 Hello everyone, welcome back to another session in dentistry and more. Today's topic in prosthotics is mental attitude of complete denture patients. So a complete denture patient's psychology will be of very different like the other patients who was to a dentist for dental treatment because the patient has no teeth. He is going to have a complete artificial set of dentures. So how's classified the patients into basically four categories that is class one, class two, class three and class four. They are the first group philosophical then exacting, historical then indifferent. And also there is one more classification that is cooperative and uncooperative. So in cooperative we have apprehensive. So apprehensive further divided into anxious, frightened, obsessive or exacting, chronic complainers and self-conscious people. Okay so these are the classification of complete denture patient. So we'll start with the first group that is philosophical. They are the best people, the best patients to deal with. They present themselves prior to the extraction of their teeth. They have no experience in wearing denture and they do not anticipate any special difficulties even though they don't have any previous denture wearing experience. Okay this type of patients can be described as very easygoing, congenial and they are mentally well-adjusted, cooperative and confident of the dentist. So they are very easy to manage, they're very cooperative, they have full confidence in the dentist. The second category that is exacting. So this type of patients are precise and they have average intelligence, they are very concerned people and they usually dissatisfied by their previous treatment. Okay so they are not happy with the previous dentist because they start complaining about the previous dentist and they do not have the confidence with the present dentist also. So it is very difficult to satisfy these people but once they are satisfied they become the supporters to the dentist. So exacting group is very difficult to get satisfied but once they are satisfied they will become very cooperative of the dentist. The third group is historical. Historical means this type of patient does not want to have any treatment done. So they come out of compulsion from their relatives or friends or from any other people and they have a highly negative attitude to the dentist and the treatment. So they are very very difficult to manage. Okay because they have no desire to get the treatment done they came to the clinic just because of the compulsion because their parents says their relatives their friends or any such people. Okay they came to the clinic because of just because they are being forced. Okay that is why they are very difficult to manage and the class 4 is indifferent. So this type of patients are not concerned about their appearance and they feel very little or no necessity for teeth for mastication. They are least bothered people. Okay so hence they are uncooperative and will hardly try to become accustomed to the denture. Okay even we provide them a denture they won't wear it because they don't feel to use it for mastication or for an aesthetic purpose. So they will not maintain the denture properly and do not appreciate the effort and skill of the dentist. Okay that is indifferent people. So these are the four groups, philosophical, exacting, historical and indifferent. So philosophical are the best group of patients whereas historical is very difficult to manage. So next thing we should think about the prognosis of this four group. So the philosophical group they accept dentist judgment and instructions and they have the excellent to best prognosis whereas the exacting group they are methodical and demanding. Ask a lot of questions and they have best to good prognosis. Historical having good to poor prognosis because they are emotionally unfit. They are never happy. And the last one indifferent group they doesn't care about the dental treatment and gives up very easily. We can say they will be good to poor prognosis. So the next classification we have cooperative and uncooperative. So cooperative means these patients represent the optimum group. They may or may not recognize the need for denture but they are very open-minded and are amenable to suggestion. So procedure can be easily explained and they become fully cooperative. So apprehensive patients okay so even though these patients realize the need for denture they have some irrational problem which cannot be overcome by ordinary explanation. So the approach to all of these patients is to talk with them and to make them speak out their thoughts about the denture. So again apprehensive patients can be further classified as anxious, frightened, obsessive, chronic complainers and self-conscious people. So anxious people so these patients are anxious and upset about the uncertainties of wearing denture. They often put themselves into a neurotic state. In extreme and rare cases they may be psychotic. So the second group is frightened group. They fear that they will not be able to wear the teeth. They may fear that the teeth will not look well and extreme cases should be referred to a psychiatrist. So third group obsessive or exacting. These patients are of exacting nature and are accustomed to giving directions to others. And the next group is chronic complainers. So they are a group of people who are habituated, fault-finding and dissatisfied. So it is best to have an understanding with such patients before the work starts. And the next group is self-conscious people. So it is wise to give overt reassurance to the self-conscious patient and permit participation in the reconstruction as far as feasible in order to establish some responsibility in the result. Okay, so that is the various categories of apprehensive patient. And the last one is uncorporative patient. So this type of patients present themselves usually upon being urgent by relative and friends. They does not feel for denture although the need exists. Their general attitude is negative. So most of the cases and attempt to make dentures for these individuals is a waste of time. So in this case dentists must collect information about the patient habits, diets, past dental history and the physical characteristics. So the expectation of the patient should be taken into consideration to achieve a patient satisfaction. Okay, so this small topic highlighting the mental attitude of complete denture patient. So we have four types, philosophical, exacting, historical and individual.