Clean dentures: Their contribution to good health

Plaque on removable dentures may contain bacteria that can cause serious systemic diseases. Keeping dentures meticulously clean will help to reduce the risk of oral and other common diseases. The following article will show you what you can do for your patients.

The threat of bacterial plaque

Bacterial plaque on removable dentures often causes oral health issues. In many cases stomatitis occurs. Existing teeth are exposed to an elevated risk of caries and root caries in particular. Furthermore, the possibility of periodontal disease increases. Mucositis and the subsequent risk of periimplantitis may endanger implant restorations.

Older people are at risk

Not only oral pathogenic bacteria but also bacteria that are associated with systemic diseases have been found in plaque samples taken from dentures. They include bacteria that cause lung disease and pneumonia, which represent potentially life-threatening conditions. Older people in particular are affected: Almost one third of the patients have to be hospitalized. Chronically ill patients will show more severe symptoms of pneumonia and the recovery period will be longer. The mortality rate increases with age. As a result, almost every fifth patient between 80 and 89 years of age will die due to complications of pneumonia.

Prevention-based strategies need to be implemented

As a result of these risks, a prevention-based treatment strategy is essential. The aspect of “easy cleaning” should be addressed early on in the planning phase of the restoration process. The good health of the oral cavity is based on the following requirements:

• impeccable fit of the denture and
• thorough oral hygiene and denture cleaning regime.

Plaque removal is a must

The removal of plaque is indispensable. Ultrasonic baths have proved to be highly effective in cleaning removable dentures. They smooth out rough surfaces, which reduces the accumulation of bacterial plaque and prevents irritation of the gum tissue. In certain cases, dentures may have to be relined to improve their fit. Chlorhexidine-containing products are recommended for controlling harmful germs. Long-term experience has proved the wide spectrum of action and the safety of chlorhexidine. Products featuring various delivery forms and concentrations are available to satisfy the different needs of patients and practitioners.

Dental appliances have to be cleaned thoroughly

Removable dentures must be cleaned daily. This helps to prevent the build-up of plaque and therefore bad breath, tartar, thrush fungus and other inflammations. 

Needs-based oral hygiene

For additional oral care, an oral hygiene product such as Cervitec Gel containing 0.2% chlorhexidine and 900 ppm fluoride is recommended. If the use of a mouth rinse is indicated, a mild, alcohol-free product is a good choice, for example, Cervitec Liquid.

Regular recalls

Ideally, recall appointments should be made every three to six months. The appointments are used to

• record the oral situation,
• check the effectiveness of the treatment and
• if necessary adjust the measures or introduce and explain new ones.

The help of health care personnel should be enlisted in all cases. This type of action provides an important contribution to the maintenance of good health and well-being of seniors up to a very advanced age. 

Eight tips for at home or in a frail care facility

The following eight tips are specially designed to ensure that dentures are correctly cleaned at home or in a frail care facility:

1. Denture wearers should wear their glasses when they clean their teeth and their dentures.
2. A cosmetic mirror may be helpful in carrying out the oral and dental hygiene regime
3. After every meal, food residue should be removed with a denture brush and the dental appliance should be rinsed under running water. To prevent any breakage of the denture during the cleaning process, the basin should be half-filled with water or lined with a towel.
4. The cleaning of dental appliances by motor-impaired patients may be made easier by manufacturing a customized silicone base, which stabilizes the denture during the cleaning process.
5. Once a day, the inner and outer parts of dental appliances must be thoroughly cleaned with a denture cleaning brush. Toothpastes are not suitable for this purpose because they contain abrasive components. They may irreversibly roughen any composite resin parts, which would promote the growth of bacterial plaque.
6. Very old patients should remove their dentures over night to reduce the risk of pneumonia.
7. Nursing staff should work with gloves.
8. Frail care facilities and hospitals should seriously consider investing in an ultrasonic bath.

A customized silicone base stabilizes the denture and makes cleaning easier. (Picture: Dr F. Zimmerling)

The oral care gel is easy to apply to telescopic copings.

At home, dentures are best cleaned and conditioned with a suitable interdental brush and an oral care gel. (Picture: Dr F. Zimmerling)

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