22 May 2024 : Clinical Research
Impact of Patient Education Formats on Treatment Adherence and Denture Hygiene in Edentulous Patients: A Comparative Study
Youssef Abdullah Algarni1CDEFG, Rashmi S. Gupta2ABCEF, Lakshya Kumar3ABCEF, Khurshid Mattoo4ACDEF*, Syed M. Yassin5CDEFG, Mohammad Zahir Kota6CDEFG, Fawaz Abdul Hamid Baig6CDEG, Mohammed Ibrahim6CDEFG, Suheel Manzoor Baba1CDEFG, Shadi Abdullah Hamzi7BCEFDOI: 10.12659/MSM.944175
Med Sci Monit 2024; 30:e944175
Table 1 Concise patient education and motivation (PEM) post-insertion prosthesis instructions.
| Category | PEM Instructions |
|---|---|
| I (Nature of prosthesis) | Prosthesis is a single unit and cannot replace natural teeth. The prosthesis has limitation (eg, taste, wear, shrinkage, water sorption). Problems can be overcome only with patience, determination, and skill. Minute variations in the movement of food particles cannot be detected. The prosthesis cannot detect variation in size and location or texture differences. Biting force with prosthesis is 1/5 that of natural teeth, and force applied on one side affects the other side |
| II (First oral feeling) | Strained face feeling with the new denture. Muscles take time to assume different positions. Bulkiness initially develops nausea or gagging, which is temporary and purely psychological. Lips feel protuberant initially. Prosthesis should not be shortened as it will affect seal and function |
| III (Sialorrhea) | Initially for 1–2 days salivary flow will increase, but it will reduce slowly over time. The saliva should not be allowed to collect in the mouth and should be swallowed repeatedly. Unnecessary rinsing or spitting should be avoided |
| IV (Speech) | Altered speech initially, which is overcome by adjusting tongue. Avoid rapid conversation for adjusting speech fluency. Read loudly in front of a mirror for practice. Alteration in your speech will be more obvious when making certain sounds (eg, /s/,/z/,/f/). Do not repeat same words |
| V (Mastication) | Prosthetic mastication is a new skill to be learned. Eat soft/crispy foods, avoid sticky food, take small bites and chew thoroughly. Food should be halved and placed bilaterally on posterior teeth. Chewing strokes should be vertical. Avoid hard food and eating in gatherings until the learning period is over. Chewed food to be placed towards corner of the mouth, and be aware that taste may be altered initially |
| VI (Patient individuality) | Prosthesis must not be compared with other patients’ prosthesis, nor the experience of other wearers. One must not exhibit prosthesis to curious socialites. Problems related to prosthesis will be resolved by learning which takes time. Do not overexpose yourself after wearing a new prosthesis. Your adaptation ability gets compromised with age; therefore, patience and persistence are the key |
| VII (Hygiene) | Do not wear the prosthesis continuously. Gradually increase number of wearing hours to maximum of 8 hours. Remove prosthesis before sleep. Oral tissues should be given rest. Oral physiotherapy, which includes finger massaging and warm saline gargling, is a must. Tongue is to be cleaned with brush to increase taste perception. Take a regular and balanced diet added with supplement nutrients and avoid alcohol. Clean prosthesis with soft brush under running water, avoid stiff brush. Clean prosthesis after every meal, soak prosthesis once in a day in cleanser for 30 minutes. Brush the prosthesis in a basin filled with water. Sit down and wash it; do not wash it standing. Avoid toothpaste to clean denture. Irritated mucosa should be given rest. When out of mouth, the prosthesis should be placed in clean water, which should be changed daily. A prosthesis in a container should be covered with a lid. Calculus accumulation should be avoided by regular cleaning, and if present should be removed with mild white vinegar solution |
| VIII (Tongue position) | New assumed tongue position must be learned to improve prosthesis stability, mandible foundation is weaker than maxillary; therefore, certain functions should be avoided. Prosthesis stability depends on correct tongue and surrounding muscles. Practice opening and closing as demonstrated. Relationship between prosthesis contours and muscles should be learned, and improper tongue position cannot be a solution to solve prosthesis problems |
| IX (Miscellaneous) | No household remedy or repairs are to be performed, prosthesis is made of plastic which changes; therefore, follow-up correction is essential. The dentist and patient have responsibilities to be fulfilled to make prosthesis adaptation quick, must keep the prosthesis away from children and pets |
| The instructions listed under various categories are concise and summarised without detailed description that was demonstrated to the patients during clinical stages. Category types: I – Nature of prosthesis; II – First oral feeling; III – Sialorrhea-Excess saliva; IV – Speech; V – Mastication; VI – Individuality of patient; VII – Tissue and prosthesis hygiene; VIII – Tongue position; IX – Miscellaneous. | |