Is it possible to make predictably good dentures or must I expect denture patients continually on the doorstep? What we require is a system that routinely produces functional and cosmetic dentures, I believe we have this with the BPS technique.

Lots of articles describing the BPS technique are available, for this article I will merely highlight some aspects of denture construction where feel BPS is superior to 'standard/basic' dentures. We can look at this from the typical four visits of denture construction.

Primary Impressions - the old adage an impression is only as good as the tray it's taken with remains true. If primary impressions are poor so will be the special trays hence the denture fit. The Accu Tray system provides good primary impressions - especially critical with lowers, extensions should be drawn on the impressions to ensure the lab produces special trays exactly as required.

Secondary imps and bite - border moulding is very helpful in order to gain functional impressions, again with the lowers if there isn't much ridge, it's got to be a must to try to gain some retention.

Facial support is as much about getting the correct vertical as where we place the teeth. Changing vertical with bite blocks is difficult and time-consuming, changing vertical by turning a screw around is easy and precise, hence we are much likely to get it right.

The pin and the plate set up allows the patient to trace an envelope of movement and for our purposes provide the reproducible retruded position. As clinicians we often feel we have got the lower jaw back, yet so often finished dentures occlude in a postured forward position. Doing the intra-oral gothic arch tracing assures us we are recording the correct bite (at the correct height).

So far in comparison to our 'basic set' we have better impressions, we have accurately built up the face and recorded the correct bite. Already we are constructing the dentures on a much surer foundation and this alone would produce better results but there is more!

Try-in visit - I see a lot of patients who start by complaining about the function of their dentures, but if we can improve the cosmetics as well, we have overdelivered on our promises. Clearly it is this overdelivering of promises that makes happy patients who will want to refer others to us. The information sent to the technician from the second visit in itself should provide a good aesthetic result. I believe that as dentists we should be willing to move the teeth in wax during the try-in visit to get the best cosmetic result possible, obviously with the patient's input all the way along. Many dentists would say Vivodent PE teeth are the gold standard in acrylic teeth and have yet to be superseded. For some cases it is also worth considering porcelain teeth.

Fit visit - Personally I would advise routinely using pressure indicating paste for fit surface adjustments and taking a squash bite and remounting the dentures on an articulator for any small adjustments to the bite. It is important to follow up patients after the fit visit and not to view treatment as finished after fitting the dentures and waiting for the patients to get back to us.

To generalise most patients complaints can be put under one of two headings - 1. Functional: fit and bite; 2. Cosmetic: facial support or tooth related, e.g. position shape/colour of teeth.

BPS is a standardised technique that will improve all of these areas of concern. As dentists we need a system that standardises denture construction and takes out the guesswork. BPS not only does this for us clinicians but also for the laboratory. Using a BPS registered lab is a must, as after taking the time to accurately record all the relevant impressions you must use a lab who knows how to produce an excellent denture from them. Denture construction requires a team approach in which the lab is essential.

Excellent results can be achieved but it takes time, making dentures in time slots of 15 minutes will not produce dentures of quality. It is up to us as dentists to educate patients of the time it takes to make excellent dentures and the cost implications of that time. I have found that patients with denture problems are willing to pay more for treatment when they know it involves more of our time and more expensive materials.

We need to plan out treatment time at our hourly rate and make an allowance for any necessary adjustments visits. Doing so will increase your practice revenue. Complete denture construction can be one of the most rewarding areas of dentistry; many people are self-conscious of their dentures, which are ill fitting and cosmetically poor. Imagine how happy patients are who in the past would not go out to restaurants for fear of their dentures falling out, and after your treatment can eat with confidence. Or how about a patient who would not have their picture taken or dreaded meeting people as the appearance of their teeth was so unsatisfactory, what is it worth for them to have natural looking teeth?

Given time, our confidence and competence as clinicians making dentures will improve dramatically. For the vast majority of patients there is a much better alternative, shouldn't these patients be given the option of a BPS denture?