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Some patients think once they get dentures, they never have to worry about their teeth again. It is up to you to set them straight. Here’s what the experts had to say about the care and maintenance you need to communicate to patients about their dentures.
Sometimes when a patient gets a denture, they think, “That's it for dental care for the rest of my life.” However, you know that is not the case and that their expectations for the appliance are already too high.
Per Polident, dentures last between five and ten years.1 However, Raymond Choi, DDS, a mini-implant dentist and educator for Glidewell Laboratories, says many times patients hold onto them for longer than that.
“I heard or read somewhere that the average age of dentures in America is about 12 to 18 years,” Dr. Choi says.
So, how do you set proper expectations for care and maintenance of a denture once you deliver a prosthesis? We spoke to denture experts to see what they had to say.
Dr. Choi says the best time to go over the expectations for care and maintenance is right from the start. He does it when he meets patients rather than when he is finished with treatment.
“I always find that to be more effective to do it upfront. Patients are more receptive and rather than doing it at the end or afterward when they have some issues. So that's a good time or at least at the delivery appointment,” Dr. Choi says.
Rinse the denture after eating. Shirin Khoynezhad, DDS, is a prosthodontist and the Director of Second-Year Pre-Clinical Dentistry at the University of Alabama starts the conversation with patients about caring for dentures with rinsing their mouth and the prosthesis after they eat. When dining out, she encourages her patients to go to the bathroom and rinse the denture.
Brush the teeth and the contact surfaces in the mouth. Dr. Choi shares a few things with his patients, beginning with how to brush them. There are many different ways to do this properly. Some people use a soft nylon brush with a little bit of toothpaste while others use denture cleaning tablets at night. Dr. Choi tells them to get a denture brush with a little bit of toothpaste and to scrub the surfaces of the denture lightly under warm running water.
Dr. Khoynezhad agrees, adding she wants the patients’ to pay attention to the contact surfaces of the denture in their mouths. She suggests they brush the roof of their mouth and gums at the same time they are brushing the denture.
“I tell them to make sure that all the areas underneath the dentures are also clean,” she says.
Leave the dentures out at night. Next, Drs. Choi and Khoynezhad explain that patients should not sleep with a denture in their mouth and that it is vital to leave it out at night. They tell patients that because the denture covers all their gums, it is not healthy for them to always wear it; the gums need a break.
“That’s not good, especially with patients who are prone to denture stomatitis,” Dr. Khoynezhad says. “They have to make sure that they soak the denture overnight and clean it in the morning to give the tissue a rest and to deep clean the denture.”
“I tell the patients that gums cannot breathe as well when the denture is there all the time. They can relate to that little bit better,” Dr. Choi says. “And not only that, all the germs that are in the mouth stick to the dentures. By wearing the denture all the time, the patient is keeping the germs around their gums 24/7.”
“After they soak it, if they are using any denture cleanser, patients have to make sure they rinse the denture well because that is chemicals. It’s not good for the body, and it can irritate the soft tissue as well,” Dr. Khoynezhad says. “So, I tell them they have to make sure they rinse it in the morning.”
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Take an easy but thorough approach to cleanings. Many patients are surprised to learn they should not use whitening toothpaste on a denture.
“I have had patients come in feeling proud that they brushed the dentures so well. But actually, they are basically abrading the denture,” Dr. Khoynezhad says.
Dr. Khoynezhad explains to them that acrylic teeth are different than natural ones. The materials in the denture do not hold up well to the abrasive forces of the paste.
She also warns patients not to boil the denture. While it seems like it is doing a good job cleaning it, you can damage the denture.
Come in for periodic professional cleanings. Dr. Khoynezhad recommends that her patients see her regularly so that she can professionally clean their dentures for them.
Explain how dentures work long term. Many patients do not know that when you first extract the teeth, the supporting bone tends to resorb quickly over the next year and how that changes the ridge or gums. Dr. Khoynezhad tells them how the denture cannot adapt to the changes in the gums and supporting bone structure.
“Everything changes in the body. Dentures don’t,” Dr. Khoynezhad says, adding that she explains to patients how the fabricated denture will not fit over time as the oral environment changes.
Drs. Choi and Khoynezhad both explain to patients that their new dentures will need to be replaced as part of the maintenance conversation. Dr. Choi also explains that as dentures age, they also absorb more stains and germs.
Patients tend to hang onto dentures because getting a new denture is a process, and there are costs involved. Plus, once patients get comfortable with a denture, they find a way to work with what they have and don’t want to make a change.
Dr. Choi understands how patients feel. However, he explains that after around five to ten years of service, patients should replace their denture. Many times, this is a surprise to new denture patients who thought getting dentures was the end of coming to the dentist.
"So, it is a surprise to some patients, but through a straightforward explanation and education I think most people quickly realize that it is necessary," Dr. Choi says.
Describe what can happen without proper maintenance. Dr. Khoynezhad also tells patients that once a denture is ill-fitting, there can be complications that cause them discomfort.
"When dentures get loose, then more food gets underneath it. Plus, you get more trauma here and there over the denture because it's not seating nicely, like the snowshoe effect," Dr. Khoynezhad says.
Also, the force areas move once a denture become ill-fitting. Some areas get more force than they did and ulcers and sore spots form.
"Where they get irritated, it is good housing for those organisms to start growing and cause stomatitis," she says.
Schedule their first appointment for a check-up. Some patients do not realize the importance of periodic examinations. Many get a denture and do not return to the office until it breaks, or they need it relined.
To combat this reality, Dr. Choi emphasizes the fact that he wants to see his patients at least once a year for oral cancer screening, gum health assessment, and also to see if the denture is causing any problems in their mouths. He schedules that denture check-up appointment before they leave that day.
“I tell them they can reschedule when the time comes,” Dr. Choi says of the appointment he schedules. “But we'll have you in the system so that we get you back to make sure that you're doing okay.”
1. “How long do dentures last?” Web. 8 August 2019. https://www.mydenturecare.com/en-au/expert-advice/living-with-dentures/looking-after-your-dentures/how-long-do-dentures-last/