8 - Denture maintenance Flashcards

1
Q

List common reasons for poor denture hygiene.

A
  • poor manual dexterity
  • inability to self care (eg dementia)
  • xerostomia (polypharmacy)
  • poor diet
  • old dentures (loss of polished surface)
  • lack of OH knowledge
  • wearing dentures 24/7
  • ill fitting dentures
  • poor neuromuscular control
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2
Q

What are examples of debris that can build up on dentures?

A
  • plaque
  • calculus
  • food
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3
Q

Define the pellicle layer.

A
  • salivary proteins and bacterial products
  • create a layer to which oral debris and microorganisms adhere to
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4
Q

What makes up oral debris?

A
  • mucin
  • food
  • desquamated epithelial cells
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5
Q

What bacteria are found in the oral biofilm?

A
  • staph aureus
  • E. coli
  • alpha streptococci
  • spirochaetes
  • fusobacteria (sulphur products create halitosis)
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6
Q

What fungi are found in the oral biofilm?

A

Candida has an affinity for PMMA, acidic environment under denture favours candidal activity

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7
Q

Where does debris accumulate on dentures?

A
  • fit surface as not exposed to saliva and cleaning effects
  • soft linings attract bacteria
  • xerostomia can exacerbate problems
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8
Q

What are the consequences of poor denture hygiene?

A
  • caries
  • periodontal disease (enhances but does not cause)
  • denture stomatitis
  • halitosis
  • pain
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9
Q

What is aspiration pneumonia?

A
  • denture acts as reservoir for respiratory pathogen
  • pneumonia is caused by aspiration of food, reflux and oral bacteria most commonly in older people
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10
Q

How are dentures mechanically cleaned?

A
  • soap and soft bristle brush
  • microwave for 20s (PMMA dentures)
  • ultrasonic
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11
Q

Why is mechanical cleaning of dentures important?

A
  • removes obvious debris
  • must be mechanically cleaned before chemical cleaning
  • give the ability to establish better hygiene
  • hygienist cannot clean dentures must be done by dentist
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12
Q

What are the ideal properties of a chemical denture cleaner?

A
  • cheap
  • easy to use
  • effective removal of biofilm
  • effective stain removal
  • bactericidal and fungicidal
  • harmless to denture materials
  • non-toxic
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13
Q

What are different types of chemical denture cleaners?

A
  • alkaline peroxides
  • alkaline hypochlorites
  • acids
  • enzymes
  • abrasive cleaners
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14
Q

Describe alkaline peroxide denture cleaner.

A
  • most common
  • light-duty denture cleaner
  • active ingredient is sodium perborate
  • effervescent
  • tablet or powder form
  • does not effectively remove stains or calculus
  • eg steradent
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15
Q

Describe alkaline hypochlorite denture cleaner.

A
  • very effective antibacterial and anti fungal cleaning
  • may corrode metal elements (10 mins max if metal)
  • do not use for soft linings
  • eg dentural
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16
Q

Describe acid denture cleaner.

A
  • good at dissolving calculus and stains
  • citric acid or vinegar
  • do not use for soft linings or metal based dentures
  • eg. denclen
17
Q

Describe enzyme denture cleaner.

A
  • expensive
  • proteolytic enzymes
  • dextranase, mutanase and protease
  • eg. polident
18
Q

Describe abrasive denture cleaner.

A
  • good for stain removal
  • can cause damage to denture
  • less effective antimicrobial activity than other cleaners
  • adjunctive chemical soak required
  • eg dentu-creme
19
Q

What are some drawbacks of using chemical denture cleaners?

A
  • must follow MI
  • can cause damage or bleaching
  • allergies
20
Q

What effect can acidic cleaners have on metal based dentures?

A
  • tarnishing and corrosion
  • galvanic reactions
21
Q

How should metal based dentures be cleaned?

A
  • soak in water overnight
  • alkaline peroxide cleaner for 15 mins
  • alkaline hypochlorite cleaner for 10 mins
22
Q

How should soft linings be cleaned?

A
  • soak in cold water overnight
  • alkaline peroxide for 15 mins
  • avoid hard toothbrushes
23
Q

What daily care steps should denture patients take?

A
  • brush dentures daily, soft bristles and no toothpaste
  • rinse dentures after each meal
  • soak dentures daily following MI
  • rinse throughly with water after chemical then soak overnight in water
24
Q

What may cause poor compliance with removing dentures at night?

A
  • dignity
  • relationships
  • self-esteem
  • TMJ issues
  • bruxists