Ethics & Law · patient case question
What is the MOST important thing to assess first?
Patient case: Fifth set of dentures in fifteen years
Patient: 84-year-old man, complete denture wearer.
Chief complaint: I just do not like these dentures. I want the bite adjusted.
History: Four sets of complete dentures made over the past fifteen years, each by a different dentist. He cannot say specifically what is wrong with the current set.
Findings: Retention and stability are good. Borders are correctly extended. Occlusion is balanced with even bilateral contacts. Vertical dimension appears appropriate. No mucosal pathology.
Show answer and explanation
Correct answer: A. His expectations and psychological adaptation
- A. CORRECT. This is the classic exacting or philosophical patient in House's classification. Four prostheses in fifteen years with good retention and no demonstrable technical fault means the problem is unlikely to be mechanical. Explore what specifically he dislikes, what he expects a denture to do, and whether that is achievable. A fifth remake without this conversation fails identically.
- B. Vertical dimension deserves evaluation, but nothing in the findings suggests it is at fault.
- C. Ridge form informs prognosis but does not explain dissatisfaction with a well-fitting prosthesis.
- D. Base extension is part of the technical check, and it is already reported as correct.