in a smile.
2. Placement of the upper two anterior teeth with the proper profile is the key to success in making dentures. Placement of the posterior teeth is critical for efficient chewing - choosing teeth that have the best cutting edge is equally essential.
3. Placing the upper and lower teeth in the correct over/under bite is extremely important for proper speech.
4. Location of the sore spot using pressure indicating paste and eliminating them are vital for the patient’s comfort.
5. Proper balancing of the bite ensures stability in chewing.

There are numerous other factors that also have to be correct for high-quality dentures (e.g. the peripheral borders have to be adequate and the post dam area must be sealed off at the back of the upper denture to prevent the patient from gagging and maximize retention). A lab must be trained properly to provide the best dentures and to understand the numerous components that come into play (and in many cases concurrently) when manufacturing dentures.

In many commercial laboratories, a large number of technicians must work at a fast pace in order to keep manufacturing costs low, therefore many details that ensure well fitting and efficient dentures can be lost during the process. After talking with several denture technicians, most expressed the following:

1. Denturists should receive a greater remuneration for their work.
2. Technicians that have closer contact and communication with the dentist are providing better work.
3. Dentists who specialize in the making and fitting of dentures provide a better product and service.
4. The most common complaints regarding work received from dentists are poor impressions and bad bites.

Moodley's Mathematical Formula (MMF) For Setting Denture Teeth

The MMF is the ideal method for setting each denture tooth in its most ideal and strategic position for aesthetics and optimal function. There is an ideal setting for each tooth placed in a denture/dentures, normal occlusion or cross bite. Knowing where to place each tooth results in a stable denture.

The complete “Moodley Method” ensures all necessary information for manufacturing the “perfect” denture is in place – complete and accurate. At most, only one or two adjustments are required before the patient is absolutely satisfied.

In my opinion, especially as more and more denturists are licensed throughout the world, dentist and denturist should work together as partners to provide a more complete denture care system that include implants, etc. This would be the ultimate in a better care system for all patients, dentists and technicians.

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