Doctor & Assistant

Resources.

Office Preferences

We see cases of many shapes and sizes and these are our favorites.

Case Packaging

Our ideal packaging and... some not so ideal ones too.

Materials & SDS

Links and information on the products we use.

Denture Tips

Information on what we like to see when going through the denture process.

Repair Needs

Information on what we need for different repairs.

Since the beginning, one of our main values has been relationships. We pride our selves on building relationships with not only our doctors but their staff as well. Our main concern is your patients and we want to provide the best we can for them by working closely with you. We have compiled a section filled with tips, facts, and suggestions just for doctors and their staff.

Impressions and Model Work

With all of the different impressions and models we receive we have found our favorite methods.

The traditional method of alginate in a metal perforated tray is the most user friendly and consistent technique we work with. Working time is just long enough while mixing but still short and comfortable for the patient.

We accept impressions of any type as long as they are packaged properly in a sealed bag, ziplock bags are great. If you are using a hydrophilic impression material like alginate please wrap the impression in a moist paper towel, wet enough that the whole towel is wet but not so there is excess water in the bag.

We would be happy to pour your models, but if you enjoy doing your own model work, we ask that you please use a yellow stone or something similar in strength.

Impression TIps

When taking an impression keep the patient seated upright, this helps them breathe well and in turn helps the impression material set up a little quicker. Before taking the impression, rinse out the patient’s mouth to help remove little saliva bubbles and other anomalies. A general rule of what we need in an impression is everything, or at least all that you can feasibly get. For orthodontic work we need all of the teeth and the full palate. For dentures and sports guards we need everything, as far into the vestibules as possible.

Model Tips

After taking a beautiful impression, spray it with a disinfectant and let it sit for the recommended time. Rinse it with well with cool water to remove all of the disinfectant and leave a little water in the impression. If you are hand mixing your stone remember to vibrate the bowl of stone to allow bubble to rise and escape the mix. Use your spatula to add a little stone to one side of the impression and let it work it’s way around. Continue to vibrate the impression through this process to remove all of the bubbles possible. Once the teeth are filled in, stack the stone carefully to not trap any bubbles and continue to build a base about half an inch high, a horseshoe base is prone to breaking and leads to inaccuracies.

Case Packaging

An excellent case starts with the impression but can easily be sabotaged if not packaged properly. Be it a model or an impression, there are a few simple steps to ensure we get your case in the best shape possible.

THe Perfectly Packaged Case

He we have the ideal packaging of any case. Clean and simple make for a well filled prescription.

Handwriting is easily legible.
Doctor and Patient name are complete.
Appliance type is written thoroughly.
The case has been disinfected and rinsed, as marked in the check box.
To finish things off the slip is stapled with a single staple through the pull tabs of the bag.
The impressions are well wrapped in damp paper towels to insure a humid environment.

Too Big

Just RIght

Too Small

We know that some offices prefer to do their own model work, but please keep it workable. A gigantic model can be a hassle to work with and a model that is itty bitty is quite fragile and may not leave enough anatomy for us to work with.

We gladly accept model work but please wrap them.

Wrapping a model in a dry paper towel is an easy way to protect the occlusal and prevent chipping and breaking.

This example shows many of the most common errors we see.

Doctor name should not just be an initial.
There is no patient name.
There is not start date and the due date is set to ASAP. Our ASAP may not be yours.
Call me for a prescription is ok but we would like a phone number as well.

This case may have been disinfected but without the boxed being checked we wont know.
There is an abundance of staples and they are through the sealed portion of the bag. This can cause the bag to leak on it’s way to our office among other problems.

Poor Rx

Please use a blue or black pen and write legibly.

With this case the prescription is filled out well , however it was placed inside the bag. This makes the rx wet, contaminated, and thus ruins it.

We appreciate an abundance of information, but if you scratch out a lot please use a new rx, we will gladly give you more at any time.

Poor Packaging

Alginate with out a humid environment will certainly dry out and distort and often pull out of the tray.

NO FISHBOWLS PLEASE. There should be just enough water to wet the paper towels and create a humid environment. Too much water can cause the alginate to swell and distort.

Denture Tips

With dentures being such a long and intense process, we would love to provide advice in person or over the phone, but since you’re here these are our best words of advice.

Don’t skip any steps, it sounds silly but every step along the way is necessary to provide your patient with the best final product possible.

When taking an impression for a final cast, we advise using a medium base VPS such as EXAFLEX Regular Type or something similar.

If you are doing an impression within the baseplate of a wax rim or tooth try-in please do not place it back on the old model.

Wax rims are intentionally left a little large in order for you to contour and mark them to accurately communicate to us proper overjet & overbite and occlusal plane. The most vital landmarks are: Midline, High Lip Line, & Cuspid Eminence.

Wax Rims

Wax rims are a vital stage in creating the perfect denture. Custom baseplates made on a model from a custom tray impression are and essential diagnostic tool for the lab tech to accurately fabricate a denture.

Wax rims should be contoured chair-side in order to determine an optimum occlusal plane, facial contour for the incisors, midline and cuspid eminence.

When wax rims come from the laboratory they are made of soft wax and intentionally oversized so that the doctor can easily mold them.

Steps for adjusting a wax rim

Place the wax rim in the mouth to test initial fit. If there are two, test them individually.
Place the wax in a bowl of warm water to soften the wax, a flame is ill advised as it may over melt the wax or seperate it from the baseplate. If you have a maxillary and mandibular, do the maxillary first.
When only one arch is being done you will need to adjust the occlusal of the rim to create a natural Vertical Dimension of Occlusion, or VDO.
Be sure to mark the main anatomical landmarks: Midline, High Lip Line or Smile Line, and the Cuspid Eminence. Without these you will likely need multiple wax try-in appointments.

Full Denture over Full Denture

Maxillary

Fully seat the wax rim and take note of the occlusal plane, typically this is horizontal to the patient’s eyes, keeping in mind the overall facial features. Cut the occlusal of the wax rim to match the patients natural plane.
Adjust the anterior of the rim so that it contours nicely with the patients lips. This determines the position of the incisors.

Mandibular

Once the maxillary is completed, place both wax rims in the mouth. You made need to adjust the occlusal plane of the mandibular if the maxillary was adjusted greatly.
Have the patient close to the proper VDO. Mark the rims in the posterior for alignment or take a bite registration.
Be sure to mark the main anatomical landmarks: Midline, High Lip-Line or Smile Line, and the Cuspid Eminence.

Repairs

What we need to fix nearly anything

Retainers

Fixed / Soldered

Guards

Flipper

Retainers

Fixed / Soldered

Guards

Flipper

Making a new appliance is always better than a repair

An all new appliance always looks better, fits better, & lasts longer.

Denture Repairs

Please do not use superglue, and encourage your patients to do the same.

Reline

For a reline we recommend a using a polyvinyl impression in the denture that captures all the way into the vestible. This allows us to maintain the current vertical dimensions.

When doing a reline with a partial denture we would like an under/over impression with a polyvinyl on the tissue side and an alginate over the top of the appliance in place.

Full Dentures

To fix a broken denture or to replace a missing tooth please give us all of the pieces the patient provides and a fresh impression of the arch. An opposing arch is always helpful especially if there are occlusal considerations.

Partial Dentures

For any partial repair (including fixing a broken clasp, a saddle repair, and adding a tooth) we need an impression of the appliance in place and an impression of the opposing, especially if there are occlusal considerations.

We do not weld clasps onto metal frame works but if a clasp is necessary we can add a wrought wire clasp if the current design allows.

Everything we use is hand selected

From the temperature of our water to which high quality heat cure denture acrylic we use, everything is refined to perfection to ensure we can provide the best appliances. In an era where severe allergies have been narrowed down to individual chemicals and material science is of great importance, we want to freely offer as much information as we can.