Chapter 27- Advice for denture wearers.

Approximately 20% of the adult population of the UK wears a denture of one sort or another. A denture is a removable appliance to replace missing teeth.

The device may be temporary or permanent.

A temporary denture is one worn after a tooth/teeth has/have been lost while you wait for the gum to heal up before having a bridge, an implant or a more deluxe type of denture in the future.

A permanent denture is the finished article, one you are going to wear long term. Permanent is a bit of a misleading term really as like anything it will wear out, break and need modifying as your dentition changes over time.

The denture body may be made of various materials; – acrylic, acrylic and metal [chrome cobalt] and soft flexible nylon based plastic. It may also have a soft lining made from silicone rubber or acrylic. The teeth can be made of acrylic, porcelain, composite resin amongst other materials.

The important things to remember about a denture is it has been custom made for you, it is a precision appliance, if you want it to last, like anything else you need to look after it and care for it correctly. If it is a partial denture the health and longevity of your denture depends on the health of your teeth and the health of your teeth depends on the cleanliness of your denture.

Here are the rules-

  • Take it out at night.
  • Take it out when you clean your teeth if it is a partial denture.
  • Clean it correctly.
  • Store it correctly.
  • Have it checked by your dentist on a regular basis.
  • Keep a spare.
  • Have a new one at regular intervals as advised by your dentist.
  • Use denture fix sparingly.

Night time removal.

It’s very important that you take your denture out at night. It’s lovely and warm and moist under a denture. Just the sort of conditions bacteria and fungi like to grow in. On the roof of your mouth you have lots of little ridges, these are called rugae and some people have really bobbly [very technical term] skin on the roof of their mouths [palate]. Bacteria and fungi love to live in these little microclimates and as with anywhere else on your body it’s not a good idea to have bacteria and fungi in places they shouldn’t be.

Cleaning of your denture.

It is really important that your denture like your teeth is cleaned regularly, efficiently and thoroughly without damaging it.

It amazes me that people who would not dream of putting dirty knickers on their bums will happily put dirty dentures in their mouths. You have to think of your denture like a picnic plate, you wouldn’t eat your dinner of a dirty plate so why would you eat your dinner off dirty dentures. If your cutlery in a restaurant wasn’t clean you would complain and ask for a new set. Just because you can’t see under your dentures when you are wearing them, like your knickers it matters that they are clean!

It only takes 30 minutes after cleaning for the structures in your mouth and your denture to be covered in a film of salivary proteins [this is called the salivary pellicle] once this happens other bits of debris, old dead cells, food, bacteria, fungi get stuck onto the surface. Once bacteria and fungi are attached they will of course set up home and start to breed.

Dirty dentures will stain, smell, collect tarter [calculus] and the proliferating bacteria and fungi will cause other oral disease;- caries, gum disease [periodontitis], denture stomatitis, angular cheilitis. Micro-organisms growing on a denture are also associated with other systemic [whole body] diseases, either because they get into your blood system or because you inhale them. Poor denture hygiene has been shown to be linked to a higher risk of pneumonia in elderly patients.

If you have a partial denture it is even more important that it is kept free from debris as if bits of food and plaque are held onto your teeth by your denture you will develop cavities in those places.

It is also important [and this may sound obvious but to some people it isn’t] take your denture out when you clean your own teeth.

Cleaning Regime.

Last thing at night.

Remove your denture and clean your own teeth effectively, efficiently and thoroughly.

Put some water or a flannel in the bottom of the wash basin so if you drop your denture it won’t break.

Hold your denture between your thumb and your fingers front to back not side to side as you are liable to flex and crush it.

Scrub your denture with a denture brush, a manual tooth brush or your electric toothbrush. Scrub the side with the teeth and the side that goes on your gum [the fitting surface].Use a denture cream, soap, liquid soap, washing up liquid but whatever you do DON’T USE TOOTHPASTE. Toothpaste contains mild abrasives to keep the stains off your teeth, it will scratch the acrylic of your denture meaning it will stain, collect debris and look less life like.

You need to scrub a full set of dentures for 3 minutes. 1½ minutes for the top set and the same for the bottom. 45 seconds for the side with teeth and the same for the fitting surface. Using this as a guide you must calculate the time needed for your particular denture depending on the surface area your denture covers. The fitting surface is especially important as bacteria and fungi live on your dentures and you need to eradicate them each time you clean in order to reduce reinfection. If you have a soft lining on your denture use a soft brush gently to avoid damage and be careful cleaning round any clasps so as not to bend them.

When you have mechanically cleaned your denture you may put it in a proprietary cleaner if you wish. All cleaners on the market use different chemicals, make sure the one you purchase is suitable for the type of denture you have [it may not be if your denture is part metal, is a soft denture or has a soft lining]. Make sure you read the instructions very carefully and only soak your denture for the length of time stipulated, otherwise you may damage it. When you have removed it from soak, rinse thoroughly and either leave dry in a safe place or in water overnight.

DO NOT PUT YOUR DENTURES IN HOUSEHOLD BLEACH you will make them brittle and damage them.

In the morning.

Clean your teeth if you do it before breakfast, put your dentures in, have your breakfast and then take your dentures out, re clean your teeth and use your little brushes [see chapter 26] and then  clean your denture with a brush and denture cream or soap/detergent.

After lunch.

Clean your teeth if possible, clean your denture or at least if you can’t do that if you are out and about get your denture out and rinse it under the tap. Ideally rinse your denture after eating anything.

Denture cleaning machines.

You can now purchase ultra-sonic denture cleaning machines/baths. You may find them in a large chemist or your dentist may be able to advise you where you can purchase one online. As with anything make sure you follow the instructions especially as to length of time to be used, solutions to be used and type of denture it is suitable for.

Storage.

It is a good idea to have a special box to keep your denture in either a ‘denture box’ [available from the chemist] or a designated box of your own. It’s very easy, especially if you haven’t got your glasses on to; – knock them of the bedside cabinet, loose them amongst the sheets and end up putting them on a hot wash by mistake, drop them on your tiled bathroom floor etc.

Whatever you do don’t leave them lying around. I have had patients lose their teeth in the most peculiar of circumstances.

One gentleman left his dentures on the kitchen table at night and they were stolen by rats [I am not making this up, apparently rats like jackdaws are attracted to shiny things, they also left something in their place because some rats are borrowing rats- rats are very interesting!].

Another lost their dentures on a picnic, took them out to eat lunch, wrapped them in a paper napkin, put all the picnic rubbish in the council bin, got halfway home on the motorway, realised their mistake, rushed back only to find the efficient council concerned has just emptied all the bins!

Countless patients have lost their dentures swimming in the sea, if you are going for anything more than a paddle take your teeth [and your earrings] out first. One lady surprisingly found both of them several hours later wedged together between two rocks- truth is sometimes stranger than fiction!

If you think you are going to be sick, try and take your teeth out first. I had one lovely lady flushed hers round the U bend before she realised she had lost them. Sadly she was at a very smart function she had been looking forward to for ages and she had no choice but to go home.

Visit your dentist.

Whatever type of denture you have it is important to have it checked on a regular basis by your dentist.

Your dentist will check the fit, the wear and the material for fractures. Your ridge carries on shrinking under your denture, so you end up with a gap underneath where debris collects, it may be possible to correct this with a reline. An ill-fitting denture is more likely to break as it rocks and if it’s a partial denture will put more strain on your own teeth. If your denture does have a little crack this is much easier to repair at this stage than to wait till it has completely broken in two.

If you have a partial denture and you are visiting your dentist to have your own teeth checked DON’T FORGET TO TAKE YOUR PARTIAL DENTURE WITH YOU.

If you have complete dentures still visit your dentist at least annually for all the above reasons but also to check the health of the rest of your mouth. Sometimes nasty little cancers grow under dentures.

You need a spare.

Unless your denture is only temporary you need a spare. If you have an old one even if it doesn’t fit perfectly that will do. If you fall over and break your denture you can’t go to work without it. If it’s a break, a couple of days and it will be fixed but if it’s completely smashed or worse lost altogether you may need several weeks while a new one is made. Make sure you take your spare on holiday with you.

A new one every 5 years.

Your mouth changes shape over time, your own teeth move, your ridge shrinks and you wear your artificial teeth down so they no longer feel ‘sharp’.

As we all get older it takes longer to adapt to new things, if you leave it many years before you replace your denture you will find the new denture more difficult to adapt to. So better to have a new denture on a regular basis. Keep your old one as a spare. Try it in occasionally to make sure you can still wear it even though it’s only going to be needed in an absolute emergency.

If you find your new one difficult to adapt to, wear it round the house first, like a new pair of shoes till you get your confidence up and do go back to your dentist if you feel it needs adjusting. I always tell my patients a new denture will need at least 6 adjustments as standard. You might be lucky and need none or you might need more. Your dentist will be happy to help you, your dentist will want you to be happy with the service you have received. No one wants an unhappy customer!

Denture fixatives.

This is basically glue to help stick your dentures in. In an ideal world no denture would need adhesive but not always so. Or it might be the case that most of the time it’s fine but if you have to give a speech, a presentation, a lecture or you are going to some really important social event and you just want a bit of help to give you confidence, a bit of insurance against disaster. Denture fix can be very useful. Buy a good brand, follow the instructions and make sure you remove it thoroughly from your denture and your mouth last thing at night or bacteria and fungi will grow in it. Use it sparingly and only when absolutely necessary.

I hope this information is useful but if you have any other questions please ask your dentist.

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