Caring For Dentures

CARING FOR DENTURES

We will discuss what happens when things don’t go as planned, and our denture wearing patients come to us for advice. Nearly 69% of adults between 35-44 years old have lost >1 permanent teeth. 26% of adults that are 75 years old and older are missing all of them. In 2020, 41 million people were denture wearers.

Daily care tips for denture wearers:

• Don’t let dentures dry out
  • Place them in a denture cleanser soaking solution or in plain water when you’re not wearing them.
    • Never use hot water, which can cause dentures to warp.
  • Most dentures today, including the teeth and pink denture base, are made with plastic(acrylic).
    • The teeth of a denture are typically made from various types of resin or porcelain. Very few are still made with porcelain teeth today.
  • Be careful with your beloved pet, dogs love to get a hold of dentures!
  • Many dentures are broken by dropping them in the sink.
    • Dropping a porcelain denture might result in breakage.
  • Brushing the dentures – brushing dentures daily will remove food and dental plaque and help prevent them from becoming stained.
    • Always brush dentures over a folded washcloth.
      • If the dentures slip out of the wearer’s hand, a washcloth might prevent breakage.
    • Patients can use special creams for dentures or any toothpaste.
      • Some sources recommend dishwashing liquid (Dawn works great) or hand soap to clean dentures.

What NOT to do:

• Do not use any household abrasives.
• A regular or denture brush works fine, but patients should not rely solely on denture cleansers.
• Some dentures have a permanent soft liner and this material requires special care. A patient should not use conventional brushing methods for these.
  • They are given a special solution to clean them with at the time they were given their denture.
• Take care of your mouth – brush your gums, tongue, and palate every morning with a soft-bristled brush before you insert dentures.
  • This stimulates circulation in your tissues and helps remove plaque.
• Patients should NEVER super glue their dentures!
  • Most of the time dentists are professionally unable to repair them after they have been glued.

Fungal Infection

Up to half of those wearing dentures will develop a fungal infection called oral stomatitis (candidiasis).

• Tips you can follow to prevent this infection:
  • Keep smiling, eating, and speaking with confidence.
  • Give your dentures a rest:
    • Remove dentures out for 6 to 8 hours a day to allow the tissues of your mouth to heal from any soreness or irritation that may have occurred throughout the day.
    • Removing dentures while sleeping is a good way to give the mouth a rest.

Consult your dentist

See your dentist if dentures break, chip, crack or become loose.

• Don’t be tempted to adjust them yourself — this can damage them beyond repair.
• Never should a pharmacist recommend a “denture repair kit”
  • Care is best left to the dental professionals to fix any damaged denture.

Adjust your eating habits:

• Cut foods into smaller pieces to allow better chewing
  • Note: Adding gravy or a pat of butter can help to soften up some foods
• Chew on both sides of your mouth to avoid dislodging dentures while eating.
  • Avoid chewy types of food like caramel and hard foods like nuts, which can loosen your dentures.

Soaking the dentures:

• Alkaline peroxide cleaners are the most common.
  • When dissolved in water become alkaline solutions of peroxides, releasing oxygen for mechanical cleaning.
• Soak for 4-8 hours.
  • Best for new stains and plaque.
  • Soaks are useful for inhibiting growth of Candida albicans, which can cause stomatitis.
• Examples:
  • Hypochlorite (bleach; Polident® and Efferdent®): removes stains, bacteria, fungi.
    • Hypochlorite dissolves plaque, but not calculus/tartar in the mouth when formed.
  • Sodium Hypochlorite (0.5% NaOCl solution; Dentural®) is effective in decreasing microorganisms without changing the color of the denture resin.
    • Acid containing solutions:
      • Shorter soaking times recommended.
      • May be used with ultrasonic cleaners.
      • Usually contain citric acid
      • Examples:
        • Polident®, Stain Away®.
      • Avoid persulfate, it may cause allergic reactions.

DENTURE ADHESIVES

Denture adhesives are pastes, powders or adhesive pads that may be placed in/on dentures to help them stay in place. In most cases, properly fitted and maintained dentures should not require the use of denture adhesives.

• Shrinkage in the bone structure in the mouth causes dentures to gradually become loose over time.
  • When this occurs, the dentures should be professionally relined or new dentures made that fit the aging mouth properly.
    • Denture adhesives fill gaps caused by shrinking bone and give temporary relief from loosening dentures.
      • They are effective, but NOT a permanent solution!!
      • If dentures are ill-fitting, refer to a dentist.
    • How they work: The denture adherent holds dentures in place while chewing or speaking. They also form a seal that keeps food particles from sticking between the dentures and gums, which can be a problem with whole grains, or even fiber laxatives like psyllium (Metamucil®)

TYPES OF DENTURE ADHESIVES:

• Paste Application: Use a “pea-sized” amount in 4-5 locations on denture
  • Examples: Fixodent®, Poligrip®
• Powders: Easier to clean & better initial retention
  • Falls sharply within the first six hours
• Thin Adhesive Liners (wafers or pads): Sea-Bond®

Tips for adhesive use:

• Remind patients to scrub off the adherent each time the dentures are cleaned.
• Inform patients that a 2.4-ounce tube of denture adhesive should last them 7 to 8 weeks if they wear both lower and upper dentures.
• Recommend daily removal of denture adhesives from the prosthesis and the oral cavity.
• Pharmacists Role: Remember, a film of saliva helps hold dentures in place. Inadequate saliva flow may cause dentures to be loose.
  • Inadequate saliva flow may be due to prescription and OTC medications
    • Examples: anticholinergics (dicyclomine or Bentyl®, hyoscyamine or Levsin®), tricyclic antidepressants (amitriptyline or Elavil® is the worst), or first-generation antihistamines (diphenhydramine or Benadryl®)
  • Treatment options:
    • Change to nortriptyline (Pamelor®)
      • Less anticholinergic
    • Second- or third-generation antihistamines
      • Example: loratadine (Claritin®) or fexofenadine (Allegra®)
    • Zinc
      • Active ingredients: polymethyl vinyl ether-maleic anhydride (PVM-MA) zinc and calcium salts with carboxymethylcellulose.
      • Problem: Chronic, excessive ingestion of zinc can result in copper deficiency
        • Copper deficiency is an established and increasingly recognized cause of neurologic disease & extremity weakness and numbness
      • Some marketed denture adhesive creams contain zinc at levels of about 17-34 mg/g.

WHAT does the ADA (American Dental Association) have to say:

To earn the ADA Seal:

• Clinical data demonstrating the effectiveness of the denture adherent in providing increased biting force, increased retention, and that the integrity of the dentures is not affected by the adherent.
• Effergrip®, is the only adherent that has the ADA seal.
  • It has coloring agents, dispersal agents, wetting agents and adhesives: Polymethylvinylether maleic acid calcium, Polyethylene Oxide, Sodium Carboxymethylcellulose.
  • Zinc-free.
  • Rod Messner says: “I tell my patients that the selection of a denture adhesive is what works best for them. It’s a vanilla or chocolate thing. I tell patients to use them, they do help! If they are doing some public speaking or going to a special event…..USE THEM!! Provides an extra level of confidence.”

See the dentist:

• Just because a patient may not have all their natural teeth, does NOT mean that they do not need to visit the dentist
• Patients still have gums and an oral cavity that need to be routinely checked
• A dentist will also check the fit of the denture and changes to the structure that holds the denture
  • Extremely important as a patient ages
• Once-a-year check-up recommended by Dr. Rod Messner

Pharmacists’ role in medication management:

• MANY medications, such as anticholinergics, cause varying degrees of xerostomia
  • Adversely affect denture retention.

Have a great day on the bench!!