Denture maintenance, care and hygiene

Question 1

What is the pellicle layer?

Answer 1

• Salivary proteins and bacterial products

Question 2

What bacteria is present in debris?

Answer 2

• Staph.aureas
• E.coli
• Alpha steptococci
• Spirochaetes
  Fuso bacteria give off sulphur products = halitosis

Question 3

What fungal is present in debris?

Answer 3

Candida - Have affinity to adhere to PMMA
- Environment under denture more acidic, favours candidal activity

Question 4

Why does debris accumulate?

Answer 4

• Fit surface not exposed to cleansing effects of saliva
• Increased problem with decreased salivary flow in elderly
• Polypharmacy leads to xerostomia
• Denture surface not smooth

Question 5

Effects of poor denture hygiene?

Answer 5

• Caries
• Periodontal disease
• Denture stomatitis
• Halitosis
• Pain
• Traumatic kerotosis

Question 6

How are dentures related to pneumonia incidents?

Answer 6

• Dentures can act as reservoir for potential respiratory pathogens in oral cavity
• Increased risk of aspiration pneumonia

Question 7

Mechanical denture cleaning?

Answer 7

• Soap and soft brush
• Remove obvious debris
• Can use ultrasonic
• Chemical cleaning ineffective if not mechanically cleaned first

Question 8

What are some ideal properties of denture cleaners?

Answer 8

• Cheap
• Easy to use
• Effective removal of biofilm mass
• Non-toxic

Question 9

What are some chemical denture cleaning products?

Answer 9

• Alkaline peroxide like steradent
• Alkaline hypochlorites like dentural (don’t use soft linings)
• Acids (don’t use for soft linings or metal based dentures)
• Enzymes
• Abrasive cleaners (can damage denture)

Question 10

How to clean soft linings?

Answer 10

• Prone to damage
• Soak in effervescent alkaline peroxide for max 15 mins (cold water)
• Soak in cold water overnight

Question 11

What is the FDI guidance for advice to patients on denture care?

Answer 11

• Brush dentures daily with soft brush and using non-abrasive cleaner
• Don’t use toothpaste
• Over basin full of water so don’t break
• Soak dentures daily for max 20mins with alkaline peroxide or alkaline hypochlorite
• Leave out at night
• Visit dentist regularly

Question 12

What is the advice to patients on denture wear?

Answer 12

• Manage expectations and change
• Speech, aesthetics, function
• Discomfort
• Check can insert and remove
• Written and verbal instructions
• Record in notes

Question 13

What is the NICE Quality standard NG48 regarding care homes?

Answer 13

• Adults living in care homes supported twice a day to clean teeth and carry out daily care for dentures