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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 28-31

Frequency of denture cleansing – A survey


1 Department of Public Health Dentistry, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
2 Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India

Date of Submission06-Oct-2021
Date of Acceptance08-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Dr. N Nagappan
Reader, Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_18_21

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  Abstract 


Introduction: Most of the patients clean their dentures only once a day. However, according to ideal practices, the complete dentures should be cleaned regularly at least twice a day to prevent ulcers, periodontal diseases, and various lesions in the oral cavity. Like natural teeth dentures also should be cleaned with a brush or with denture cleaners. This must be done regularly to prevent food accumulation and plaque formation. The most common outcome of improper cleaning of the dentures may lead to a condition called denture stomatitis which is the inflammation of the mouth due to poor oral hygiene. Hence, it is necessary to clean the dentures properly to avoid the above-mentioned problems. Materials and Methods: The present study was conducted with 50 patients of age groups ranging from 40 to 65 years. A questionnaire was prepared, and the information was collected based on details such as age, gender, duration of denture wearing, frequency of denture cleansing, the materials used to clean the dentures, and nocturnal denture wearing habits. The purpose of the study was explained to the patients and their consent along with their signature and was recorded on the questionnaire. The data were later tabulated, and statistical analysis was done using the SPSS software, and the results were given. Results: The present study reveals that most of the patients were aware about importance of denture cleansing and materials used to clean the dentures. They were also aware about the technique to clean dentures and also about the nocturnal use of dentures and adverse effects of not maintaining their dentures properly. Conclusion: Based on the study, the denture hygiene of patients has significantly improved with patients brushing their dentures twice a day or sometimes thrice a day with cleansing liquid and tablets. However, there are a few patients who slept with their dentures at night which should be avoided. Thus, dentists should take the responsibility of providing postplacement denture hygiene instructions and also to motivate the patients.

Keywords: Cleansers, dentures, elderly, frequency


How to cite this article:
Preethy M, Nagappan N. Frequency of denture cleansing – A survey. Int J Soc Rehabil 2021;6:28-31

How to cite this URL:
Preethy M, Nagappan N. Frequency of denture cleansing – A survey. Int J Soc Rehabil [serial online] 2021 [cited 2022 Jun 28];6:28-31. Available from: https://www.ijsocialrehab.com/text.asp?2021/6/1/28/331475




  Introduction Top


Replacement of missing teeth is successful only when patients are motivated and aware of correct prosthesis use and hygiene. The quality of the denture, occlusion, denture age, and hygiene are the important factors to be considered.[1]

The most common lesions include denture stomatitis, angular chelitis, traumatic ulcers, denture irritation hyperplasia or epulisfissaratum, flabby ridges and can even result in oral carcinomas.[2] These lesions are acute or chronic reactions to plaque or a reaction to constituents of the acrylic base or a mechanical denture injury.

Denture stomatitis is an inflammation of the oral mucous membrane involving the palate mucosa when it is completely or partially covered by denture.[3] Food particles may get lodged between the denture and gingiva or the palate and allows the growth of Candida species which may cause denture stomatitis.[4] Denture stomatitis may also be caused due to wearing dentures at night, smoking, age of the denture, and poor oral hygiene.[5],[6] Hence, once an edentulous patient is fitted with a complete denture, the most important phase of the treatment will be proper denture maintenance.

Tooth loss in any adult population is common as the age advances because the factors that leads to the loss of teeth – dental caries, loss of periodontal support, a history of dentoalveolar trauma, a history of dental care – are additive over time. For this reason, the rates of complete tooth loss are customarily the highest in the oldest age groups mostly after the 5th decade of life.[7]

Loss of teeth in elderly people is very common, and it may be due to caries, periodontal infections, trauma, or bone resorption. Hence, in such cases, the only possible treatment will be the fabrication of a complete denture. This treatment will be successful only if the patients are fully aware of denture maintenance and hygiene.[4],[8] Proper care of the dentures and the surrounding oral mucosa are mandatory to avoid certain complications. Poor denture hygiene can lead to various complications such as denture stomatitis, angular chelitis, traumatic ulcers, and oral carcinomas.[9],[10]

For elderly people, proper care of mucosal tissues and care of the dentures are mandatory to maintain the overall health. In addition, there may be greater social consequences of mouth malodour due to unclean oral prosthesis for someone whose dietary intake is strongly linked to socialisation, such as an older person who attends a senior activities center for meals. Dentures which are not cleansed adequately cause or contribute to oral mucosal lesions, impairment in eating, and thus will have a more profound effect on a fragile elder than on a younger, healthier person.[11],[12]

Various methods of denture cleansing are available such as mechanical and chemical methods. The most common and widely used is the mechanical method of denture cleansing which involves using a toothbrush. There are brushes specifically designed and sold commercially for this purpose.[10] Chemical denture cleansers are immersion type cleansers which are sold in powder and tablet forms. They can be broadly divided into alkaline peroxides, alkaline hypochlorite, acids (hydrochloric acid and phosphoric acid), and disinfectants (chlorhexidine gluconate and salicylate).[10] The combination of mechanical method and chemical method is the most recommended as well as effective and safe method to clean dentures, for persistent accumulations and stains.

Patients should be instructed to rinse their dentures and their mouths after meals whenever possible. The mucosal surfaces of the residual ridges and the dorsal surface of tongue also should be brushed daily with a soft brush; denture cleansers may also be used. However, it has been observed that the majority of denture wearers do not pay necessary attention to the cleanliness. This may be due to decreasing manual abilities due to advanced age.[4],[13],[14] Thus, it is the primary duty of the dentist to create the awareness about denture hygiene and also about the products available to clean the dentures. Hence, this cross-sectional study aimed to investigate the denture cleansing habits among denture wearers.


  Materials and Methods Top


The study was conducted with 50 patients of age groups ranging from 40 to 65 years. A questionnaire was prepared, and the information was collected based on details such as age, gender, duration of denture wearing, frequency of denture cleansing, the materials used to clean the dentures, and nocturnal denture wearing habits. The purpose of the study was explained to the patients and their consent along with their signature and was recorded on the questionnaire. The data were later tabulated, and statistical analysis was done using the SPSS software, and the results were given.

Statistical analysis

The tabulated data were analyzed using the SPSS software Version 21,IBM SPSS Statistics. Descriptive statistics were obtained, and the frequency distribution along with the cumulative percentage was also calculated. The analyzed data were interpreted.


  Results Top


Out of 50 patients who were interviewed, 50% (25) were male and 50% (25) were female, and 46% of patients have been wearing their dentures for 1–3 years, 40% of patients have been wearing their dentures for 5–10 years, and 14% have been wearing dentures for more than 10 years. These data are evident in [Table 1].
Table 1: Duration of denture wearing

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Out of the 50 patients, 38 patients (76%) were comfortable with their dentures, whereas 12 patients (24%) were not comfortable with the dentures and experienced some problems.

The data are shown in [Table 2].
Table 2: Comfort level of patients

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The next topic which was asked was about the method the patients used to clean their dentures. It was concluded that 46% of patients used tooth brush to clean their dentures, while 40% of patients used their hand to clean the dentures and the remaining 7% used materials such as cotton or cloth to wipe their dentures. The data are shown in [Table 3].
Table 3: The cleansing methods used

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When the patients were asked about the material they used to clean [Table 4] their dentures, it was seen that 46% of patients used their tooth pastes to clean; 28% used cleansing powder and 26% used cleansing liquid to clean their dentures [Table 5].
Table 4: Material used to clean

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Table 5: The awareness towards cleansing products

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The patients were also asked about their awareness of the cleansing products available in the market. To this, 68% of patients gave a positive reply and 32% gave a negative answer.

The most important aspect of this survey was to know the frequency of cleansing. When the patients were questioned regarding this, it was observed that 22% of patients cleaned their dentures only once a day, whereas 56% of patients cleaned their dentures twice a day [Table 6].
Table 6: Frequency of cleansing

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Cleaning their dentures was associated with the advice of the dentist. Patients who followed their regular dental check-up kept their dentures cleaner compared to the others.

The next question that was asked was about the nocturnal denture wearing habits. It was seen that 54% of patients slept with their dentures and 46% of patients removed their dentures during the night [Table 7].
Table 7: The nocturnal use of dentures

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No significant difference was observed between gender and denture hygiene and also age and denture hygiene.


  Discussion Top


Poor denture hygiene has a negative impact on elderly people and can cause many systemic manifestations and infections. When a denture is placed in the mouth, a coating of glycoprotein develops. This thin pellicle becomes contaminated with food debris and microorganisms. Hence, denture stained by tobacco and medicines results in unpleasant taste and malodor. This favors candida growth and proliferation in the denture leading to mucosal irritation. Denture care is, therefore, an imperative step to maintain denture quality, esthetics and longevity to ensure good oral health status. Thus, it is essential to maintain proper denture hygiene regularly.[10]

In this study, it is seen that 46% of patients have been wearing dentures for the past 1–3 years only, whereas 40% of them have been using dentures for 5–10 years and only a small portion of patients are long-term denture wearers that is for more than 10 years. It is also observed that 76% of patients were comfortable with their dentures, whereas 26% experienced some problem and were not comfortable in using their dentures.

It is also seen that 46% of patients used tooth brush to clean their dentures and 40% used only their hand to clean their dentures and 7% of patients used substances such as cotton or cloth to just wipe their dentures without washing them. It is thus seen that these patients have either not received the appropriate information from their dentist or have not been following them as per the instructions given.

When the patients were assessed for their awareness about various denture cleansers available in the market, it was observed that 68% of patients were aware about the availability of denture cleansers in the market, whereas 32% of patients were totally not aware about such cleaning agents.

The most important aspect of this study was to assess the frequency of denture cleansing and it was seen that 22% of patients cleaned their dentures once a day, whereas 56% of patients cleaned their dentures twice a day. Thus, it is observed that majority of patients are cleaning and maintaining their dentures properly.

It is also observed that majority of the patients remove their dentures during the night. Patients were also additionally aware that nocturnal use of dentures may result in denture stomatitis and other oral mucosal lesions.

It was also observed that gender and denture hygiene were not significantly related. None of the patients were aware of denture brushes and they used ordinary tooth brushes to brush their dentures. Thus, it is essential that dentists give all the possible instruction to their patients on how to clean the dentures and also the oral mucosa to maintain a good oral hygiene.

Peracini et al. reported 58.49% of the patients using immersion for cleaning and among the substances used for immersion of the dentures, water was the most frequently used (38.71%) followed by sodium hypochlorite (33.87%). In the study by Baran and Nalça, 42.9% of the patients immersed their dentures in water and only 1.6% immersed them in hypochlorite solution. Hoad-Reddick et al. found that a combination of methods (brushing and soaking) was used more frequently.[1]

The primary objective of maintaining the complete denture is to prevent the occurrence of lesions such as commissuralchelitis, burning mouth syndrome, mouth ulcer, denture irritation hyperplasia, gagging leading to caries and periodontal disease in the oral cavity. In elderly patients, care of the mucosal tissues and the dentures of the edentulous mouth are very important for overall health. The main aim of cleaning the denture is to remove the plaque adhering to the denture which in turn will eliminate the cause of denture stomatitis. Denture cleansers can be used for this purpose. An ideal denture cleanser should be simple to use, should be efficient in removing organic and inorganic matter or plaque from denture surface, have antimicrobial properties and be compatible with all denture base materials.[15] Chemical agents for denture cleansing have advantage of being simple to use, and several investigations have shown their efficacy in reducing biofilm formation in vitro[16],[17],[18] and in vivo.[19],[20] Thus, it is the duty of every dentist to educate the patient about the importance of denture hygiene and frequency of cleaning the dentures.[21]


  Conclusion Top


Based on the study, the denture hygiene of patients has significantly improved with patients brushing their dentures twice a day or sometimes thrice a day with cleansing liquid and tablets. However, there are a few patients who slept with their dentures at night which should be avoided. Thus, dentists should take the responsibility of providing postplacement denture hygiene instructions and also to motivate the patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol 1981;10:65-81.  Back to cited text no. 1
    
2.
Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol 1981;10:65-82.  Back to cited text no. 2
    
3.
Barbeau J, Séguin J, Goulet JP, de Koninck L, Avon SL, Lalonde B, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:51-9.  Back to cited text no. 3
    
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Manderson RD, Ettinger RL. Dental status of the institutionalized elderly population of Edinburgh. Community Dent Oral Epidemiol 1975;3:100-7.  Back to cited text no. 4
    
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Gendreau L, Loewy ZG. Epidemiology and aetiology of denture stomatitis. J Prosthodont 2011;20:251-60.  Back to cited text no. 5
    
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Parizi MT, Taheri S, Amini P, Afshar MK, Afshar MK. Evaluation of denture hygiene among removable denture wearers referred to clinics of Kerman, Iran. J Oral Health Oral Epidemiol 2013;2:44-8.  Back to cited text no. 6
    
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Patel IB, Madan G, Patel B, Solanki K, Chavda R. Behaviours and hygiene habits of a sample population of complete denture wearers in Ahmadabad. J Int Oral Health 2012;4:29-38.  Back to cited text no. 7
    
8.
Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol 1981;10:65-83.  Back to cited text no. 8
    
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Douglass CW, Gammon MD, Atwood DA. Need and effective demand for prosthodontic treatment. J Prosthet Dent 1988;59:94-104.  Back to cited text no. 9
    
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Namrata M. A questionnaire survey of dental students' attitude toward denture cleansing. Int J Orofac Res 2017;2:8-10.  Back to cited text no. 10
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Shay K. Denture hygiene: A review and update. J Contemp Dent Pract 2000;1:28-41.  Back to cited text no. 11
    
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Abelson DC. Denture plaque and denture cleansers. J Prosthet Dent 1981;45:376-9.  Back to cited text no. 12
    
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Kanli A, Demirel F, Sezgin Y. Oral candidiasis, denture cleanliness and hygiene habits in an elderly population. Aging Clin Exp Res 2005;17:502-7.  Back to cited text no. 13
    
14.
Polyzois GL. Denture cleansing habits. A survey. Aust Dent J 1983;28:171-3.  Back to cited text no. 14
    
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Ingram DM, Bosse GM, Baldwin R. Ingestion of a denture cleanser: Did it cause gastric perforation? J Med Toxicol 2008;4:21-4.  Back to cited text no. 15
    
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Jagger DC, Harrison A. Denture cleansing – The best approach. Br Dent J 1995;178:413.  Back to cited text no. 16
    
17.
Nikawa H, Yamamoto T, Hamada T, Sadamori S, Agrawal S. Cleansing efficacy of commercial denture cleansers: Ability to reduce Candida albicans biofilm activity. Int J Prosthodont 1995;8:527-34.  Back to cited text no. 17
    
18.
Webb BC, Thomas CJ, Harty DW, Willcox MD. Effectiveness of two methods of denture sterilization. J Oral Rehabil 1998;25:416-23.  Back to cited text no. 18
    
19.
Jagger DC, Al-Akhazam L, Harrison A, Rees JS. The effectiveness of seven denture cleansers on tea stain removal from PMMA acrylic resin. Int J Prosthodont 2002;15:549-52.  Back to cited text no. 19
    
20.
Gornitsky M, ParadisI I, Landaverde G, Malo AM, Velly AM. A clinical and microbiological evaluation of denture cleansers for geriatric patients in long-term care institutions. J Can Dent Assoc 2002;68:39-45.  Back to cited text no. 20
    
21.
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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