DENTUREINSERTION/PATIENT EDUCATION/MAINTENANCE

The moment new dentures are placed in the patient’s mouth; all of the procedures involved in
denture construction are subject to review and re evaluation. A failure to spend adequate time at the
try-in appointment leads to trouble on insertion of dentures.
Prior to the placing of dentures in the patients mouth, the dentures should be inspected to be sure
that there are no imperfections on the tissue surface, the polished surface is smooth, the denture
flanges have no sharp angles and are not too thick, and the denture borders are round and smooth
with no obvious over extension.

BEHAVIOURAL FACTORS AFFECTING INSERTION

There is a wide spectrum of behavioral problems associated with denture insertion. There is the
easily satisfied patient who returns after the insertion visit only for one or 2 minor adjustments. At
the other end are me patients who becomes an office fixture with frequent short visits.

Patient motivation
All patients have a threshold of acceptability that determines their response to denture insertion.
This threshold is part of the motivation mechanism of the patient which may be identified early in
the treatment.
Deep seated frustrations, not easily discernible and an inability to fully comprehend denture service
may go undetected in some patients. (COLLECT H.A), such patients are generally poor risks for
successfully completion of dentures.

Communication
Establishing good communication between doctor and patient early in treatment can prove highly
supportive. Early discussion provides clues that are useful about expectations at the time of denture
insertion.

TRIAL PLACEMENT OF THE DENTURES

It is generally wise to remove the patient’s old dentures atleast 15 minutes before the new dentures
are inserted. This allows the oral tissues to separate and return to a resting form.

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The steps involved in trial placement of dentures are:
1. Inspecting the processed dentures.
2. Evaluating interferences to the seating of the dentures.
3. Checking the fullness of the mouth.
4. Checking degree of tooth and mucosa visibility.
5. Checking clearance at the heels of the dentures.
6. Checking clearance at the anterior region.
7. Checking the occlusal pattern for prematurities.
8. Asking the patient about the comfort of the basal seat
9. Testing for coincidence of centric occlusion and centric relation.
10. Testing the periphery of the dentures for excessive thickness, height and snugness.

Inspecting the processed dentures

The dentist should inspect the tissue side carefully for beads or nodules of denture base material.
Any nicks and accidental deformation of the casts reproduced in the tissue surface of the denture
should be identified. A suspicious area should be compared with the diagnostic cast and the mouth.
This should be done before the initial insertion. Evaluating interferences to the seating of the
dentures
The flanges of the dentures should be examined for the presence of undercuts that may bruise the
tissues and prevent the seating of the denture. In such a case the undercut should be tested with
some disclosing wax. The dentures should be gently seated and not snapped in its place until all
severe undercuts have been located and relieved.

Checking the fullness of the mouth

Excessive fullness of the lips and at the base of the nose should be corrected at this time. Height
and thickness have to be corrected to effect pleasing facial contours. Checking degree of tooth and
mucosa visibility
The labial flange with little/no adjustment after processing should be present This outcome
necessitates careful festooning and contouring in the wax in order to effect the most pleasing lip
contour.

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Checking clearance at the heels of the denture
The clearance of the dentures in the areas of tuberosity and retromolar pad in the mouth has to be
rechecked. Whenever a lack of clearance is suspected the patient is asked to close into disclosing
wax that has been placed on the tuberosity. If clearance is not present, the denture base will show
through.

Checking clearance at the anterior region

Anterior clearance has to be rechecked when the dentures are in the patients mouth. From canine to
canine, a piece of articulating paper should be drawn through freely when teeth are in centric
relation.

Testing the occlusal patterns for prematurities

The checking of the occlusion varies depending on the nature of the occlusal pattern employed.
When the occlusal pattern is anatomic, testing for prematurities involves not only centric but
eccentric positions as well. There should be simultaneous contact protrusively and laterally.
When the neutrocentric occlusal concept is employed, testing the occlusal pattern for prematurities
involves securing simultaneous contact of the front and back, right and left sectors of the occlusal
pattern in centric position only. No attempt is made to secure simultaneous contact in eccentric
positions.

Comfort of the basal seat

The patient should be asked about the comfort of the basal seat at this stage of the trial placement.
Testing for coincidence of centric occlusion and centric relation. When occlusal inclines are present
on a denture, it is almost impossible to check, in the mouth, the precise coincidence of centric
occlusion and centric relation. This is done by employing "SYNGE'S LAW1 (Gabel, 1954) where
it is found that mucoperiosteum (the denture attaching membrane) is 250 times as displaceable as
the periodontal membrane (the natural tooth attachment). The mucoperiosteum and PD ligament
has a differential in thickness of 5:1 and differential in rigidity of 1:2.
Hence, whenever inclines are present in a denture, centric occlusion should be checked most
carefully on an articulator, where the surface of the cast is not displaceable.

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Evaluating borders
The borders and the contour of the polished surfaces of the dentures in the mouth has to be
determined so the
1. The border extensions and contour are compatible with the available spaces in the vestibule.
2. The borders are properly relieved to accommodate the frenum attachment of the reflections of
the tissues in the hamular notch area.
3. The dentures arc stable during speech and swallowing.

Disclosing wax can be applied on the borders of the dentures and all the border moulding
movements are carried on. Any one extension are identified and relieved by grinding and the
relieved area is polished.

Testing for adequate retention

The test for adequate retention differs depending on the type of occlusion employed when the
neutro occlusal concept is used; the test is limited to vertical retention only. After the dentures are
seated, the upper in the premolar area is grouped with index finger and thumb and pulled directly
downwards. The retention should be sufficient to resist dislodgement.

When the anatomic occlusal pattern is employed, further testing for horizontal retention is
necessary. The upper denture is contacted lingually at the canine areas and attempts are made to
flip it. The 3-dimensional occlusal forms (use of cusp and inclines) will demand of the dentures
more retention, especially horizontal retention, to resist the horizontal stress component resulting
from functional inclined planes.

Checking stability in centric closure

In spite of the simultaneous contacts in all areas of occlusal pattern the denture may still not
function comfortably if they are not stable. Dentures are not stable if they skid in forceful centric
closure. It is often due to the extension of the pattern to areas directly above the lower molar
incline.

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CLINICAL ERRORS
Errors in registering Jaw relations
This may be the result of one or more factors.
1. Record bases that do not fit accurately.
2. Shifting of the record bases over displaceable tissues.
3. Excessive pressure exhorted by the patient during registering of maxillo mandibular relation.
4. Unequal distribution of stress during the maxillo mandibular retention registration.
5. Patients not registering clinical errors because of systemic factors such as muscle spasm, TMJ
abnormalities, impairment of muscle tonus etc.

Errors in mounting casts may be caused by

1. Record bases that are not properly seated and secured to casts during mounting.
2. Occlusion runs not being definitely locked /keyed for correct orientation during mounting on the
articulator.

Correcting occlusion

Occlusal harmony in complete denture is necessary if the dentures are to be comfortable, to

function efficiently and to preserve the supporting structures.
Occlusal faults can be determined by obtaining an interocclusal record from the patient and
remounting the dentures on an articulator. These faults can be corrected by careful selective
grinding procedures.

Occlusal disharmony in the completed dentures may result from.

1. Undetected errors in registering jaw relation.
2. Errors in mounting casts on the articulator.
3. Difference in tissue adaptation between the processed denture bases and the record bases that
were used in recording maxillo mandibular relations.
4. Changes in supporting structures since the impressions were made in case the patient is using
other dentures.
5. Interferences of casts in the posterior region during mounting.

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6. Articulator not maintaining horizontal and vertical relationship of casts.
7. Inaccuracies introduced by changes in the plaster used to mount the casts.

Correcting occlusal disharmony

There are many acceptable intraoral methods for correcting occlusal disharmony.
However, the intraoral methods are more accurate if the uneven contacting of the teeth has been 1st
correct with laboratory remount and patient remount procedures.

Articulating paper
Articulating paper alone will not give as accurate an indication of premature contacts. The
resiliency of the supporting tissues allows the dentures to shift; therefore the paper markings are
frequently false and misleading. Articulating paper should be placed on both arches at the same
time.

Central bearing devices

Correlator, a type of central bearing device has been used by some operators. The central bearing
pin works on a spring. As the patient closes his mouth, the pin in the mandibular mounting,
contacts a metal plate in the vault of the maxillary denture. Thus by holding the maxillary denture
up and the mandibular denture down, the pin creates a tension before the teeth contact. If a
premature contact is made by one tooth, the dentures do not shift because the spring holds the other
teeth apart. The interceptive occlusal contacts are located with articulating ribbon. Another type of
central bearing device called the coble device has a central bearing pin without a spring.

Occlusal wax
Adhesive green stick wax is placed on the occlusal surfaces of the mandibular denture. Points of
penetration that occur upon closing with the jaws in centric relation may be marked with a lead
pencil and relieved where indicated. With this method one may also locate points of interferences
during functional movements. One disadvantage of this method is that shifting of the dentures over
resilient supporting tissue in eccentric jaw position will give false markings. This is an excellent
method for correcting occlusion in the centric position.

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Patient remount and selective grinding
The patient remount method is to remount the dentures on an articulator by means of inter occlusal
records made in the patients mouth. To carry out a patient remount procedure, orient the
mandibular denture to the maxillary denture by means of interocclusal record with jaws in clinical
error.
1. Place 2 thicknesses of passive type wax on the occlusal surfaces of the mandibular teeth.
Soften with a flame from alcohol torch or immense in water at 130°C.
2. Carry to the mouth and have the patient close into the wax when the jaws are in the CR. Closure
must be short of tooth to tooth contact. Chill with cold air and remount.
3. Trim the wax so that only slight indentation remain and expose the facial side so that the seating
of maxillary denture can be visually checked.
4. After properly orienting the mandibular denture to the maxillary denture by means of
interocclusal record, secure with sticky wax. Seat the mandibular cast in the denture and attach to
the mandibular member of the articulator with plaster.
5. To check what has been recorded to be the patient’s centric occlusion, another interocclusal wax
record is made.
6. The dentures are replaced on the articulator with the condylar elements fixed; place the teeth in
the indentation in the wax record. The condylar elements should rest against the stops
7. The procedure is repeated until 3 consecutive besides one accepted.
8. When the accuracy of the articulator mounting is verified, occlusal disharmony when the jaws
are in CR or in eccentric relation can be corrected by selective grinding procedures.

Patient Education and Complete Denture Maintenance

Patient education should help create a positive attitude by informing the patient about
a. The special problems associated with wearing complete dentures.
b. Advising the patient on ways to overcome or compensate for these problems.
c. Informing the patient of proper oral and denture hygiene and
d. Warning the patient about drug store denture products.
A thorough patient education program should begin with the initial patient visit and be carried on
through out the denture construction.

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The 1st phase: Should be, preliminary verbal in nature and the patient should be encouraged to ask
any questions and misunderstandings should be thoroughly discussed.
The 2nd phase: Consists of a clear, well-written summary of the expected problems and hygiene
recommendations.

A complete patient education program should include the following:

1. The nature of complete dentures
2. The 1st oral feelings
3. The problem of excess saliva
4. Speech accommodation
5. Eating suggestions
6. Proper tongue positions
7. The importance of tissue health-
8. The proper cleaning of complete dentures.
9. Warnings about over-the-counter denture products.
10. The danger of do-it-yourself dentistry.

The nature of complete dentures

The patient should have a fundamental understanding of the nature of the denture foundation.
The first concept that should be discussed with patient is that of retention. The dentist should point
out that natural teeth have roots that are surrounded by bone. A denture, on the other hand, is
placed on wet, slippery mucosa. The patient should be encouraged to ask questions in the
discussion and allowed to voice his or her conclusions.
It should be pointed out that natural teeth and their embedded roots form an effective arrangement
for the mastication of tough foods. A denture rests on bone with a delicate layer of mucosa between
the denture base and the bone. Masticatory forces generated by dentures are limited by the amount
of pressure that can be comfortably applied on this interposed tissue.

It should be explained to patients that teeth have an acute proprioceptive system; they are able to
detect minute variations in movement as well as differences is size, location and texture. Denture
patients, on the other hand, have lost their "tooth guidance mechanism". A great deal of the success

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rests with the patient’s ability to understand the basic problems associated with complete dentures
and to overcome or compensate for them.

First oral feelings

As soon as the dentures are inserted the patient should be allowed to view themselves. This visual
input will help assure the patient and counteract the patient's overwhelming and feelings. They
must be forewarned that they will experience a temporary feeling of fullness. There are 2 reasons
for this; 1st, the dentist wants to take advantage of as much tissue area as possible to aid in
stabilization, retention and the distribution of chewing forces, thus the new denture may be slightly
larger than the old denture.2nd , any small changes in denture contour tend to be perceived by the
mouth as bulk or excess.
The patient should be reassured that this feeling of fullness disappears with familiarization.

Excess saliva
New dentures are often interpreted as foreign objects by the oral system. This leads to a stimulation
of salivary glands to produce saliva. If the flow is excessive, the patient may complain of floating
dentures and a general excess of water saliva. The patient should be assured that this overactive
flow of saliva is a normal reaction to new dentures and will slowly decrease over the next few
weeks. Deglutition will be necessary to evaluate the excess saliva and patients should be advised
that compulsive rinsing or spitting should be avoided as it is unsettling to the denture bases.

Speech
Owing to the initial feelings of bulk and the accompanying excess of saliva, patient’s speech may
be distorted. This speech distortion is especially evident during the formation of the sibilant sounds.
The fluency of speech may also be affected, that is, the patients' speaking may become
uncoordinated during rapid sensation.
The patient should be encouraged to read about while at home. Speech with reading practice
quickly assumes a natural tone and fluency.

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Eating
Patient education is particularly important when considering denture function. Patients have to be
advised that chewing is not random, but an intentional and selective activity. Their eating skills
must be slowly developed and refined. Initially patients must limit-themselves to soft foods or
crispy foods that are easily communited they should avoid tough, fibrous foods that will overtax the
capacity of their residual ridge. Patients should be instructed to divide the normal food in half and
place each half posteriorly and bilaterally. Placing the food posteriorly, in the area of the 1st molar,
increases the power of masticatory stroke and places the load over the primary stress bearing areas
(i.e.) maxillary tuberosites and mandibular buccal shelf area. Bilateral chewing is also used in
stabilization of the denture bases by distributing the forces of mastication to both sides of the
residual ridges. This counteracts the potential tipping of the denture base. The chewing stroke itself
should be an up and down motion. This helps to minimize lateral thrusts and stabilizes the
mandibular denture base.
Patient education in regard to chewing can increase their diet selection which in turn increases their
degree of oral satisfaction.

Tongue position
The most common complaints of complete denture patients are that of "loose" mandibular denture.
Patients should be educated to the three basic handicaps associated with the mandibular dentures.
1st although the area of the mandibular denture basal seat is approximately l/3rd the area of
maxillary dentine, both the subjected to same occlusal loads and thrusts. 2nd, the mandibular denture
is surrounded lingually as well as buccally by muscles, all of which have a potential for denture
base disruption.
Last and most important, the mandibular denture depends on proper tongue position to maintain
adequate peripheral seal and stability.
The tongue is in intimate contact with the lingual surface of the denture, and the floor of the month
is at a stable and able to resist a gentle push on mandibular incisors.
If on the other hand, the dentist sees the occlusal surfaces of the teeth, the lingual surface of the
denture and the anterior floor of the month, the tongue is in a retracted position. The denture will be
unstable and will be easily dislodged by a gentle push on the mandibular incisors.

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The first step in treatment is to make the patient aware of the importance of tongue position.
Second, demonstrate the proper tongue position and the subsequent increase in denture retention
and stability. The patient must practice opening and closing while the tongue assumes a normal
position.

It is important, for the dentist, as well as for the patient to realize that a tongue position problem
and the patient’s problem. No denture adjustment or relining procedure will correct it.

Maintaining tissue health

There are 3 factors involved in the maintenance of healthy edentulous oral tissues:
A. Adequate tissue rest
B. Proper denture hygiene and
C. The cleansing of oral tissues

A. Adequate tissue rest:

Removing the maxillary and mandibular dentures before sleeping serves 2 purposes:
- It provides a convenient time for soaking the dentures in a cleaning solution.
- It allows oral tissues to rest Adequate rest allows the oral tissues to affect the daily stresses upon
them by denture wearing. Failure to allow the tissue to recover from these forces may result in
increased sources and irritation. Additionally, many patients clench and brux during sleep. These
can be powerful movements that can severely damage the underlying foundation. Removal of one
or both of the dentures will eliminate this potential hazard.

B. Complete denture hygiene

DENTURE CLEANSERS
Patients use a wide variety of agents for cleaning artificial dentures. In approximate order of
preference, these include:
1. Dentifrices
2. Proprietary denture cleansers

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3. Mild detergents
4. House hold cleansers
5. Bleaches and vinegar.
Both immersion and brushing techniques are used with these materials.
The most common commercial denture cleansers use immersion techniques. These cleansers are
marketed in powder and tablet forms. Immersion agent contain
(1) Alkaline compounds
(2) Detergent
(3) Sodium perborate and
(4) Flavouring agents when dissolved in water, sodium perborate decomposes to form an alkaline
peroxide solution. This peroxide solution subsequently releases oxygen, which is reported to loosen
debris via mechanical means.
House hold bleaches can also be used as denture cleansers these are in expensive, safe and as
effective as commercial cleansers. The formula is:
1 table spoon (15 cc) sodium hypochlorite (house hold bleach).
1 teaspoon (4cc) calgon
4 ounces (114cc) water

This cleaning solution should only be used for complete acrylic dentures with resin a) porcelain
teeth. It is not recommended for any prosthesis containing cr-co (a) other metals as the sodium
hypochloride may pit, (or) corrode the metal.
The sodium hypochlorite provides a bleaching action that, when used in the above concentration,
does not affect the color stability of the resin, denture base or teeth. The weak sodium hypochlorite
solution is also an affective germicidal agent Calgon: a water softener provides a detergent action
that effectively softens and loosens food debris.

Patients should be encouraged to thoroughly brush their dentures with a soft brush under running
water after chemical soaking. This ensures that the entire chemical cleaner is removed from the
denture prior to bisection.

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To effectively remove calculus over night soaking with 4 ounces (114 cc) white vinegar is
recommended. The solution of vinegar provides a safe concentration of acetic acid which
decalcifies calculus deposits.

Mechanical cleaning
The use of a brush soap or denture cleaning paste, and water is a very popular method of cleaning
complete denture. Gentle brushing with a soft denture brush and a nonabrasive detergent is an
effective cleaning method especially when combined with over night soaking.

Sonic cleaners
They are relatively new denture accessory. They employ vibratory energy (not ultra sonic energy)
to clean dentures.

Myerr and krol

That sonic action cleaner was effective in removing calculus, cigarette and coffee stains.

Nicholson, Stark and Scott

Demonstrated that the sonic action cleaner and sodium hypochlorite solution were more effective
than sodium hypochlorite solution alone. Cleaning soft lining materials

Certain commercial cleaners cause detrimental changes in the temporary lining materials. The
recommended cleaning procedure for soft temporary lining material is gentle washing under cold
running water with soft cotton. The external surface may be brushes in normal manner. If the
denture is to be lift out over night, it should be stored in plain water with teeth down. The denture
should rest on the teeth, not the denture border, where the weight of the denture could distort the
soft lining material.

C. Tissue hygiene and massage

Gentle brushing a nibbling of the residual ridges with a wash cloth removes plaque and food debris
which can cause or exacerbate areas of local irritation. The best regimen should include denture
brushing and tissue cleansing. The loss of taste perception often associated with older age groups

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and complete denture wearers can be markedly improved by thorough oral hygiene including
tongue cleaning (Langan M.J).

Over the counter denture products

Too often the patients will come into the dental office after having prolonged the weaning of an ill-
fitting denture by home relining, home repairing or excessive use of an adhesive powder or paste.
Dentists must assume the responsibility of educating their patients to the dangers of do-it-yourself
dentistry.

Potential danger of do-it-yourself prosthetics

The findings of means study (J.P.D, 1964) supports the current belief that the do-it-yourself repairs
and relining can induce or perpetuate pathologic changes in the oral tissues.
There are a variety of pathologic changes commonly seen under the home-relined denture. The
most common tissue change is indication and inflammation. Acute reactions range from erythema
to ulceration. If present over a long period of time, this chronic inflammation leads to severe bone
resorption. Palatal petechiae and papillary hyperplasia are common in the palate of such patients.

The open palatal area that is present in many relining pads may contribute to papillomatosis.
If there are rough edges and over extension on the denture periphery after home refitting epulis may
develop. The porous nature and large voids promote staining and increased colonization of
microorganisms, notably Candida albicans.
In addition to the pathologic pressure areas that home relining creates the do – it yourself refitting
may also create a dangerous discrepancy in the position of the denture. Not only do the reline
materials and adherent add thickness to the denture base, thereby increasing vertical dimensions,
but they also can disrupt the proper horizontal relationship of the denture as well. The immediate
effect of the loss of these two important relationships is a malocclusion. The perpetuation of the
situation leads to tissue soreness, inflammation and accelerated bone loss.

Home repairs and self adjustments

There are 4 basic types of denture repairs
- A repair of an anterior tooth or teeth

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- A repair of posterior tooth / teeth
- A repair of fractured denture flange
- Repair of fractured denture base.

Each of these repairs poses a different danger if attempted by the untrained patient. Most of these
types of repairs are unsightly and can result in a malpositioned tooth and anterior prematurities. The
home repaired posterior tooth can result in a premature contact and bilateral disharmony. The most
dangerous repair is the broken denture flange or fractured denture base. This type of home repair
can result in a misalignment of the fragments unequal pressure on the denture foundation and a
malocclusion.
The problem with home adjustment is that patients invariably have difficulty in locating the
offending area and have no Judgment in knowing how much to relieve the denture base. It is the
dentist responsibility to advise the patients that inoperable damage can be done of these
adjustments are attempted outside the dental office.

DENTURE ADHESIVES AND DENTURE CLEANSERS.

INTRODUCTION
The use of denture adhesives is widespread among complete denture patients and yet their
uncontrolled usage is in direct opposition to research findings. Commercially available denture
adhesives are products that have the capacity to enhance treatment outcome.
Denture adhesive is referred to a commercially available non toxic soluble material that is applied
to the tissue surface of the denture to enhance denture retention, stability, performance.

COLOR RED DYE

Preservatives" Sodium borate and methylparaben
Used in powder-silicon dioxide+ calcium stearate to minimize clumping
Used in cream- petrolatum, mineral oil and polyethylene oxide - to bind the material and make their
placement easier.

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COMPOSITION
Main ingredients-
Gelatin, pectin, or gum (older version)
Sodium carboxy methyl cellulose (CMC) or polyvinyl methyl ether malice anhydrate (PVMMA)
present version called OANTRE2 polymers.
Thickening agent - cellulose
Anti bacterial agent- hexachlorophene
Filler- Magnesium oxide
To reduce surface tension- Sodium lauryl sulphate
Flavouring agent- Peppermint oil and menthol
They are supplied in the form of a powder or paste in petrolatum jelly or paraffin oil.

Mechanism of action
The material swells 50-150% by volume in the presence of water, filling in spaces between
prosthesis and tissue. The forces required to pull 2 disks apart is directly proportional to the
viscosity of the liquid between them. Saliva increases the viscosity of the adhesive.
The ingredients containing carboxyl groups such as CMC, PVM - MA produce stickiness through
covalent bonds formed on hydration.

INDICATIONS:
1. When a well made complete dentures do not satisfy a patient’s perceived retention and stability
expectations.
2. Patients who suffer from xerostomia due to side effects, a history of head and neck irradiation
systemic disease or the disease of salivary glands [xerostomia patients must be educated, however
that the adhesives bearing denture will need to be deliberately moistened with water before it is
seated in the otherwise dry month to initiate the actions of the material]
3. Several neurological diseases which can complicate the use of complete dentures.
4. Cerebrovascular accidents (stroke) which may have rendered part of the oral cavity insensitive to
tactile sensation or partially or wholly paralyze oral musculature.

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5. Orofacial dyskinesia which is a prominent side effect of phenothiazine class, tranquillizers
neuroleptics or gastrointestinal medication.
6. Points who have undergone resective surgery for removal of oral neoplasia or those who have
lost intra oral structures and integrity due to trauma.

CONTRAINDICATION:
Denture adhesives are not indicated for retention of improperly fabricated or poorly fitting
prosthesis.

PROPER USE OF ADHESIVES CAN BE DEFINED AS FOLLOWS

- They must never be used on ill fitting denture
- They must be used on fitting surface. Care should be taken into to apply on the borders as
peripheral seal may be affected.
- A thin layer of adhesive is adequate.
- In compromised patients antimicrobials like Nystatin and Clortrimazole can be mix with adhesive
powder / paste.
- The denture must be cleaned daily using a denture cleansers.

PATIENT EDUCATION
It is mandatory that dentists educate denture patients about denture adhesives - i.e. their use abuse
advantages, disadvantages and available choices.
The choice between cream and powder is largely subjective powder formulation as a rule does not
confer the same degree of "hold" nor does their effect last as long in comparison to cream
formulations. However powder

1. Can be used in smaller quantities

2. Are generally easier to clean out of dentures and off tissue and
3. Initial 'hold' for powder and achieved sooner than it is with cream formulations.

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