Cleaning and Storing Dentures
Practical Denture Care Advice
Unfortunately no standard Denture Care recommendations exists from the dental profession.
The Oral Health Foundation published a white paper giving Denture Care Guidance for people with FULL Dentures (August 2018). It looked at all the denture care advice literature available globally and concluded that there appears to be huge variations in advice, some giving conflicting messages and causing confusion.
People are coming into care homes with more of their own teeth than ever before 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), this 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. For people with some missing teeth partial dentures are a simpler and more affordable option for replacing lost teeth than implants and other complex dentistry.
Practical advice 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.
Encourage residents to leave their dentures out at night.
Plaque that forms on the surfaces of removable dentures may have a significant impact on oral health. It can lead to the denture-supporting mucosa being infected (stomatitis), or even lead to serious general health complications such as pneumonia.
Overnight denture wear have also been linked to 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 care advice for residents in care homes.
Physically cleaning dentures with a toothbrush or denture brush eliminates microbial plaque better than inactive methods, such as soaking.
USING A DETERGENT
Using a mild antibacterial soap or denture cleaning paste. (Soap in an inexpensive alternative to denture 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 causes scratches on the denture.
ENCOURAGING RESIDENTS TO LEAVE THEIR DENTURE/S OUT AT NIGHT
Denture wearers should not keep their dentures in the mouth overnight, unless there are specific reasons as people are at a higher risk of developing stomatitis.
Denture-related stomatitis is a symptomless red lesion under a denture that is caused by the yeast Candida. Soaking in a denture cleanser solution after mechanical cleaning seems to be beneficial for preventing denture stomatitis and the potential risk of pneumonia events in these groups of people.
Denture wearing during sleep was significantly associated with a higher risk of pneumonia
Soaking in Water
Soaking the denture/s in a named denture pot with water is adequate in most cases.
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. Please note that mouthwash with Chlorhexidine will stain.
Soaking in Denture Cleaning Solution
Although soaking dentures using denture cleaning significantly decrease the denture biofilm and the amount of C .albicans to a greater extent than dry or water preservation, manufacturers usage instructions must be adhered to as (peroxide -based effervescent tablets) will etch (acrylic) and corrode (chrome) dentures overtime. (manufacturers instructions usually direct a maximum 20 mins) NOT OVERNIGHT!
Dental technicians advise that dentures are NOT stored dry due to the dentures drying out and warping.
STORING DENTURE TABLETS
After an incident occurred in 2016 whereby a resident with dementia wandered into another residents room and after ingesting a denture cleaning chemical he very sadly died. Any denture cleaning tablets should be stored in a sluice or other room away from residents.
Provided that daily brushing of remaining natural teeth is carried out and tongue is brushed and not coated, Cleaning dentures with a brush, soap and water and storing in a named denture pot of cold water. Soaking dentures from time to time (as manufacturers instructions) should suffice.
Soaking in a denture cleanser solution after mechanical cleaning seems to be beneficial for preventing denture stomatitis and the potential risk of pneumonia events in these groups of people.
TYPES OF DENTURE CLEANING SOLUTIONS
Alkali hypochlorite disrupts the bacterial cell membrane and dissolves mucins in the plaque.
Sodium hypochlorite is not recommended for long-term soaking of acrylic dentures. Soaking for more than 10 minutes may damage and lighten the colour of the acrylic denture material. It is not recommended for metal-based dentures.
Alkali peroxide disrupts the denture plaque through a process of effervescence
Acid-based cleansers disrupt the bacterial cell membrane and dissolve calculus.
Enzyme-based cleansers use specific enzymes that degrade fats, glycoproteins and other structures that then help destroy microorganisms in the plaque.
Oral rinses include any dental mouthwash products available on the market, and these have a good range of antibacterial properties. They can be used to soak dentures in. However, those containing chlorhexidine can stain dentures.
Adverse effects of denture cleaning solutions
Allergy Persulfate has been included in denture cleansers, but it has recently been reported that it could cause allergic reactions. In February 2008, the Food and Drug Administration (FDA) issued a report about persulfate risks.
Misuse of denture cleansers has also been cited as a cause of health problems, from oesophageal burning to low blood pressure or internal bleeding.
Denture Care Guidelines for FULL Denture/s by Oral Health Foundation (August 2018)
The Oral Health Foundation have looked at all the guidelines globally for denture care and have produced a white paper which gives guidance denture care for denture wearers, carers, healthcare and dental professional of those people that wear FULL dentures.