4. Excursive contacts

If the canine relationship is not acceptable, and will be changed, excursive contacts will change as well. Nonetheless, the presence of working and balancing contacts should be evaluated both visually and with articulating paper intraorally, and then compared to the contacts on the articulator, to verify the accuracy of the articulator settings. If the

contacts appear noticeably different (check the amount of space between posterior teeth in excursions) or the markings are different between the intraoral and articulator situations, the protrusive record should be remade, and the condylar inclination reset.

5. Esthetics

Check the amount of the incisal display, the harmony of the maxillary teeth with the smile line, the accuracy of the midline, and the cant of the occlusal plane. Check for proper soft tissue profile, contours, lip support, display of the vermilion border, and correct nasolabial angle. Ask the patient for their opinion of the appearance, prior to voicing your opinion so that you avoid biasing the patient. It can be helpful to have a family member or friend attend the wax try-in to provide a third opinion on appearance.

If you or the patient have reservations about the appearance, the problem should be clearly resolved prior to final processing. Never attempt to persuade a patient out of a concern they may have – the problem will be yours later if the patient still does not like the appearance. It is helpful to the technician if the dentist can make changes, but major changes can be delegated to the lab, if necessary.

6. Phonetics

Phonetics can be assessed more readily at the try-in stage since denture teeth have replaced the relatively bulky occlusion rims. Patients will normally find speaking more comfortable at this appointment. Watch for lisping. It can be caused by non-uniform overjet of the anterior teeth, diastemas between teeth or faulty palatal contours.

Sometimes a crowded tongue space can adversely affect phonetics. If the initial wax tryin has a diastema between anterior and posterior teeth due to canine malrelationship, this can allow for the escape of air, and produce altered phonetics. In most instances phonetics can not be corrected until the final wax tryin, when the diastemas should be eliminated. If patients have not worn dentures for an extended period, or if the new denture will have dramatic changes in contour, tooth position and/or vertical dimension, the patient should be allowed to read a passage from a magazine out loud for 5 minutes to allow them time to assess phonetics and comfort.

Sibilant sounds (‘S’, ‘Z’‘T’ ‘CH’ ‘SH’, ‘sixty-six’, ‘Mississippi’) - upper and lower incisors should approach end to end relationship

Fricative sounds (F, V, ‘Fifty-Five’ , ask patient to count from 50 to 60) - upper incisal edges should just touch the posterior one third of the lower lip

7. Denture base contours

Denture base contours can affect phonetics, comfort and retention. In general, the denture bases should not be convex in shape.

Remove excess wax to provide room for tongue if you note the patient struggling with phonetics, or noting that they do not have enough tongue space. Ensure that the denture base is not unduly thick or thin. Excess bulk will impair comfort, and a base that is too thin will be structurally weakened.