Follow us:

Journal of dentistry oral health and preventive measures (JDOHPM)

Review

The Patient Motivation and Education of Oral Hygiene, Treatment of their Partial and Complete Dentures

Corresponding Author: Antons Maksimovs*,Faculty of Dentistry, Riga Stradins University, Riga, Latvia, and Email:maksimovs.a@inbox.lv

Article Information

Article Type: Review

Received  : October 05, 2018
Accepted  : October 11, 2018
Published : October 15, 2018

Abstract

Introduction:Successful complete denture treatment can be achieved when the patients are motivated and aware of appropriate denture wear and hygiene. It is important to explain what patient need to treat dentures like natural teeth. Should keep them as clean as possible so that don’t lose any more teeth or have inflamed gums or bacterial and fungal infections.

Purpose:The aim is to identify patient problems associated with cleaning dentures, to show dentists how many patients do not follow the rules of dental hygiene. 

Methods:Review of the scientific publications and a summary of the results.  Information gathering using other authors' researches.

Results:Poor condition of complete and partial dentures seen in the population is mainly due to irregularly cleansing habits and also less usage of cleansing solutions. Dentists should give proper instructions regarding maintenance of denture hygiene.

Conclusion:Now and in the future, dentists need to pay more attention to their patients, not only the prosthetics of the teeth, but also the teaching of people, patients how to care for dentures.

Keywords:dentures, biofilm, dentist, hygiene, patient

 

Article

Introduction
The primary job for a dentist and hygienist has been oral care for the patients. Today our job involves good communication as well as exceptional care. Dentists are often the patient’s first impression of the dental clinic. The dentist builds strong sincere relationships through listening and establishing what the patient wants and needs in regard to his or her dental, oral health[9]. 

Successful complete denture treatment can be achieved when the patients are motivated and aware of appropriate denture wear and hygiene[3]. 

Proper hygienic care of removable dentures is an important means of maintaining a healthy oral mucosa in denture wearers. Dentists and patients should realize that microbial plaque on dentures may be harmful to both the oral mucosa and the patient's general health. It is the responsibility of the patient to maintain oral hygiene through a daily home care routine. It is the obligation of the dentist to motivate and instruct the patient and provide the means and methods for plaque control[1]. 

The conditions under the denture base promote the growth of microorganisms. High humidity and temperature, as well as inaccessibility for self-cleaning by saliva, promote the replication of bacteria and fungi[6]. 

It is important to explain what patient need to treat dentures like natural teeth. Should keep them as clean as possible so that don’t lose any more teeth or have inflamed gums or bacterial and fungal infections. 

Poor condition of complete and partial dentures seen in the population is mainly due to irregularly cleansing habits and also less usage of cleansing solutions. Dentists should give proper instructions regarding maintenance of denture hygiene[8]. 

Dentures can be cleaned or disinfected mechanically, chemically, or through a combination of both mechanical and chemical procedures. The disadvantages of mechanical procedures are ineffective in removing an unacceptably large proportion of adherent microorganisms. It causes scratches and irregularities on the surface of the dentures. Chemical methods for disinfecting dentures include soaking or immersion in solutions such as vinegar, sodium hypochlorite, glutaraldehyde, iodoforms, chlorine dioxide, or alcohol solutions. However, the chemical disinfection may present disadvantages such as denture staining, bleaching, denture corrosion, odor, and patient's oral tissue reactions. The use of microwave energy has been suggested in dentistry as a simple alternative to prostheses disinfection[7]. 

Other research results
There are many studies which show old and completely new ways of cleaning and disinfection of partial, complete dentures.

1. Research

A total of 53 partially edentulous patients were recruited for this study. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces the state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6- and 12-months following rehabilitation. 

With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and II[2]. 

2. Research

A sample of 224 complete denture wearers (162 women) aged 37–89 years was studied. Subjects were interviewed using questions related to overnight denture wearing and denture cleaning habits. Of the patients, 55.8% removed their dentures during the overnight period and 88% did this every day. Most of the patients used brushing with toothpaste (105 patients – 46.87%) as a cleaning method. More than a half of the subjects (63.4%) showed biofilm and calculus on their dentures.

1. Figure[13]

Heavy encrustation of calculus and plaque (arrowed) on maxillary (a) and mandibular dentures (b). The maxillary and mandibular dentures present a heavily abraded fitting area with deposited calculus and stains. [13]

3. Research

Soft-lined dentures after 19 months of use by a smoking and coffee-drinking patient (a) and after 10 months of use by a patient maintaining good oral hygiene (b). Strong discoloration (a) and numerous microbial colonies (b) can be observed[5]. 

2. Figure [5]

 

4. Research

After a half year of use under clinical conditions, fungalcolonies were present on one-third of the examined silicone linings on average. After 12 months, fungal colonies were detected on as many as 44% of the linings on average[6]. 

5. Research

The domestic microwave oven can be used to disinfect the dentures. The microwave disinfection method can be used repeatedly for disinfecting the dentures up to 650 W for 3 min. The repeated microwave disinfection showed statistically nonsignificant change in the surface hardness of the PMMA resin. It is safe, as it does not require chemicals, which may cause irritation to patients’ soft tissue or do not need to compromise on esthetics, due to discoloration. The use of microwave energy has been suggested in dentistry as a simple alternative to prostheses disinfection[7]. 

3. Figure [14]

6. Research

Nearly half of the subjects clean their dentures daily once. Participants from the younger age group and who had been wearing dentures for 2 years maintain better frequency of cleaning. The majority of these subjects used water and brush for denture cleansing. After seeing the condition, half of the dentures were rated as good 50.3%, followed by fair and poor as 29.5 and 20.2% respectively[8]. 

Discussion

Daily oral care is just as important for people who have experienced tooth loss. Some steps which dentist shouldexplain to patients how keep their mouth clean and gums healthy, if they use dentures[12]. 

• Dentures may break if you drop them. When handling your dentures, stand over a clean, folded towel or a sink full of water. This way, if
   patient accidentally drop the dentures, they are less likely to break.
• Dentures are not immune from plaque and tartar build-up, so it's important to brush dentures every day. To brush dentures, use a soft-
   bristled brush and gently brush the surfaces of the dentures, being careful not to break or bend the plastic. Between brushings, it's
   important to rinse dentures after each meal.
• Brush all the surfaces of the dentures, including the surface that fits against gums. This is especially important if patient use any kind of
   denture fixative.
• Be careful not to scrub too hard as this may cause grooves in the surface.
• Many toothpastes, household cleaners, and mouthwashes can be too hard on the dentures, so it is recommended that to use a mild hand or
   dish soap to get dentures clean. 
• When you are not wearing dentures, they need to be kept moist. Dentures that are not kept in a denture cleaning solution or in water can dry
   out, lose their shape or even crack and break.
• Even ifpatient have a full set of dentures, it's important to keep gums and tongue clean[10,11]. 

Conclusion

• Now and in the future, dentists need to pay more attention to their patients, not only the prosthetics of the teeth, but also the teaching of
   people, patients how to care for dentures. Now there are many studies on this topic. Which show both old and completely new ways of
   cleaningand disinfection dentures.
• The patients need instructions and motivation concerning denture hygienic and denture removal overnight[3]. 
• The use of sodium hypochlorite and chlorhexidine and mechanical cleansing with a toothbrush decreased microbial viability in healthy
   complete denture wearers[4]. 

 

References

1.   Ejvind Budtz-Jørgensen, (1979) The Journal of Prosthetic Dentistry, Materials and methods for cleaning dentures, Elsevier.
2.   Ribeiro, D. G., Pavarina, A. C., Giampaolo, E. T., Machado, A. L., Jorge, J. H. et al. (2009), Effect of oral hygiene education
      and motivation on removable partial denture wearers: longitudinal study. Gerodontology, 26: 150-156. doi:10.1111/j.1741-
      2358.2008.00272.x
3.   Takamiya, A. S., Monteiro, D. R., Barão, V. A., Pero, A. C., et al. (2011), Complete denture hygiene and nocturnal wearing
      habits among patients attending the Prosthodontic Department in a Dental University in Brazil. Gerodontology, 28: 91-96.
      doi:10.1111/j.1741-2358.2010.00369.x
4.   Fernanda Valentini-Mioso, Tamires T. Maske, Maximiliano S. Cenci, Noéli Boscato, Tatiana Pereira-Cenci,(2018) Chemical
      hygiene protocols for complete dentures: A crossover randomized clinical trial,The Journal of Prosthetic Dentistry,
      ISSN 0022-3913, https://doi.org/10.1016/j.prosdent.2017.12.022.
5.   Chladek, Grzegorz, Jarosław Żmudzki, and Jacek Kasperski. (2018) “Long-Term Soft Denture Lining Materials.
      ” Materials 7.8 (2014): 5816–5842. PMC. Web.
6.   Mutluay, M.M.; Oguz, S.; Fløystrand, F.; Saxegaard, E.; Dogan, A.; et al. (2008) a prospective study on the clinical
      performance of polysiloxane soft liners: One-year results. Dent. Mater. J., 27, 440–447.
7.   Jaiswal, Priti et al. ((2018)) “Effect of Repeated Microwave Disinfection on the Surface Hardness of a Heat-Cured Denture
      Base Resin: An In Vitro Study.” Contemporary Clinical Dentistry 9.3: 446–451. PMC. Web. 1 Oct. 2018.
8.   Apratim, A., Shah, S.S., Sinha, M.R., Agrawal, M.A., Chhaparia, N., et al. (2013). Denture hygiene habits among elderly
      patients wearing complete dentures. The journal of contemporary dental practice, 14 6, 1161-4.
9.   Peri-Implant Therapy for the Dental Hygienist: Clinical Guide to Maintenance and Disease Complications,Susan S. Wingrove,
      ISBN: 978-0-470-96285-5, Aug 2013, Wiley-Blackwell [85 -87. Page]
10. https://www.nathansondental.com/dentures
11. https://www.dentalhealth.org/denture-cleaning
12. https://www.toothwisdom.org/a-z/article/daily-oral-care-for-patients-with-dentures/
13. Sutula, Justyna & Coulthwaite, Lisa Ann & Thomas, Linda & Verran, Joanna. (2012). The effect of a commercial probiotic
      drink on oral microbiota in healthy complete denture wearers.
      Microbial ecology in health and disease. 23. 10.3402/mehd.v23i0.18404.
14. https://www.nature.com/articles/bdjteam201534

Address
  • 27 Old Gloucester street,
    London United kindom,WCIN3AX.
Contact Us
License
Creative Commons Licence
This work is licensed under a Creative Commons Attribution 4.0 International License.
© 2018. Vagus Inprosys All right reserved.