Randomized clinical trial of complete denture cleaning methods in residents of care institutions

Ana Paula Sponchiado,Edvaldo Antonio Ribeiro Rosa,Maria Cecília Carlos Lopes Giacomel,Rosimeire Takaki Rosa,Rodrigo Nunes Rached,Evelise Machado De Souza

doi:10.20396/bjos.v20i00.8661060

Abstract

Aim: To evaluate the efficacy of ultrasonic bath and traditional brushing in the hygiene of complete dentures of dependent residents in long-term care institutions (LTCIs). Methods: A randomized cross-over clinical study was conducted in 17 maxillary complete denture wearers living in LTCIs. Cleaning protocols were brushing or ultrasonic bath, both applied with neutral liquid soap. Biofilm biomass were estimated by MTT reduction assay and specific microbial load (CFU) of Streptococcus spp., Staphylococcus spp. and Candida spp. were quantified by selective and differential culture media. Results: Ultrasound method showed higher percentage reduction of biofilm biomass and specific microbial loads of Streptococcus spp. compared to brushing (p<0.01). Reduction of microbial loads of the other microorganisms were not different between cleaning methods (p>0.05). Conclusions: The ultrasonic bath proved to be a feasible alternative method for the mechanical cleaning of complete dentures in LTCIs.

Highlights

Denture stomatitis affects approximately 65% of patients with maxillary complete dentures and it is commonly associated to poor oral hygiene[1]
Systemic dissemination of microorganisms from oral infections associated with biofilm accumulation in complete dentures may cause bacterial endocarditis, aspiration pneumonia and chronic obstructive pulmonary disease in dependent elderly patients[7,8,9]
The current study compared the efficacy of the mechanical cleaning methods brushing and ultrasonic bath, on denture biofilm mass and specific microbial loads

Summary

Introduction

Denture stomatitis affects approximately 65% of patients with maxillary complete dentures and it is commonly associated to poor oral hygiene[1]. The condition may be aggravated by trauma, continuous use of the dentures, allergic reaction to the denture base and cleaning products, hyposalivation, inadequate diet and use of antibiotics[2,3]. Candida albicans is the main etiological agent of this condition or associated to other pathogenic and opportunistic microorganisms, such as Streptococcus spp., Staphylococcus spp. and Lactobacillus[4,5,6]. Systemic dissemination of microorganisms from oral infections associated with biofilm accumulation in complete dentures may cause bacterial endocarditis, aspiration pneumonia and chronic obstructive pulmonary disease in dependent elderly patients[7,8,9]. Complete dentures can be cleaned using chemical and/or mechanical methods such as hypochlorites, peroxides, enzymes, mouthwashes, brushing, sonic and ultrasonic vibration[10,11]

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