Denture maintenance Flashcards
List common reasons for poor denture hygiene.
- poor manual dexterity
- inability to self care (eg dementia)
- xerostomia (polypharmacy)
- poor diet
- old dentures (loss of polished surface)
- lack of OH knowledge
- wearing dentures 24/7
- ill fitting dentures
- poor neuromuscular control
What are examples of debris that can build up on dentures?
- plaque
- calculus
- food
Define the pellicle layer.
- salivary proteins and bacterial products
- create a layer to which oral debris and microorganisms adhere to
What makes up oral debris?
- mucin
- food
- desquamated epithelial cells
What bacteria are found in the oral biofilm?
- staph aureus
- E. coli
- alpha streptococci
- spirochaetes
- fusobacteria (sulphur products create halitosis)
What fungi are found in the oral biofilm?
Candida has an affinity for PMMA, acidic environment under denture favours candidal activity
Where does debris accumulate on dentures?
- fit surface as not exposed to saliva and cleaning effects
- soft linings attract bacteria
- xerostomia can exacerbate problems
What are the consequences of poor denture hygiene?
- caries
- periodontal disease (enhances but does not cause)
- denture stomatitis
- halitosis
- pain
What is aspiration pneumonia?
- denture acts as reservoir for respiratory pathogen
- pneumonia is caused by aspiration of food, reflux and oral bacteria most commonly in older people
How are dentures mechanically cleaned?
- soap and soft bristle brush
- microwave for 20s (PMMA dentures)
- ultrasonic
Why is mechanical cleaning of dentures important?
- removes obvious debris
- must be mechanically cleaned before chemical cleaning
- give the ability to establish better hygiene
- hygienist cannot clean dentures must be done by dentist
What are the ideal properties of a chemical denture cleaner?
- cheap
- easy to use
- effective removal of biofilm
- effective stain removal
- bactericidal and fungicidal
- harmless to denture materials
- non-toxic
What are different types of chemical denture cleaners?
- alkaline peroxides
- alkaline hypochlorites
- acids
- enzymes
- abrasive cleaners
Describe alkaline peroxide denture cleaner.
- most common
- light-duty denture cleaner
- active ingredient is sodium perborate
- effervescent
- tablet or powder form
- does not effectively remove stains or calculus
- eg steradent
Describe alkaline hypochlorite denture cleaner.
- very effective antibacterial and anti fungal cleaning
- may corrode metal elements (10 mins max if metal)
- do not use for soft linings
- eg dentural
Describe acid denture cleaner.
- good at dissolving calculus and stains
- citric acid or vinegar
- do not use for soft linings or metal based dentures
- eg. denclen
Describe enzyme denture cleaner.
- expensive
- proteolytic enzymes
- dextranase, mutanase and protease
- eg. polident
Describe abrasive denture cleaner.
- good for stain removal
- can cause damage to denture
- less effective antimicrobial activity than other cleaners
- adjunctive chemical soak required
- eg dentu-creme
What are some drawbacks of using chemical denture cleaners?
- must follow MI
- can cause damage or bleaching
- allergies
What effect can acidic cleaners have on metal based dentures?
- tarnishing and corrosion
- galvanic reactions
How should metal based dentures be cleaned?
- soak in water overnight
- alkaline peroxide cleaner for 15 mins
- alkaline hypochlorite cleaner for 10 mins
How should soft linings be cleaned?
- soak in cold water overnight
- alkaline peroxide for 15 mins
- avoid hard toothbrushes
What daily care steps should denture patients take?
- brush dentures daily, soft bristles and no toothpaste
- rinse dentures after each meal
- soak dentures daily following MI
- rinse throughly with water after chemical then soak overnight in water
What may cause poor compliance with removing dentures at night?
- dignity
- relationships
- self-esteem
- TMJ issues
- bruxists
