It’s estimated that up to 80% of removable oral appliances are infected with Candida Albicans, a yeast infection of the mouth. The risk of infection increases with use over time.
Millions of people are infected with pathogens like Candida and Streptococcus in the U.S. alone. Most of these people have been suffering from low-grade infections for so long that they don’t even know they are sick. The symptoms—cheilitis, stomatitis, and loss of taste—become normal.
Denture-wearers are particularly at risk for developing long-term oral infections. Factors like age, medication, and illness can make people significantly more prone to Candida and Strep. Many elderly people continue to use their dentures well beyond the recommended replacement time and do not know how to properly clean them. Medications can exacerbate the issue by disrupting the normal oral flora and/or causing dry mouth. Unfortunately, these infections are often left untreated because when denture-wearers have a problem, they go to a drugstore, not a dentist.
That’s why it is important for dental professionals to educate patients about the hygiene risks associated with oral appliances. Even though the number of people with prosthetic teeth and removable dental devices keeps growing, there is still not much information out there for people to take proper care of their appliances. I’ve seen this personally—I started my career as a denture technician before practicing cosmetic dentistry for over 35 years.
Many patients don’t know that toothpaste is too abrasive for removable oral appliances. Dentures, mouth guards, snoring devices, and retainers are softer than teeth. Regular toothpaste and a toothbrush will damage these appliances and actually make them less clean.
Though the scratches are microscopic, there will be a visible difference in shine, finish, and color and the appliance will become the perfect breeding ground for bacteria.
Dental professionals are aware of the prevalence of Candida and Streptococci on oral appliances, but there isn’t an easy way to prevent these infections at home on a daily basis. Major brand denture cleansers can only claim to kill “odor-causing bacteria,” and many require an overnight soak. Unfortunately, these cleansers have no effect on virulent pathogens like Streptococci and Candida.
I developed several over-the-counter products for maintaining oral appliances. The Cleanadent line includes soaking crystals used in a sonic cleaning unit to kill pathogens like Candida and Strep, remove heavy stains in 20 minutes, and to clean deeply to help prevent colonization.
With information becoming ever more accessible and removable oral appliances on the upswing, the dental community should do more to educate patients about maintaining their appliances, understanding the risks facing their oral health, and looking for the right products when developing an oral hygiene routine. I always gave a few packets of a cleanser and a sonic cleaner with every removable. And patients appreciated it!
Lorin Berland, DDS, is a prominently published author on clinical dentistry and has been featured as a thought leader for the dental field in national TV programs and publications, such as 20/20, Time, Town & Country, and GQ. In 2008, Dr. Berland was recognized by the AACD for “Outstanding Contributions to the Art and Science of Cosmetic Dentistry.” Dr. Berland is working on an education campaign on oral hygiene for removable appliances. He has developed a line of products for treating common conditions like Candida and dry mouth. Details are available at DrBDentalSolutions.com.
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