Five things you should know about dentures

The following article appears at http://rdh.pennnet.com/display_article/298176/56/ARTCL/none/none/5-things-you-should-know-about-dentures/

by Clare Van Sant, RDH, BS

A thorough cleaning of their dentures may rate low on the priority list of some denture patients. For these patients, a quick brushing and occasional five-minute soak might be the extent of their denture care. Since in many cases poor oral hygiene is a contributing factor to their tooth loss in the first place, convincing these patients to adopt a more stringent daily cleaning routine may be an uphill battle.

Another major challenge with this population is motivating them to visit the dental office for routine recall appointments. One report indicates that only 19 percent of denture wearers remember their dentist’s instruction to come back for regular checkups. How can dental hygienists, who recognize the importance of daily disinfecting dentures and routine professional evaluations, help denture patients understand the importance of both regular office visits and everyday at-home care?

The answer may be as simple as sharing a few important facts. We know some patients are hard to motivate and may be resistant to change; however, sound clinical evidence can be a powerful influence for some people. Here are some lesser-known facts about dentures that any dental professional can use to help motivate patients to manage their dentures.

• Partial and full acrylic dentures have surface pores -

To the eye, the acrylic surface of a denture appears solid and unbroken, but under a microscope, pockmarks are revealed. What does this mean to denture patients? A quick brushing every day may not be enough to thoroughly clean the denture. Even a very thorough brushing may not be sufficient to reach bacteria harbored in microscopic crevices. A denture brush and foaming toothpaste simply may not penetrate the many hiding places that microbes find in a denture surface.

Some might wonder if this is really a cause for concern. After all, everyone’s mouth is filled with germs, thus we get morning breath. But research has isolated Staphylococcus aureus, Streptococcus mutans, Klebsiella pneumoniae, Escherichia coli, and hundreds of other garden-variety germs in acrylic dentures. Keep in mind that while our mouths have the benefit of the body’s immune system, acrylic denture material has no such germ-fighting properties, so bacteria can easily reproduce within the denture.

From the dental hygienist’s point of view, one of the most important reasons patients should control denture bacteria is to help prevent unnecessary exposure to microbes that could cause oral and systemic disease. But denture bacteria can also have an effect on one of the biggest everyday problems patients are motivated by - bad breath. Eighty-seven percent of denture wearers report that malodor is a major concern. Because the body’s scent receptors become accustomed to a smell they are exposed to frequently, patients rightly fear that they may not be able to detect odor coming from their dentures. Dental hygienists can help patients manage their malodor and exposure to microbes by educating them on the effectiveness of overnight soaking in reducing odor-causing bacteria.

• Overnight soaking can kill 99.9 percent of denture germs -

Pharmacy shelves are lined with denture cleaning options, from all-natural soaking solutions to high-end ultrasonic devices. It’s easy for denture wearers to think one cleaning option is as effective as the next, and therefore choose the fastest or least expensive one. But fast may not be best. By encouraging the use of an overnight soak such as Polident® (GlaxoSmithKline Consumer Healthcare), dental hygienists can empower patients to kill up to 99.9 percent of the bacteria that colonizes on their prostheses. This level of disinfection may not be reached with many quick-fix cleaning methods. Other good products on the market include Dentist On Call Denture Wipes (Majestic Drugs Company) or ProClean™.

Many patients who adopt overnight denture soaking find that the quick-soak method still has its place in their daytime routine. While a three- to five-minute soak may not achieve the 99.9 percent kill rate of an overnight soak, it can nevertheless be effective in reducing bacterial counts and helping patients freshen up quickly before a social event.

• For patients who suffer from dry mouth, contaminated dentures pose potential health risks -

Dental professionals should be mindful of the prevalence of dry mouth in the aging population. The likelihood of xerostomia increases with the number of medications a person takes. Since people over 65 use an average of three prescriptions and two over-the-counter medications per day, they stand a good chance of suffering from dry mouth.

In normal conditions, saliva provides a variety of protective functions and may be considered the mouth’s first line of defense against harmful bacteria. Denture wearers with reduced salivary flow should be particularly concerned about the cleanliness of their dentures. Dental professionals should make a point of inquiring about dry mouth with all patients, with special attention to dry mouth sufferers wearing dentures, and with emphasis on the importance of thorough daily cleaning to combat bacteria. To relieve ongoing symptoms of xerostomia, dental hygienists can recommend oral moisturizers that provide symptomatic relief and aid denture retention, which boosts patient confidence.

• Older patients - with or without dentures - have higher bacterial counts in their mouths -

Researchers have discovered higher counts of lactobacilli and yeasts in the saliva of older people, particularly older denture wearers. This is due to several factors, including reduced salivary flow and diminished immune system protection. Unfortunately as people age, their mouths require more vigilant care, which can be an issue for patients experiencing declines in dexterity and self-sufficiency. Dental hygienists can review denture cleaning regimens and products with these patients to ensure that they make nightly soaking part of their routine. If manual dexterity is a problem, supplemental denture cleaning methods (e.g., denture wipes or stationary denture brushes) can be explored.

The average full-mouth denture in the United States is 17.6 years old -

Does the dental office consistently recommend routine professional oral evaluations to denture patients? Does the denture patient understand that follow-up is essential, and should not be only when their dentures have loosened or become uncomfortable, or when an oral infection is causing complications? It has been reported that 57 percent of denture wearers seldom or never receive a routine checkup.

Depending on denture retention and stability, dentures should be replaced every five to seven years - a recommendation that greatly conflicts with the average denture age stated above. Obviously, most patients do not consider replacement that often and hope to get many years of wear out of their dentures. While this is sometimes possible, patients need to be reminded that routine professional evaluations and keeping dentures clean may help prolong the life of both full and partial dentures.

By sharing these five little-known facts with their patients, dental hygienists can inspire even less-compliant denture wearers to consider the many benefits of well-maintained dentures. Since thorough daily cleaning and routine professional follow-up can prolong the life and comfort of dentures, encouragement by dental professionals is worth the effort. The denture wearer experiences greater confidence, satisfaction, and pleasure, and produces more smiles and a healthier, happier life with dentures.