O21 Malodour in denture wearers

Abstract

A significant proportion of the adult population wear complete or partial dentures, a proportion increasing with age. Denture plaque has not been studied to the same extent as dental plaque, and although there are many similarities in microbial composition, there are some significant differences. Plaque on denture fitting surfaces, particularly of the upper denture, is associated with denture‐associated stomatitis, with the aetiological agent generally acknowledged as the yeast Candida albicans. In addition, poor denture hygiene and a more acidogenic denture plaque appear to be factors contributing to the condition. Anaerobic microorganisms, although present in denture plaque, have been specifically investigated rarely. Teeth adjacent to partial dentures are also more susceptible to caries and periodontal diseases, perhaps due to an increased plaque buildup at the prosthesis/tooth interface. Dentures are fabricated from polymethylmethacrylate, using casts constructed from impressions taken in the mouth. The denture‐fitting surface is not smooth (although the lingual/labial surfaces are polished) hence plaque accumulates more readily at the relatively stagnant sites. Over time, the epithelial surfaces in the edentulous mouth alter in shape, and dentures may fit less well. Soft liners, or more temporary tissue conditioners are applied to the prosthesis to improve comfort and fit. These materials, are more porous, and may thus entrap and accumulate more plaque biofilm. Little work has been done on malodour associated with denture wearers. There may be a number of reasons for this:(i) the population is deemed to be one which is less cosmetically aware, less likely to invest in products to enhance aesthetics. As the global population ages, and lifespan extends along with enhanced finance, leisure time and health status in selected developed countries, this presumption is perhaps inappropriate.(ii) The nature of malodour in denture wearers is ill defined. The wide age and health range presented by denture wearers poses problems in terms of defining the target populations and specific conditions.(iii) The origin of malodour in denture wearers – and indeed in the elderly in general – is varied: underlying serious illness (malignancy), chronic illness, ulcers, increased medication etc. are all likely to affect breath odour – ammonia, ketones etc.(iv) The increased likelihood of the presence of Candida spp. in the mouth may contribute ‘yeasty’ odours.(v) Poor denture hygiene, accumulation of calculus on prostheses, deterioration and colonization of soft liners will cause significant increases in plaque quantity. Products of deterioration of inert materials in the mouth may also contribute to odour.This presentation will review current status in the area, suggest possible causes of malodour in denture wearers, and consider the need for further work.