- Email: [email protected]
One Man’s Solution to Dentures
One man's solution to dentures
Kenneth M. Tucker,*
DDS,
and Royal B. Dunkelberg,f
A sawed-in-half billiard ball . . . furnace cem ent . . . liquid solder . . . bone . . . carpet tacks . . . plaster . . . liquid plastic . . . grease . . . w ood screws— put them together and what denture!
have you g o t?
A
By using various combinations o f these elem ents, one man, untrained in dentistry, was able to make his own dentures. H e has worn dentures o f one variety or an other o f his own fashioning for about 40 years. But dental science will out! H e
DD S, Oklahoma City
All patients admitted to this hospital receive an oral examination as a part of their work-up. The patient was wearing crude maxillary and m andibular dentures (Fig. 1). The dentures were pink with a gray metallic strip simulating the labial and buccal surfaces of the teeth. Part of this strip had been scored to denote the anterior teeth. Dark, flat, scored objects, which we later learned to be wood screws, acted as the molars (Fig. 2A). O ral examination revealed an edentu-
now, at the age of 76 years, wears acrylic dentures made by the authors. This man’s story is not one to shake present-day prin ciples o f denture construction and esthet ics or to contribute a new technic to the literature. It m erely conveys some of the humor and pathos the dentist may m eet in his practice. (Som e dentists were not quite so fortunate as the authors in their en counter with this man and, doubtless, to them there was no hum or.)
This is the story of a truly ingenious man, his prosthodontic problems and how these problems were solved. He is 76 years old and was adm itted to the Veterans Ad Fig. I • Patient with complete maxillary and man ministration Hospital, Oklahoma City, for dibular dentures. Note gray metallic strip simulat ing labial and buccal surfaces of teeth the repair of an inguinal hernia.
Tucker and Dunkelberg: SOLUTIONTODENTURES• 655 lous m outh with a normal maxillary ridge and a grossly absorbed mandibular ridge (Fig. 2B). Clinically, the mucosa had a normal color with no abnormal tissue present. The adaptation and oc clusion of the dentures were poor (Fig. 2C, 3). The patient related that he had lost his teeth many years ago and he had made his present dentures himself. He further stated that the dentures he was presently wearing were not the only dentures that he had made. Arrangements were made to photo graph the patient and his dentures and to record his story. T hat story, using his own words where possible, is as follows: “I lost my teeth in 1913, a result of fights with the police in . . . . “I went without teeth until I had a set made while I was in the Army just after World W ar I. I couldn’t wear these and I went without teeth until 1923, when I had a set made at a Dental College in Des Moines, Iowa. I wore these for about a m onth during which time I went back to the school five or six times. Every time I went back the teeth hurt more. I finally got so disgusted that I asked for my money back. I was told that this couldn’t be done as the money had been turned over to the manager. I told the dentist to pre pare to fight me because I wanted some thing out of this. We battled until I was arrested and I got a year in jail. They was working on the teeth and kept them. “About a year later I went to Minne apolis. I had a set made there and these did not fit either. I returned a few times and he ground off all the ‘molders.’ There were no teeth left, just a crevice and these were of no use to me. Again I asked for my money back. He told me that he wasn’t the manager and couldn’t give me back my money. I challenged this man, we fought, and the police came and got me. For this I was put in the workhouse for six months. “From there I went to Sioux City, Iowa, and had a set made and it was the same thing. I wanted to get my money
Fig. 2 • A: Occlusal view of dentures showing wood screws being used as molars. B: Maxillary and mandibular casts showing extreme resorption of mandibular ridge. C: Tissue side of dentures showing poor adaptation and extension back but was told that the manager had the money. I was told that I couldn’t get it and so I fought again. They were work ing on the teeth at the time and kept them. “The next set was made at a Dental College in Omaha, Nebraska. They didn’t fit either and the same thing happened. “The next set was made in Winona, Minnesota. I went in and asked the den tist if he could make me a set that I could use and he said, ‘You bet I can,’ and to get right in the chair. H e made them and I got them the next day. He gave me a dollar and told me to go down and get a steak. I went down and got a steak and then a guy came along with some whisky. We drank the whisky and I lost the teeth. This was the only set that I could eat
656-J. AMER. DENT. ASSN.: Vol. 71, Sept. 1965 with and I lost them after eating with them one time. “I then thought that I could make some myself. This was about 1925 or 26 and I was in O m aha at the time. I started to pick up material that I thought I could use to make a plate. I decided I could make a plate out of a billiard ball. So, I went out and got a billiard ball, but some guy seen me get it. I was arrested and got six months in the county jail, but I was allowed to keep the ball. The judge said that I had paid for it. “I cut the ball in two with a hack saw and chopped the inside out to fit my mouth. I took an impression of my mouth and ‘turned it’ with furnace cement. I finished chipping the inside of the ball out until it looked like the mold and then carved the teeth out. This didn’t fit so good, so I took another impression ‘turned it’ with furnace cement and made a model. I filled the billiard ball plate with liquid solder and put it on the furnace cement. “One half of the billiard ball was used for the upper plate and the other half was used for the lower. I chipped the in side of the ball out with a file that I picked up. I had ground it (the file) on the sidewalk to make a point on it. “T he billiard ball teeth wore off in about six months. I sawed the back teeth off and put bone in, but it wore off. Then I put carpet tacks in the ‘molders’ and soldered them in. The tacks never did
Fig. 3 • Dentures occluded
taste right and they left a ‘whang’ in my mouth. “The next set I made out of liquid solder. I took a piece of paper, cut it out to somewhat fit my mouth and put some plaster on it. When it hardened I trimmed it up to fit my mouth, then I took more plaster and took an impression of my mouth. I trimmed this up until it was workable. I put furnace cement in the plaster impression and then painted liquid solder on the furnace cement mold. I built up the liquid solder, painting it on with a small brush. This was in Omaha in 1926. “I m ade six sets of teeth this way. The back teeth m ade out of liquid solder wore out and I had to make new plates until I got on to the screws. The set I wear now was made 25 years ago when I first used screws. “When liquid plastic came in I painted the plates with this. As the plastic wears off I paint on new. The top plate has got heavy in the last four-five years because of the liquid plastic I keep adding. The plate is so heavy I can’t do heavy chew ing. I don’t like to use powder or any ad hesive to keep the plate in so I keep add ing plastic. “W hen I put the solder on I let it dry for 72 hours, then I boil the plate in grease for 30 minutes. Any kind of grease will do. Boiling shrinks it and I have to add more solder on and boil it again. The solder tastes bad and has a poison in it. Boiling gets the taste and the poison out of the liquid solder. “I wear the teeth all the time and take them out only to clean them. I clean my teeth with soda. (H e then said that a well-known denture cleanser was the best thing to use to clean plates but he couldn’t use this because ‘it makes my stomach sick.’) “My m outh never gets sore except when I don’t clean them. W hen I am not drinking I clean them every day but when I am drinking I may leave them in my mouth for months. I can eat anything except tough foods.”
Tucker and Dunkelberg: SOLUTIONTODENTURES•657 T he patient was asked where he had learned to make a dental impression. H ad he ever worked with a dentist or a tech nician while he was in jail, or at any other time? His answer was: “The idea just came to me. I picked it up on my own.” He further stated that he was barred from school in the third grade because he knew more than the teacher. This was the extent of his formal education. Before fabrication of the acrylic den tures, the old dentures were weighed. The maxillary denture weighed 2 1 J4 dwt., and the weight of the m andibular denture was 14J/2 dwt. The new dentures weighed 13-1/6 dwt. and 10% dwt. respectively. The posterior extension of the old den ture ended approximately 4 mm. short of the ham ular notch areas and approxi mately 7 mm. short of the flexion line in the fovea palatinus area. The interocclusal distance of the old dentures was approximately 5 mm. Acrylic teeth were used in the new dentures with zero degree posterior teeth. These teeth were arranged on a flat plane as advocated by Hardy 1 and Jones .2 Bal ancing ramps were made by tipping the mandibular second molars. The maxillary second molars were taken out of occlu sion, and the dentures were balanced at the insertion appointment. T he patient said that he liked his new dentures much better than the old ones. H e also said that he felt as if he did not have anything in his mouth. One interest
ing comment was: “They don’t hit no where.” We have assumed that the occlusion of the posterior teeth was simul taneous and not a single area as seen in the home-made dentures. The patient was seen 24 hours post insertion. Two small irritated areas were noted, but he did not want these corrected because he feared that the dentures would be ruined. The stabilization and retention (especially the m andibular) were good. Phonetics also was good. The patient reported that he had worn the teeth continuously, taking them out only to clean them. He reported that he had eaten crisp bacon, toast, mashed po tatoes, green beans and com bread. The patient was seen one week later for adjustment. Two sore spots had devel oped, both on the right side of the m an dibular denture. One was opposite the crest of the ridge at the mental foramen area and the other opposite the flange at the distobuccal angle. He has used the dentures for three months now and, so far, he hasn’t fought either of us. 921 Northeast T hirteenth Street The authors wish to thank David H ilb ran d , chief, m edi cal illustration, Veterans A dm inistration Hospital, O kla homa City, to r preparation o f the photographs. *Staff dentist, Veterans A dm inistration H ospital, O kla homa City. fC hief, dental service, Veterans Adm inistration Hos pital,O klahom a City. 1. Hardy, I. R. Technique for use o f non-anatomic acrylic posterior teeth. D. Digest 48:562 Dec. 1942. 2. Jones, Phillip M. Efficient, nontraumatic posterior occlusion. JAD A 64:345 March 1962.
Kenneth M. Tucker,*
DDS,
and Royal B. Dunkelberg,f
A sawed-in-half billiard ball . . . furnace cem ent . . . liquid solder . . . bone . . . carpet tacks . . . plaster . . . liquid plastic . . . grease . . . w ood screws— put them together and what denture!
have you g o t?
A
By using various combinations o f these elem ents, one man, untrained in dentistry, was able to make his own dentures. H e has worn dentures o f one variety or an other o f his own fashioning for about 40 years. But dental science will out! H e
DD S, Oklahoma City
All patients admitted to this hospital receive an oral examination as a part of their work-up. The patient was wearing crude maxillary and m andibular dentures (Fig. 1). The dentures were pink with a gray metallic strip simulating the labial and buccal surfaces of the teeth. Part of this strip had been scored to denote the anterior teeth. Dark, flat, scored objects, which we later learned to be wood screws, acted as the molars (Fig. 2A). O ral examination revealed an edentu-
now, at the age of 76 years, wears acrylic dentures made by the authors. This man’s story is not one to shake present-day prin ciples o f denture construction and esthet ics or to contribute a new technic to the literature. It m erely conveys some of the humor and pathos the dentist may m eet in his practice. (Som e dentists were not quite so fortunate as the authors in their en counter with this man and, doubtless, to them there was no hum or.)
This is the story of a truly ingenious man, his prosthodontic problems and how these problems were solved. He is 76 years old and was adm itted to the Veterans Ad Fig. I • Patient with complete maxillary and man ministration Hospital, Oklahoma City, for dibular dentures. Note gray metallic strip simulat ing labial and buccal surfaces of teeth the repair of an inguinal hernia.
Tucker and Dunkelberg: SOLUTIONTODENTURES• 655 lous m outh with a normal maxillary ridge and a grossly absorbed mandibular ridge (Fig. 2B). Clinically, the mucosa had a normal color with no abnormal tissue present. The adaptation and oc clusion of the dentures were poor (Fig. 2C, 3). The patient related that he had lost his teeth many years ago and he had made his present dentures himself. He further stated that the dentures he was presently wearing were not the only dentures that he had made. Arrangements were made to photo graph the patient and his dentures and to record his story. T hat story, using his own words where possible, is as follows: “I lost my teeth in 1913, a result of fights with the police in . . . . “I went without teeth until I had a set made while I was in the Army just after World W ar I. I couldn’t wear these and I went without teeth until 1923, when I had a set made at a Dental College in Des Moines, Iowa. I wore these for about a m onth during which time I went back to the school five or six times. Every time I went back the teeth hurt more. I finally got so disgusted that I asked for my money back. I was told that this couldn’t be done as the money had been turned over to the manager. I told the dentist to pre pare to fight me because I wanted some thing out of this. We battled until I was arrested and I got a year in jail. They was working on the teeth and kept them. “About a year later I went to Minne apolis. I had a set made there and these did not fit either. I returned a few times and he ground off all the ‘molders.’ There were no teeth left, just a crevice and these were of no use to me. Again I asked for my money back. He told me that he wasn’t the manager and couldn’t give me back my money. I challenged this man, we fought, and the police came and got me. For this I was put in the workhouse for six months. “From there I went to Sioux City, Iowa, and had a set made and it was the same thing. I wanted to get my money
Fig. 2 • A: Occlusal view of dentures showing wood screws being used as molars. B: Maxillary and mandibular casts showing extreme resorption of mandibular ridge. C: Tissue side of dentures showing poor adaptation and extension back but was told that the manager had the money. I was told that I couldn’t get it and so I fought again. They were work ing on the teeth at the time and kept them. “The next set was made at a Dental College in Omaha, Nebraska. They didn’t fit either and the same thing happened. “The next set was made in Winona, Minnesota. I went in and asked the den tist if he could make me a set that I could use and he said, ‘You bet I can,’ and to get right in the chair. H e made them and I got them the next day. He gave me a dollar and told me to go down and get a steak. I went down and got a steak and then a guy came along with some whisky. We drank the whisky and I lost the teeth. This was the only set that I could eat
656-J. AMER. DENT. ASSN.: Vol. 71, Sept. 1965 with and I lost them after eating with them one time. “I then thought that I could make some myself. This was about 1925 or 26 and I was in O m aha at the time. I started to pick up material that I thought I could use to make a plate. I decided I could make a plate out of a billiard ball. So, I went out and got a billiard ball, but some guy seen me get it. I was arrested and got six months in the county jail, but I was allowed to keep the ball. The judge said that I had paid for it. “I cut the ball in two with a hack saw and chopped the inside out to fit my mouth. I took an impression of my mouth and ‘turned it’ with furnace cement. I finished chipping the inside of the ball out until it looked like the mold and then carved the teeth out. This didn’t fit so good, so I took another impression ‘turned it’ with furnace cement and made a model. I filled the billiard ball plate with liquid solder and put it on the furnace cement. “One half of the billiard ball was used for the upper plate and the other half was used for the lower. I chipped the in side of the ball out with a file that I picked up. I had ground it (the file) on the sidewalk to make a point on it. “T he billiard ball teeth wore off in about six months. I sawed the back teeth off and put bone in, but it wore off. Then I put carpet tacks in the ‘molders’ and soldered them in. The tacks never did
Fig. 3 • Dentures occluded
taste right and they left a ‘whang’ in my mouth. “The next set I made out of liquid solder. I took a piece of paper, cut it out to somewhat fit my mouth and put some plaster on it. When it hardened I trimmed it up to fit my mouth, then I took more plaster and took an impression of my mouth. I trimmed this up until it was workable. I put furnace cement in the plaster impression and then painted liquid solder on the furnace cement mold. I built up the liquid solder, painting it on with a small brush. This was in Omaha in 1926. “I m ade six sets of teeth this way. The back teeth m ade out of liquid solder wore out and I had to make new plates until I got on to the screws. The set I wear now was made 25 years ago when I first used screws. “When liquid plastic came in I painted the plates with this. As the plastic wears off I paint on new. The top plate has got heavy in the last four-five years because of the liquid plastic I keep adding. The plate is so heavy I can’t do heavy chew ing. I don’t like to use powder or any ad hesive to keep the plate in so I keep add ing plastic. “W hen I put the solder on I let it dry for 72 hours, then I boil the plate in grease for 30 minutes. Any kind of grease will do. Boiling shrinks it and I have to add more solder on and boil it again. The solder tastes bad and has a poison in it. Boiling gets the taste and the poison out of the liquid solder. “I wear the teeth all the time and take them out only to clean them. I clean my teeth with soda. (H e then said that a well-known denture cleanser was the best thing to use to clean plates but he couldn’t use this because ‘it makes my stomach sick.’) “My m outh never gets sore except when I don’t clean them. W hen I am not drinking I clean them every day but when I am drinking I may leave them in my mouth for months. I can eat anything except tough foods.”
Tucker and Dunkelberg: SOLUTIONTODENTURES•657 T he patient was asked where he had learned to make a dental impression. H ad he ever worked with a dentist or a tech nician while he was in jail, or at any other time? His answer was: “The idea just came to me. I picked it up on my own.” He further stated that he was barred from school in the third grade because he knew more than the teacher. This was the extent of his formal education. Before fabrication of the acrylic den tures, the old dentures were weighed. The maxillary denture weighed 2 1 J4 dwt., and the weight of the m andibular denture was 14J/2 dwt. The new dentures weighed 13-1/6 dwt. and 10% dwt. respectively. The posterior extension of the old den ture ended approximately 4 mm. short of the ham ular notch areas and approxi mately 7 mm. short of the flexion line in the fovea palatinus area. The interocclusal distance of the old dentures was approximately 5 mm. Acrylic teeth were used in the new dentures with zero degree posterior teeth. These teeth were arranged on a flat plane as advocated by Hardy 1 and Jones .2 Bal ancing ramps were made by tipping the mandibular second molars. The maxillary second molars were taken out of occlu sion, and the dentures were balanced at the insertion appointment. T he patient said that he liked his new dentures much better than the old ones. H e also said that he felt as if he did not have anything in his mouth. One interest
ing comment was: “They don’t hit no where.” We have assumed that the occlusion of the posterior teeth was simul taneous and not a single area as seen in the home-made dentures. The patient was seen 24 hours post insertion. Two small irritated areas were noted, but he did not want these corrected because he feared that the dentures would be ruined. The stabilization and retention (especially the m andibular) were good. Phonetics also was good. The patient reported that he had worn the teeth continuously, taking them out only to clean them. He reported that he had eaten crisp bacon, toast, mashed po tatoes, green beans and com bread. The patient was seen one week later for adjustment. Two sore spots had devel oped, both on the right side of the m an dibular denture. One was opposite the crest of the ridge at the mental foramen area and the other opposite the flange at the distobuccal angle. He has used the dentures for three months now and, so far, he hasn’t fought either of us. 921 Northeast T hirteenth Street The authors wish to thank David H ilb ran d , chief, m edi cal illustration, Veterans A dm inistration Hospital, O kla homa City, to r preparation o f the photographs. *Staff dentist, Veterans A dm inistration H ospital, O kla homa City. fC hief, dental service, Veterans Adm inistration Hos pital,O klahom a City. 1. Hardy, I. R. Technique for use o f non-anatomic acrylic posterior teeth. D. Digest 48:562 Dec. 1942. 2. Jones, Phillip M. Efficient, nontraumatic posterior occlusion. JAD A 64:345 March 1962.