Ann Westmore: Is the growing reluctance of many dentists to make dentures, a result of feeling they are not skilled enough, or an unwillingness to remove all the teeth?

Owen Crombie: It’s a combination of a number of people lacking the skills to do it well, because it’s one of those areas where art and science come very strongly together, together with a large amount of psychology. As I frequently tell people, the organ that holds a denture in, is the one between their ears.

Once you’ve got that through their head, the whole thing will proceed reasonably well in most cases. But it’s an area where there is very little real objectivity on whether a denture should or shouldn’t work. You can have a denture that fulfils every criterion that you were ever told about denture construction, but it just doesn’t suit a person. So you sit down and listen to them carefully and make a denture that defies all knowledge of dental construction and they walk away happily. The trouble with doing that is that in the same time it takes you to make the denture you can make a series of crowns and so on. You can have a much easier life without having people telling you that the last four dentures they had from a mechanic were perfect, how come this one isn’t. It doesn’t come as welcome news that other reasons come into play.

Don Dalley: It’s very time consuming.

John Hales: When you make a denture for a patient, you’re with them for a quite considerable time and you get to know patients well. I adopted the approach that if they liked you, they would probably like the denture you made. However I never forgot a precept quoted by Jack Isaacs from Red Cliffs. He said that a full lower denture is a little better than nothing, but not much. You wouldn’t agree with that Professor Atkinson, would you?

Henry Atkinson: I agree with a lot that has been said. But there are two complete stages in the preparation of a denture. The one you’ve been talking about is the clinical stage. That requires a great deal of knowledge and skill. The other is the technical and mechanical stage.

Going back in time a bit, when I came here in 1953, every single person on the staff of the Department acted as their own mechanic. There wasn’t a mechanic in the place. It took me about five years to get the message across that, as soon as we had technicians available in the new building, they would be making the dentures for the students. It takes a long, long time to make changes of that kind. And this is a change I think we had to make because we had to differentiate completely what I do as a dentist in the surgery from what you do as a technician in the laboratory. They are two completely separate jobs.

Owen Crombie: When I was a student, one of the first dentures we made from go to whoa was on an imaginary patient using chunks of plaster. The next one was on a real patient, who came back with real complaints. The third denture we made, we were allowed to experience the joy of trying to describe to a technician what we would like done.

If you chanced to speak to the technician they would sometimes grumble that the teaching staff had told you to do the wrong thing. So you ended up with this ongoing friction. The easiest thing for the dentist who’d been released into the wild afterwards was to say, it’s all too hard. Leave it to the mechanic down the road. Sometimes, the dentist would even start making the denture but when it needed adjustment, they’d send people back to the technician.

Henry Atkinson: That’s true enough. But what we were trying to do was to train clinicians, not technicians.

Jeremy Graham: I remember with the exam. Part of the marking was looking at our instructions to the technician, checking on what we asked them to do. That was a tiny bit stressful. Now I’m even making full uppers and lowers in nursing homes.

John Rasmussen: In the final analysis, there were lots of times when I had to go and reset teeth and do all that, and give it back to the technician and say, don’t mess it up. I do a lot with the wax models. Unfortunately it’s becoming a lost art.

When I first got through, some of those old dentists were absolute wizards. They did so many, and some of them were very bright people. They just knew everything as an art form and they were very good at it. I still love it.

Witness to the History of Australian Medicine