Denture Hygiene Basics

Denture Hygiene

• Students should be able to describe different types of dentures and obturators.
• Students should be able to recognize the importance of denture hygiene.
• Students should be able to discuss assessing denture cleanliness and the Denture Cleanliness Index (DCI).
• Students should be able to identify methods of cleaning dentures.

Types of Dentures and Obturators

• Complete/full denture: A denture that replaces all teeth in the mouth. There are different types, including those that are completely acrylic (pink), or a combination of acrylic and metal.
• Obturator: A custom-made appliance that covers an oral defect, such as a missing section of bone or gums. Useful to fill cavities or protect wounds.
• Partial denture: A removable partial replacement for missing teeth. Can incorporate metal clasps or frameworks to hold pieces firmly in place. Consist of plastic teeth and a metal frame.

Importance of Denture Hygiene

• Denture stomatitis: Condition caused by poor denture hygiene, characterized by oral inflammation. A significant health concern with potential to lead to oral ulcers and infections.
• Importance of hygiene to prevent problems associated with poor cleanliness.

Assessing Denture Cleanliness

• Using the Denture Cleanliness Index (DCI):

• Explain to patient: that the process will be assessed to improve cleaning

• Verbal/non-judgemental consent: obtain verbal consent and remain non-judgmental, reassuring

• Fill the sink with water: gently wash dentures under cold running water

• Remove loose debris: wash dentures in sink to remove loose bits

• Apply Plaque Disclosing Solution: apply plaque solution, as directed, to affected areas

• Rinse off: rinse the dentures and ensure the solution is rinsed well

• Inspect for plaque: examine dentures for evidence of plaque

• Assign DCI score: assess according to severity of problem

The Denture Cleanliness Index (DCI)

• Score 0: Clean denture; no visible plaque or staining.
• Score 1: Denture is visibly clean. Little staining (<25% of the denture surface).
• Score 2: Visible plaque and/or debris Moderately stained (25-50% of denture surface).
• Score 3: Visible plaque and/or debris. Severely stained (>50% of denture surface)
• Score 4: Visible calculus on any surface; or structural defects potentially leading to plaque retention

Denture Hygiene Instructions Based on Score

• Score 0: No intervention; maintain current methods.
• Score 1: Reinforce current methods, encourage hygiene
• Score 2: Reinforce methods, provide information leaflet.
• Score 3: Reinforce methods, additional advice leaflet, hygiene kit
• Score 4: Reinforce methods, provider advice leaflet, hygiene kit, further intervention by a professional clinician; potential reline or remake, consult professional

Methods of Cleaning Dentures

• Manual cleaning:
• Use lukewarm water, soft toothbrush
• Denture cleaning adjuncts/formulas
• Clinician demonstrations, followed by patient practice.
• Chemical cleaning: Use of solutions to clean dentures. Different types with different compositions exist, such as bleach-based, mineral acid-based and enzyme-based solutions.

Compatibility of Denture Cleaning Methods with Different Materials

• Various methods have different degrees of compatibility with specific denture materials. The table details which cleaning method is appropriate for each denture type.

Maintaining Optimal Oral Health for Denture Wearers

• Meticulous oral and denture hygiene coaching is essential for optimal oral health for denture wearers.
• Including Denture Cleansing Index (DCI) in routine check-ups allows assessing denture hygiene.
• Ensure patient’s ability to thoroughly clean dentures with mechanical (brush) and/or chemical cleaning.