Does anyone follow up annually with their denture patients?

It is our SOP to schedule annual recare visits with our complete denture patients to perform oral cancer exams, evaluate their dentures for wear and fit, and to continue discussions about upgrading to implant restorations. Most of our denture patients appreciate this service, and it seems like we get much better life cycles of our complete dentures than the typical 5-7 years, but we reline or rebase approximately every 3-4 years, depending on the patient.

Every once in a while, we get a patient who has for one reason or another decided not to let us know if they've had problems with our dentures that we might have been able to remedy.

Yesterday, we had one of these... The patient told my office manager when she called to see why she had deliberately not kept her appointment that had been confirmed, "I will not ever be back to that office! I hope the doctor liked spending my hard-earned money for these dentures that I have never been able to wear. The teeth are so flat that I can't chew!"

Now, for a little history.... The patient presented with a heavily worn set of 40+ year-old dentures with very poor ridges. Her complaint was that her maxillary denture tooth had broken, Many of her posterior teeth were missing from the denture, and she had, of course, porcelain denture teeth with a pseudo-class III occlusion. There was no option except for new denture therapy, which she acknowledged an accepted.

The denture process went remarkably well, and the patient approved the occlusal scheme and esthetic set-up in the presence of her daughter. Condylar inclinations were 0 degrees bilaterally, and she had a "loose centric," meaning that she closed all over the place without gentle guidance. Therefore, flat-plane teeth were absolutely indicated. The dentures were stable and and comfortable under function in all directions. The patient came back for her 24-hour follow-up only, during which time only minor adjustments to the mandibular anterior lingual flange were needed. She stated that she was pleased with her new dentures at that visit, but we have not seen her since.

I'm just wondering how you guys deal with situations like this.... My office manager attempted gracefully to get the patient in for me to evaluate her issues, but she is so irate that this is impossible. Fortunately, this is very atypical in my practice, but one disgruntled patient is too many for me to sleep well.

Thank you.

Here are photos of the completed case described....

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