Throughout the two-part series, we will discuss the principles of assessment for complete dentures and highlight different anatomical, physiological, pathological or psychological factors that can impact on complete denture construction. Furthermore, the use of implants to support overdentures does not preclude the need to provide optimally designed prostheses. Implant supported rehabilitation may not always be a suitable option due to general patient or local factors for example, systemic health, smoking history or availability of bone. The declining levels of undergraduate complete denture teaching may result in reduced experience and confidence when offering complete dentures in general dental practice 5, 6, 7 Society is more likely to perceive removable prostheses negatively, 4 and individuals may have higher expectations of their treatment There remains a group of patients with heavily restored dentitions who may transition to complete dentures at an older age than their predecessors and thus may find the task of adapting to wearing removable prostheses more difficult 3 Prosthetic rehabilitation may be influenced by potential issues associated with accessing dental services, systemic disease, polypharmacy, and the ability to adapt to new prostheses 8 3 Therefore, a detailed understanding of the principles of complete denture construction remains vital in providing appropriate quality of care, particularly as a variety of factors will make the process more challenging:Įdentulism is likely to be concentrated in the oldest age groups. 7Īlthough the proportion of edentate adults in the UK is small (only 6% in England in 2009), it is important to remember that this translates into approximately 2.7 million edentulous adults across England, Wales and Northern Ireland. 7 Only 37% of DFTs believed their undergraduate training had given them sufficient experience and confidence to offer complete dentures in practice. 7 During their undergraduate training, 56% made two to three complete dentures and 46% had no experience of the copy denture technique. 6 A further study explored self-perceived levels of competency of 56 dental foundation trainee (DFT) practitioners. highlighted a disparity in the overall number of hours devoted to complete denture teaching across 13 UK dental schools with some schools reporting difficulty in finding suitable edentulous patients and concerns about insufficient curricular time. explored trends across 12 British dental schools and found considerable variation in requirements for complete denture provision before graduation, staff-student ratios on clinics and the involvement of registered specialists. Various authors have also highlighted a reduction in complete denture teaching. 3 These changes have occurred concomitantly with attitudes shifting more favourably towards tooth retention with increasing preference for restorative treatment instead of extractions and corresponding negative attitudes towards dentures. 3 In addition, it is now unlikely that adults under 65 years will lose all their natural teeth and it is likely that edentulism will be concentrated within the oldest age groups. The overall proportion of edentulous adults in England has fallen sharply from 28% in 1978 to 6% in 2009. There are also positive trends in tooth retention and consequently a reduced prevalence of edentulism. 1, 2 For example, the proportion of the population aged 65 and over was 15% in 1986, 18% in 2016 and is further projected to reach 24% in 2036. 1 In addition, the population is becoming older as a result of healthcare and lifestyle improvements and this is demonstrated by a rising median age and a higher proportion of older people. The population is growing and is projected to increase from 65.6 million people in 2016 to over 74 million by 2039. The UK demonstrates a variety of general and oral health trends.
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