It is often said that dentures are not an alternative to having natural teeth, they are an alternative to having no teeth.
There are limitations in terms of retention, function and aesthetics once the natural dentition is lost.
Before treatment commences, there must be a comprehensive consenting process, including explanation of what is actually achievable.
Practitioners who take the time to effectively communicate these points in the first instance will generally encounter fewer problems later on.
The use of visual aids such as diagrams, together with accessible written advice upon which patients can reflect at their leisure, is often very useful and is strongly recommended by the General Dental Council.
Any treatment choices, such as materials or designs, should also be explained and then documented along with the patient’s response.
It is increasingly likely that the range of options will include implants as an alternative or an adjunct to a denture.
If available in-house, this would necessitate a separate, detailed discussion, which would usually be followed up with a document for the patient’s signature.
This conversation may also involve consideration of NHS versus private standard dentures.
NHS practitioners must be careful to avoid breach of their terms of service, which, amongst many other things, do not allow patients to be misled regarding the quality or availability of NHS treatment.
If, having been accurately advised, the patient selects private treatment, this must be recorded and signed for on a GP17DC form or equivalent.
Regardless of the quality of treatment, consenting and management of expectations, there will inevitably be patients who are disappointed with the outcome.
MDDUS dental adviser, Doug Hamilton, explains: 'It is critical that any such expressions of dissatisfaction are dealt with professionally and in accordance with NHS (where appropriate) and GDC (General Dental Council) requirements.'
It might be suggested that these difficulties are more likely where patients of advanced years present with old dentures which are worn out and need replacing.
Introducing new prostheses at this stage can be a thankless task and, in some instances, the best treatment is no treatment.
'However, when a replacement is unavoidable, it is important to remember that new dentures will present enormous challenges, especially for the older wearer. Patience and empathy must therefore be the prevailing approach.' Doug finishes.