Care for Dental Prostheses: What Did Clinical Study Results Reveal?

Study Results Are Alarming

Experts agree that patients should keep their dental prostheses clean. Deposits on dental prostheses − dental plaque, tartar, and food debris − can increase the risk of both stomatitis and systemic diseases, particularly aspiration pneumonia. However, few patients are able to keep their prostheses truly clean. And research confirms this.

For example, a 2001 Turkish study conducted at the Department of Prosthetic Dentistry at Marmara University in Istanbul showed that only 15.7% of patients kept their prostheses clean. 25.7% of study participants stated that they cleaned their prosthesis less than once a day. Conversely, only 8.6% cleaned their prosthesis with a brush and also soaked it in a cleaning solution. This group did not consistently use any uniform cleaning regimen. Similar conclusions were reached in another Turkish study from 2006, where only 12% of patients treated at the Department of Dentistry at Yeditepe University in Istanbul had clean prostheses.

Definition of a Clean Prosthesis

The question remains how to define a clean prosthesis. In the United Kingdom, the so-called Denture Cleanliness Index (DCI) was proposed and tested, comparing the cleanliness of prostheses using plaque-disclosing dye. Prostheses are visually inspected and scored from 0 to 4, with 0 corresponding to a plaque-free prosthesis and 4 corresponding to a prosthesis with visible tartar deposits on any surface. This system is particularly effective in educating and motivating patients to better care for their dental prostheses.

Effectiveness of Cleaning Solutions

Most professional societies state that dental prostheses should be regularly cleaned with a brush and soaked in cleaning solutions. The quality and composition of cleaning solutions vary, with some cleaning agents for dental prostheses including persulfate, which can cause serious allergic reactions. According to a report by the U.S. Food and Drug Administration (FDA), these reactions can occur whether the agent is used correctly or incorrectly.

Another method of cleaning involves alkaline peroxide-based tablets, which according to one available clinical study, reduce the amount of bacteria and yeast, such as Candida, in the biofilm on dental prostheses compared to dry storage and water storage, even with inadequate oral hygiene. Duyck et al. conducted another clinical evaluation showing that the use of cleaning tablets during nighttime storage of dental prostheses has no effect on the number of Candida albicans microorganisms, but compared to nighttime water storage, it reduces the overall number of bacteria.

Effect of Solutions on Dental Prosthesis Properties

Cleaning agents should also not damage dental prostheses. A 2010 study aimed to compare color changes, surface roughness, and flexural strength of heat-polymerized acrylic resin after immersion in two different effervescent cleaning solutions (Corega tablets and Bony Plus) and control distilled water during simulated 180-day use. No significant color changes were observed, but the group of dental prostheses treated with Bony Plus showed significantly greater surface roughness. Both types of tablets significantly reduced the flexural strength of the acrylic resin.

Another study by German doctors confirmed that currently available neutral or slightly alkaline peroxide-based cleaning tablets have no effect on denture material. However, the clinical relevance of these results still needs to be verified.

(jez)

Source: Bartlett D., Carter N., de Baat C. et al.; Global Task Force for Care of Full Dentures. "White paper" on optimal care and maintenance of full dentures for oral and general health. Oral Health Foundation, 2018.