Denture Hygiene; Are Dentures Making Your Patients Sick?
The way that patients take care of their dentures at home can have a major impact on their overall experience with the denture process. Healthy patients are happy patients, and oral hygiene is inextricably linked to overall health. Taking the time with patients to explain the proper home care protocol can greatly improve their denture experience, and can even positively affect their quality of life. In my 40 years of experience treating denture patients, I can certainly attest that many people do not take as good care of their dentures as they should.
It is well documented that denture wearers are at a significantly greater risk of developing oral infections and respiratory problems. Clinical research consistently finds that in a majority of patients tested, their dentures become infested with pathogens over time. The most common pathogens – Candida Albicans, Streptococcus, Staphylococcus, and Actinomyces – cause Oral Thrush, Denture Stomatitis, and Pneumonia. And the risk of infection increases significantly in the presence of Diabetes and Dry Mouth.
The absence of proper denture hygiene protocols has made these problems so common that tens of millions of people are infected in North America alone. Many of these sufferers have been affected by chronic low-grade infections for so long that they do not even realize that there is a problem and that they are sick. Over time, the visible and recognizable symptoms—bad breath, redness, discomfort, white tongue, respiratory issues, and loss of taste—become the “new” normal. (1)
While it is vital that dentures fit properly, and are either relined or replaced in a timely manner, it is also essential to have an effective oral hygiene routine for maintaining both the health of the mouth and the functionality of the dentures. The likelihood of developing oral infections increases considerably with factors such as advancing age, deleterious habits, and Diabetes, Sjogren’s, and Lupus. In addition, certain medications can exacerbate these problems by disrupting saliva formation, the normal balance of oral flora, and/or causing Dry Mouth. Denturists must be on the lookout for these signs as they are on the frontline to help cure and prevent further problems. (2)
From my experience, this works best when the proper denture hygiene routine is introduced at the beginning, because later if denture patients have problems, they tend to seek solutions at a drug store, not at your practice. Unfortunately, these patients and pharmacists typically cannot identify the problem, much less the solution. They are at a complete loss in identifying a specific over-the-counter product that will alleviate their situation. Ultimately, the underlying cause of their infection- the bacterial and fungal colonies and biofilm on the dentures and gums- are left untreated and the patient continues to suffer from the same recurring infections. Or worse, they might come to blame the denture.
Although the number of people with dentures keeps growing, there is relatively little scientifically-based, accessible information about proper denture and gingival hygiene, either within the profession and for the public at large. If patients are not educated about recognizing and preventing Oral Thrush, Stomatitis, and Pneumonia from their denturist, they will most likely search for this information online where they can find a range of denture myths and DIY methods that are not backed by scientific research.
For example, most patients are not aware that regular toothpaste is too abrasive for removable oral appliances. Dentures, partial dentures and overdentures are actually much softer than teeth. Regular toothpaste and the old-fashioned denture-brush can damage these appliances, roughen their surfaces, and actually make them less clean. As the microscopic scratches gradually abrade the surface of the appliance, there is a visible loss in shine, color, and finish. The surface marred denture becomes a biological sponge, an ideal environment for pathogens to thrive. On the other hand, patients need to regularly clean their gums with the right paste and a brush to remove the accumulation of bacterial biofilm. (3)
To make sure that patients are getting the right information, it’s very easy for dental professionals to just direct patients to recommended websites like www.Mouthhealthy.org, which is a great, trusted resource where patients can find a range of easy to read, clear practical information on denture topics.
This is why it’s so important that the Denturist and staff take the time to ensure that their patients are suitably educated in the maintenance of their dentures, in understanding the risks facing their oral health, and in making the right product and protocol decisions for their daily oral hygiene routine. In my experience, a good conversation with the patient, and just a few minutes of oral care a day can dramatically improve a patient’s health on their denture adventure.
(1) Oral candidiasis: An overview. J Oral Maxillofac Pathol. 2014; 18(Suppl 1): S81-5 (ISSN: 0973-029X) Singh A; Verma R; Murari A; Agrawal A
(2) Hannah, Victoria & O’Donnell, Lindsay & Robertson, Douglas & Ramage, Gordon. (2017). Denture Stomatitis: Causes, Cures and Prevention. Primary dental journal. 6. 46-51. 10.1308/205016817822230175.
(3) Papadiochou S, Polyzois G. Hygiene practices in removable prosthodontics: A systematic review. Int J Dent Hygiene. 2017;00:1– 23. https://doi.org/10.1111/idh.12323
Lorin Berland, DDS, is one of the most published authors on clinical dentistry and dental education with over 100 articles, best-selling books and instructional videos including the Lorin Library Smile Guide. Dr. Berland was recognized by the AACD for “Outstanding Contributions to the Arts & Science of Cosmetic Dentistry”, and has been featured in major national print and TV publications for his work. Dr. B began his career as a denture technician, and after more than 40 years of listening to patients and running a multi-specialty practice, he has started Dr. B Dental Solutions with a line of products specially designed to treat the real issues affecting people with oral appliances, like Oral Infections and Dry Mouth, which can be found at www.DrBDentalSolutions.com. For more information, contact Dr. Berland at [email protected] or 1-844-372-3368 (DRB-DENT).
2018 | The National Denturist, USA | Fall