Evaluating risk factors associated with poor removable prosthesis hygiene in community-dwelling elders: A cross-sectional study

Abstract

Removable dental prosthesis cleanliness is multifactorial, and key clinical and nonclinical factors associated with prosthesis hygiene should be identified to inform practice, particularly given the dearth of studies relating specifically to prosthetic factors and prosthesis cleanliness. The purpose of this cross-sectional clinical study was to evaluate removable dental prosthesis cleanliness among community-dwelling elders by using a semi-automated planimetric assessment and to determine factors associated with removable prosthesis cleanliness. The cross-sectional study was conducted among community-dwelling elders wearing removable prostheses. Digital images of plaque on removable prostheses were made after staining with a plaque-disclosing agent by using a single-lens reflex camera with a standardized arrangement. The area of plaque coverage was quantified by using a semi-automated planimetric assessment method. Participant profiles were recorded, including sociodemographic and prosthesis-related variables. Variations in removable prosthesis cleanliness were determined in bivariate and regression analyses with the forward Wald test (α=.05). A total of 97 community-dwelling elders attending a hospital dental clinic were recruited (41 men and 56 women). The mean percentage of prostheses covered with plaque was 24.8%, and 42 (43.3%) were deemed 'unclean' (plaque coverage>25%). Bivariate analyses identified numerous prosthesis-related factors associated with prosthesis cleanliness (P<.05) including prosthesis age, prosthesis material, prosthesis retention and stability, prosthesis fit, and presence of denture stomatitis. Logistic regression analysis indicated that prosthesis fit was the key factor associated with prosthesis cleanliness, accounting for sociodemographic and other prosthesis-related factors (P<.001). Prostheses that were classified as completely ill-fitting were 12 times more likely to be unclean (OR=12.03; 95% CI 3.33-43.41) than those in the well-fitting group. Among a community-dwelling sample of older individuals attending a teaching hospital, approximately half had unclean prostheses as identified by the semi-automated planimetric method. Prosthesis fit was a key factor associated with prosthesis cleanliness. The findings have implications for maintaining removable prosthesis hygiene in the community.