Abstract
BackgroundAppropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures.MethodsIn a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%.ResultsOvernight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores.ConclusionsThe use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing.Trial RegistrationClinicalTrials.gov NCT02454413
Highlights
In developed countries, there is a tendency of decreasing edentulism and increased retention of natural teeth until old age [1,2,3,4]
The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water
A recent study [18] indicates that the risk for aspiration pneumonia in very old denture wearers ( 85 years) even doubles in case they wear their dentures during sleeping as a result of increased microbial load
Summary
There is a tendency of decreasing edentulism and increased retention of natural teeth until old age [1,2,3,4]. Due to an increasing proportion of older people in the population and socio-economic deprivation as persistent risk factor for edentulism [5], the latter remains an oral health issue which is associated with impaired well-being and poor general health [6,7] Because of their impaired oral function and overall well-being, edentulous persons seek for replacement of their lost teeth. There is evidence that denture use has a positive association with nutrition, cognitive and physical function, general well-being, and even survival [8,9,10].several studies indicate that denture cleanliness and oral hygiene of denture wearers is generally poor [11,12], thereby facilitating the formation and accumulation of an oral biofilm This biofilm holds a risk for oral infection, discomfort [13,14,15], and general health problems such as aspiration pneumonia [16,17]. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures
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