Denture Care
People are coming into care homes with more of their own teeth as people are keeping their teeth for longer. In 1968 it was estimated that 1/3 of the population above the age of 65 were edentulous (have no teeth). Today it is believed to be less than 3%. Although there is a decline of residents coming into care homes with FULL DENTURES there appears to be an increase of residents with partial dentures.
Practical advice from Knowledge Oral Healthcare for the cleaning of denture/s and storage
Plaque will stick to any hard surface and will therefore adhere to dentures just as they do on natural teeth, the regular cleaning of dentures is essential to the oral and general health of denture wearers. It can lead to the soft tissues in the mouth, supporting the denture to become inflamed (stomatitis), or even lead to serious general health complications such as pneumonia.
Remove dentures at night
Denture wearers should be encouraged to removed their denture/s at night unless there are specific reasons as people are at a higher risk of developing stomatitis and an increased risk of aspiration pneumonia.
A study by Iinuma et al. in 2015 on people aged 85 or older, reported that perceived swallowing difficulties and denture wearing during sleep led to being twice as likely to suffer serious pneumonia events.
DENTURE CLEANING ADVICE
1. BRUSH DENTURE/S
Physically cleaning dentures with a toothbrush or denture brush eliminates plaque better than soaking.
2. DETERGENT
Use a mild soap or denture cleaning paste. Carers often ask if toothpaste can be used, the reason why a toothpaste is not advised is due to the fact that it is abrasive and scratches the denture.
3. STORING
Store dry
Place denture/s in a named denture pot, dry is considered best practice as drying has been shown to destroy Candida albicans which causes denture stomatitis, (a symptomless red lesion under a denture).
Storing dentures in water alone is not recommended as it may promote Candida albicans colonization!
The reason why there has been conflicting views in whether dentures should be stored dry or damp was because it was thought that keeping denture dry overnight would cause an acrylic denture to warp leading to ill-fitting but several studies have concluded that the dimensional stability of dentures was so small it was considered not to be clinically significant.
Soaking in Mouthwash
If a resident feels compelled to soak their denture/s in a solution overnight I would suggest a mouthwash. Most generic mouthwashes contain an antibacterial ingredient which will help reduce the bacterial load on the denture.
Soaking in Denture Cleaning Solution
Soaking in a denture cleanser solution (as instructed by manufacturers) after physical cleaning from time to time (1-2 times a week), seems to be beneficial for preventing denture stomatitis and the potential risk of pneumonia events in these groups of people.
NOTE
Peroxide -based effervescent tablets will etch acrylic and corrode chrome dentures overtime. Manufacturers instructions usually direct soaking for 3 mins NOT OVERNIGHT!
STORING DENTURE CLEANING PRODUCTS
If using denture cleansing tablets or solutions care must be taken. There have been cases where denture cleaning products have been ingested by people with cognitive impairment or visual problems.
NB. Any denture cleaning products should be stored in a sluice or other room away from residents.
Misuse of denture cleansers have been cited as a cause of health problems, from oesophageal burning to low blood pressure or internal bleeding.
Allergy Persulfate has been included in denture cleansers, but it has recently been reported that it could cause allergic reactions. The FDA has asked the manufacturers of denture cleaning products to change the product labelling to include warnings about the risks of allergic reactions which could be caused by persulfates. 26 Jun 2020
LOOSE DENTURES
A common problem among the elderly are dentures that are ill-fitting which can cause pain and discomfort if left making activities such as eating and talking intolerable.
There may come a time when it in the best interest of an individual to stop wearing their denture/s due to discomfort, loose/ill-fitting or people with cognitive impairment are unable to tolerate them any longer. (this tends to be people with advance dementia). Remember that this is likely to make eating difficult which impacts on their nutritional intake.
It can be upsetting for some family members to see their relative without their dentures and they may ask that their loved one continues to wear them. However, the best interest of the resident must always prevail. This issue may need to be handled sensitively, and the outcome should be always be in line with the dentist’s or doctor’s instructions
LOOSE DENTURE OPTIONS...
Reline existing denture/s
This requires the clinician taking an impression of the mouth and remoulding the inside surface of the existing denture.
New Denture/s
Making a new denture/s requires a number of dental appointments, some residents will not be able to tolerate having a new denture and may end up wearing their existing denture! A new denture may require adjustment appointments after the final fit appointment.
Making a copy of the original denture
In some cases a dentist can make a copy of a resident’s denture using their current one. This may result in the resident adapting to new dentures more easily.
It is therefore important that the existing denture/s is not disposed of.
Unfortunately there is no standard denture care recommendations that exists from the dental profession although the Oral Health Foundation published a White Paper giving Denture Care Guidance for people with FULL Dentures (Aug 2018) HERE
KOHC advise viewing the Denture Care Advice from HHE Mouth Care Matters HERE