Meeting report for February 2019
The fifth meeting of the 2018/ 2019 session, the Presidential Address was held in Lecture Theatre 2 of GDH on Tuesday 19th February 2019 commencing at 7pm.
Apologies were received from seven members
The minutes of the previous meeting, published online were approved.
The President, Mr Roddy Black, welcomed the members and guests to the meeting.
He then gave his Presidential Address entitled “Dentures – the whole tooth and nothing but the tooth”, He started by explaining to the audience how he decided on the subject of his address. He described his career to date in both General Practice, and his role in GDH seeing patients that require specialist treatment following surgery or radiotherapy for head and neck cancer, trauma, hypodontia, maintaining implant restored dentition and cases deemed not suitable for treatment in general practice. His workload comprises simple cases / implant retained dentures and more complex cases/ implant retained dentures with bars or obturator based dentures.
Mr Black then explained that he was going to discuss complete dentures past, present and future. He started by showing the audience examples of dentures made in the ancient past, those made by the Egyptians and Etruscans, which were constructed with denture teeth composed of bone and fixed in place with wires. He then described the highlights in denture construction to the present day, including when impression materials were introduced. He described where the materials for denture teeth were obtained (battlefields from dead combatants, people selling their teeth for revenue and obtaining them from enslaved people) and described the dentures constructed for George Washington.
Present Day dentures still use techniques that have been in place for a hundred years (e.g. impression compound was first used 150 years ago) and laboratory techniques have been adjusted but not changed much in 100 years.
He then posed the question: Is edentulousness a disease? This question was first asked by Douglas Atwood in 1971. It is still not clear why some people get more bone resorption than others. He discussed causes of tooth loss which not only include obvious causes of tooth loss (caries, periodontal disease and trauma) but also includes that caused by dentists.
The rate of edentulousness is decreasing (ADH Survey 1972 – 2008, Edentulousness has decreased from 90% to 40 % in the over 65 year olds and is projected to decrease to 5% in 2028) however with an increase in life expectancy we also have an ageing population with a projected 3 million people who will be edentulous in 2030. The teaching of Complete Dentures is changing, with competing demands on the undergraduate curriculum the number of hours spent teaching undergraduates the skills of prosthodontics is decreasing. In many places the provision of dentures is practiced so few times that it is considered a specialist skill. (An investigation of complete denture teaching in the UK Part 1 & Part 2: Weider et al, BDJ 2013).
Psychological factors especially a good relationship between the dentist and the patient are more important than prosthetic factors for a positive outcome (Facts and Fallacies: An evidence Base fro Complete Dentures: Carlsson, G. E., Dental Update 2017: Vol 33. No.3).
Mr Black finished his talk by discussing changes that may occur in the future: Ivoclar Digital – cad cam milling of blocks of acrylic; Formlab 3D printing. The milling of blocks avoids polymerisation shrinkage and the aesthetics of milled acrylic is improving. Intra-oral scanning of ridges and sulci is still challenging but scanning impression surfaces is giving reliable results.
He concluded by informing the audience that in his opinion Complete Dentures are still going to be the mainstay of treatment for the vast majority of patients and teaching of this should remain part of the undergraduate curriculum.
Mr Black was happy to answer questions.
Mr Robbie Thomson proposed the vote of thanks and thanked the speaker for an extremely interesting talk which both entertained and educated the audience. He then asked the audience to thank the speaker in the usual manner.
Under AOCB the President reminded members that to get CPD for the meetings they have to sign in giving their contact email address, without this CPD certificates cannot be sent out. An email will be sent out following the meeting and members were asked to follow the instructions contained in to generate individual CPD certificates. He asked the members to remember not to sign up at the last minute as booking closed at 4pm.
He asked that any member wishing to propose another member for Honorary Membership status to contact the Secretary or any of the Council members with their nominee.
He asked anyone wishing to stand for the Council to let the Secretary know.
He then informed the audience that the Annual Dinner will be held on Saturday 23rd February 2019 in the RCPS Glasgow. The cost will be £65. Dress code: Black Tie. The proceedings of the raffle are going to the Prince and Princess of Wales Hospice.
The next meeting is on Tuesday 19th March 2019 and is the AGM and Members Night. Professor Bridget Johnston will be giving an address to the Society entitled ‘Interface between oral care and end of life care – why is it important?’