Denture Hygiene

Dentures must be cared for daily, just like your own teeth, to prevent adverse effects on oral health caused by pathogens and to maintain the aesthetics and function of the denture for a long time. An esthetic-looking, clean prosthesis, like beautiful own teeth, contributes decisively to the quality of life of its wearer. If denture hygiene is neglected, foetor ex ore (halitosis; bad breath) and denture-induced stomatitis (inflammation of the oral mucosa) are the result. In the case of partial dentures for which the patient’s own teeth can still be used, the hygiene applied to the dentures also has a positive and negative effect on the remaining teeth. This is because denture plaque (microbial plaque adhering to the denture) can inevitably also cause caries (tooth decay) and periodontitis (inflammation of the tooth bed) on the remaining own teeth.

Surface condition of the denture

Full dentures and the plastic portion of partial dentures (partial dentures) are usually made of acrylic. Its surface texture depends on various factors:

• On the regularity of care
• From the aids used
• Of the processing in the dental laboratory (avoidance of slippage angles in the modeling technique, surface polishing).

Problems with denture hygiene

Through individual care habits and errors, the wearer of a prosthesis decisively affects its hygienic condition:

• Denture plaque: in the event of poor denture hygiene, soft bacterial plaque adheres to the plastic surface.
• Tartar formation: If denture plaque is not removed daily, it can solidify due to storage of mineral substances.
• Extrinsic discoloration: Color deposits from food and stimulants such as tea, coffee, nicotine can settle.
• Surface damage: frequent drying out, strong temperature fluctuations of the water during cleaning or solvents in the wrong “care products” can cause cracking (formation of fine cracks) of the plastic. Microorganisms and decomposable substances penetrate into these finest surface damages, which lead to foetor ex ore (halitosis; bad breath) when degraded by the microorganisms. If abrasive (sanding) pastes and brushes with sharp-edged bristle ends are used for cleaning, the surface of the denture is roughened, making it even easier for microorganisms, tartar and color deposits to take hold.
• Denture stomatitis (inflammation of the oral mucosa): inadequate oral and denture care favors the growth of denture plaque, including the fungus Candida albicans. Candida albicans can cause denture stomatitis in the denture-covered mucosal areas. If the disease has occurred, Candida therapy with medication is required and the prosthesis should not be worn at night.
• Regular checkups: Only by regular presentation to the dentist even if there are no complaints, he can arrange timely repairs or refurbishment of the denture and thus maintain the functionality and hygiene of the prosthesis as long as possible.

Indications (areas of application)

The indication for hygienic care of a denture arises indispensably for every denture wearer to maintain their own oral health and the functionality of the denture.

Contraindications

• None

The procedures

Regardless of procedures used, the following recommendations have proven effective:

• Thorough cleaning of the prosthesis at least once, preferably twice daily (morning and evening).
• If your own teeth are still present, they must also be cleaned twice a day.
• Brushing time for dentures must be sufficiently long to remove plaque from all surfaces.
• In between after meals, rinse thoroughly under running water.
• Also in between before reinsertion of the prosthesis rinsing the mouth.

I.Mechanical cleaning

Denture plaque (microbial plaque adhering to dentures) can be removed quite effectively mechanically by combining a suitable brush with a special, low-abrasive (emery) denture toothpaste or with a cleaning foam, provided that all denture surfaces and niches are covered and the brushing time is sufficiently long.

• Brush: Special denture brushes accommodate the curved shape of dentures by having bristle areas of different lengths. For this reason, a conventional toothbrush with a uniform bristle field is less suitable. However, toothbrushes with softer bristles that are gentler on dentures are available. When selecting a brush, care should be taken to ensure that the ends of the monofilaments (of the individual bristles) are rounded rather than sharply cut, otherwise the plastic surface may be scratched and roughened. Denture brushes are available with bristle fields arranged on two sides, whereby anchoring elements such as telescopic crowns or attachments in the denture are better reached with the second, significantly smaller field. Supplementary to this, an even narrower single tuft brush can also be used.
• Denture paste: the use of “toothpastes” manufactured specifically for dentures (e.g. Perlodent med Third Teeth Toothpaste) ensures that the denture acrylic is not abraded (abraded) or roughened by the paste. Conventional toothpastes are adapted in their abrasion behavior to the considerably harder enamel. Toothpastes for hypersensitivities (sensitive tooth necks) are adapted to the dentin hardness (hardness of the dentin) and thus less abrasive, for the softer denture resin nevertheless unsuitable.
• Cleaning foam: Cleaning foam produced specifically for dentures without abrasive cleaning agents (abrasive substances) is distributed alternatively to the denture paste for about one and a half minutes by brushing on the denture surfaces (eg Corega, Purfrisch).

II Chemical cleaning

Just like brush and paste, chemical cleaning solutions prepared with tablets or powder also enjoy great acceptance. Due to their disinfecting and cleaning effect, they are recommended because they also reach germs in niches and loopholes that are not covered by mechanical cleaning. However, the procedure should always be performed in combination with mechanical brush cleaning:

• Pre-cleaning: Before placing the denture in the prepared solution, food residues and plaque should be removed as far as possible with the brush under running water.
• The solution is mixed with lukewarm – not hot! – Water and a cleaning tablet or powder portion put on.
• Reaction time: after 10 to 15 minutes, all chemical reaction processes have run their course. A longer lying time in the solution does not lead to a better cleaning result. Special powder products promise an accelerated course within only one minute (eg Kukident Professional 1 minute).
• Post-cleaning: If dissolved plaque and tartar residues remain on the denture after the immersion bath, these are removed by brushing again under running water. In any case, the disinfectant solution should be rinsed under water, as its ingredients are not suitable for contact with the oral mucosa and can cause irritation (irritation).

Ingredients of denture cleaners	Substance class	Effect
Alkylarylsulfonates, alkylsulfates, alkylsulfoacetates.	Surfactants	Emulsifying and dispersing (dispersing) agents
Polycarboxylic acidsCitrate EDTA (ethylenediaminetetraacetic acid).	Complexing agents, builders	Purifying and stabilizing
Perborate, persulfate, percarbonate	Per compounds	Disinfecting (germ reducing) and bleaching by release of active oxygen Deodorizing
Proteases	Enzymes	Protein cleavage to improve purification efficiency
Citric acid, amidosulfuric acid	Acids	pH regulation
Sodium carbonate, sodium hydrogen carbonate	Alkali salts, CO2 splitter	Bubbling effect due to reaction with acids for faster detachment of mineral-solidified deposits
Dyes		Color change indicates the end of the cleaning process

Table

III. ultrasonic cleaning:

Ultrasonic baths are used for denture cleaning in dental laboratories, but are also available for home use and are highly recommended, especially when hand dexterity does not permit adequate denture cleaning with a brush due to disability or age. Chemical denture cleaners are added to the ultrasonic bath.

Possible complications

• Prosthesis fracture: the prosthesis may slip out of your hand during cleaning and crack or chip when it hits the sink. Therefore, always let some water into the sink before starting!
• Loss of elasticity: Elastic materials for relining dentures that remain soft lose their elasticity over time. Denture cleaners can affect this process unfavorably.
• Pale discoloration: the fading of elastic relining materials by too high doses of denture cleaners is hardly observed today thanks to the specified dosages in the form of tablets or portioned powder packaging.
• Irritation: Denture cleaners can cause irritation of the skin, eyes and oral mucosa.
• Corrosion: metallic parts of partial dentures (of partial dentures) can corrode. With denture cleaners of the new generation (eg Corega Tabs Partial Third) this problem usually does not arise.