Most of your denture cases will be replacement dentures and so I will address those folks first. The old denture will be ill-fitting, have a ground-down collapsed occlusion, be a reservoir for bacteria and Candida, look terrible, but still feels completely natural to the patient.

For a new denture to have success, the doctor must carefully determine three things:

1. That the patients needs a new denture.
2. That the patient wants a new denture.
3. That the patient is willing and able to break-in a new denture

Mrs Smith, your old denture does indeed look bad and I see where it has been repaired many times. But before we make plans to start a new denture for you, I want to go over some important information. Here, it is wise to downplay the success of a new prosthesis.
(Over-expectation is the greatest source of denture failure.) This denture is like an old shoe; it is worn out but it feels natural to you. A new denture is like a new pair of shoes; uncomfortable at first, but eventually much better than your old worn out shoes. Your old denture is ground down and a new denture will have new, undamaged teeth, so it will feel bigger at first. I think we can give you a fresh new look and help you chew better but you have to be willing to take the time to learn to use a new denture. It will feel too big around the edges and will cause some sore spots that will need to be adjusted and your speech may be a little changed at first, until your tongue gets used to normal sized teeth again. Do you understand what I mean and do you still want to proceed?

While this sounds like you are trying hard not to do a denture, surprisingly, most denture patients will want you to proceed. And if your original diagnostic “suitability for dentures in the first place” was correct, the patient will be amazed at how little trouble they had and how well they fit and how good they look. But if troublesome difficulties arise, the patient becomes more “patient” because you told them already it might be a long period of adjustment.

Never downplay your professional skills but be aware that there are some areas of dentistry where “underpromising” is the best insurance.


Make up a checksheet form that the patient can initial as denture fabrication steps are accomplished as it can help avoid the upset patient returning with new dentures in a bag and exclaiming they can’t wear them and they don’t look right”.

Denture Progress Permissions Form

1.) I have thoroughly discussed all the benefits and risks of having new dentures made and have had the opportunity to ask all my questions. I fully understand there can be no guarantees of 100% satisfaction with artificial teeth and I wish to proceed with fabricating new dentures________(initial).

2.) I have had impressions taken and acknowledge that my remaining gum ridge is not ideal but I am willing to take the time to adjust to new dentures_______(initial).

3.) I understand that this appointment to record my jaw positions and tooth position is very important and I have agreed to the color and shape of the teeth that will be used in my dentures______(initial).

4.) I approve of the looks, bite and fit of my denture teeth set in way and wish them to now be processed into the acrylic final denture_______(initial).

5.) I have received my finished dentures and approve of them and will make every effort to get used to them and re-learn how to properly chew with them(_______initial).

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