Denture Care Maintenance And Hygiene

Question 1

What denture cleaners are available to patients?

Answer 1

Soap and soft brush

Microwave (no metal) for 20s

Ultrasonic cleaners

Chemical cleaning - bactericidal and fungicidal and most effective following mechanical cleaning

Chemical agents = alkaline peroxides not as good for calculus, acids are good for calculus, hypochlorites for bacteria or fungi, abrasive cleaners for stain removal

Always follow manufacturers instructions

Question 2

how should metal containing dentures be cleaned

Answer 2

Acids can damage metal, safe to use alkaline peroxide tablets for max 15 mins

Hypochlorites for 10 minutes

Soak in water overnight

Question 3

What factors may cause poor denture hygiene?

Answer 3

Xerostomia

Poor diet

Poor cleaning - can be from poor manual dexterity or lack of OH knowledge

Systemic health conditions

Smoking

Ill fitting dentures

Poor neuromuscular control

Poor manual dexterity and ability to self care

Question 4

What debris can form on dentures?

Answer 4

Plaque biofilm

Calculus

Food

Question 5

What is the process of debris forming?

Answer 5

Salivary proteins and bacterial byproducts form the pellicle layer

Oral debris such as food, epithelial cells and microorganisms adhere to pellicle layer

Plaque turns to calculus

Bacteria and fungi colonise

Question 6

What oral issues can poor denture hygiene cause?

Answer 6

Caries

Periodontal disease

Denture stomatitis

Halitosis

Pain

Aspiration pneumonia
- denture is reservoir for respiratory pathogen

Question 7

When is debris accumulation often an issue? Why?

Answer 7

Elderly patients with reduced salivary flow / polypharmacy of drugs

Dry mouth patients

As fitting surface is not exposed to cleansing affects of saliva, and as acrylic is porous and rough debris accumulates easily

Question 8

How can aspiration pneumonia occur from poor denture hygiene?

Answer 8

Denture acts as reservoir for respiratory pathogens in oral cavity

• aspiration of food, reflux and oral MOs into the respiratory tract is the most common mechanism of pneumonia development

Question 9

What are the ideal properties of a denture cleaner?

Answer 9

Cheap and easy to use

Effectively remove biofilm

Remove stain

Bactericidal and fungicidal

Harmless to denture materials

Non-toxic

Question 10

What are some examples of chemical denture cleaners?

Answer 10

Alkaline peroxides
Abrasive cleaners
Alkaline hypochlorites
Acid

Question 11

Pros / cons of alkaline hypochlorites and when to use them?

Answer 11

Very effective bacteriocidal and antifungal
- Can use in acrylic and metal

But

May corrode metal
- Short soak for 10 minutes

Do not use for soft linings!!!

Question 12

Pros / cons of acid cleaners?

When not use?

Answer 12

Dissolve calculus and stain
- vinegar or citric acid

Do not use for metal or soft linings

Question 13

Pros / cons of abrasive cleaners?

Answer 13

Good for stain removal

Poor
- damage denture
- less effective against antimicrobials
- adjunctive chemical needed

Question 14

Negatives of chemical denture cleaning?

Answer 14

Must follow manufacturer

Damage to denture

Bleaching of denture

Allergy issues

Question 15

How would one clean metal based dentures?

Answer 15

Alkaline peroxide cleaners - such as sterident - for max 15 mins

Or alkaline hypochlorite cleaner - Milton - 10 mins / evening

Soak in water overnight

Do not use acid cleaners

Question 16

How clean soft linings?

Answer 16

Avoid toothbrushing

Alkaline peroxide cleanser - sterident for 15 minutes max

Cold water overnight

Question 17

Pros / cons of alkaline peroxides? When use? What is it?

Answer 17

• light duty dental cleaner for those who keep denture well maintained
• effervescent tablet

Pros
- useful at removal of bacteria or fungi
- can be used for soft linings

Cons
- does not effectively deal with darker stain or hard calculus