Denture Care Research Articles

Denture care of in-patients

The attitude of nursing staff to the denture care of in-patients in hospital following the introduction of written guidelines on denture care was assessed together with the need for further guidelines. A survey in the form of a questionnaire was carried out on 100 nursing staff in a general hospital. The topics covered included usefulness of the guidelines and denture hygiene and general denture care procedures on the ward together with aspects of general denture care included in the nurse training programme. There was a 66% response rate. The results highlighted that the introduction of written guidelines were helpful to the nursing staff but additional training was requested. A computer-aided learning (CAL) programme on denture care aimed specifically at nursing was then developed. A total of 81 nursing staff were surveyed following the introduction of the CAL programme. The results demonstrated that the CAL programme was well received by 100% of the staff surveyed. Further work is to be undertaken on the development of an oral-health educational programme for nursing staff.

Denture care of in-patients

Denture care of in-patients

The dental awareness of nursing home staff in Singapore – a pilot study

The aim of this pilot study was to assess the oral health knowledge among staff working in a local nursing home managed by a voluntary welfare organisation. A self-administered questionnaire was completed by 53 nursing staff working in a home with 270 residents. The questionnaire was structured to assess the staff's knowledge of dental caries, periodontal disease and the care and use of dentures. 99.6% of the respondents felt that oral health care of the elderly was very important. However, only 45.3% of them attributed the cause of dental caries to the frequent intake of sugar. Bacteria in dental plaque was identified by 88.7% of them as the main cause of periodontal disease while 96.2% of them indicated that dentures should be cleaned at least once a day and rinsed after every meal. The staff of this nursing home demonstrated positive knowledge of periodontal disease and denture care. However, their knowledge of dental caries revealed substantial room for improvement. This could signal an area for future staff training and development. Such efforts would help establish a team of caregivers who can improve the oral health and quality of life for residents in the nursing home.

Gap in Dental Care Can Lead to Diabetes, Other Disease Conditions

Gap in Dental Care Can Lead to Diabetes, Other Disease Conditions

Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city

Background Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care.

Denture care

Denture care

An assessment of the oral health knowledge and recall after a dental talk amongst nurses working with elderly patients: a pilot study*

To assess the oral health knowledge amongst nurses working with elderly people in a local hospital run by a Primary Care Trust before and after a dental training talk. Nursing staff working at Swanage Cottage Hospital completed a questionnaire designed to assess their knowledge of dental decay, periodontal disease, oral hygiene, denture care and palliative care. One month after receiving a dental talk, the questionnaire was redistributed to the participants. A t-test was used to compare the number of correct answers before and after the talk. Twenty members of the nursing staff completed the initial questionnaire and 14 completed it 1 month after the talk. Prior to the talk, of the 45 questions, the mean number of correct answers per member of staff was 23.95+/-3.83. One month after the talk this had risen by 25% to 34.9+/-3.83. This increase was statistically significant (p < 0.0001). A dental talk to a group of nursing staff caring for elderly people in a local hospital produced a significant increase in the level of oral health care knowledge.

CURRENT TRENDS IN REMOVABLE PROSTHODONTICS

This article discusses trends in the demographics and treatment of the edentulous patient. It is clear that there still is a tremendous need for removable-prosthodontic services today. While the basic process of making dentures has changed little over the past several decades, new materials and techniques can help laboratories and clinicians provide functional, esthetic restorations that offer exceptional value to patients. Implant treatment is a tremendous adjunct to removable prosthodontics in the treatment of edentulous patients, but it is not within the financial reach of all dental patients. The clinical skills required to deliver excellent complete denture care are also paramount to successful implant prosthodontics (fixed and removable) and esthetic dentistry. Even so, the opportunities to develop these skills and the interest appear to be decreasing at the same time that the need is projected to increase. In service to our patients, the profession must examine this trend closely.

Dental needs of pre-retirement and retired people in aninner-city area

Perceived and normative dental needs were assessed for people of pre-retirement (55–64years) and retirement age (65–74 years) in Camberwell, London, using a postal questionnaire and dental examination. Of the pre-retirement group, 77% were dentate compared with 65% in the older cohort. The younger age-group were more likely to believe teeth were more important and to perceive a need for dental care. People who attended for the examination were more likely to perceive a need for (64% and 15% respectively) and want treatment (39% and 17%) than non-examinees. Also, they were more likely to be unhappy with their appearance (43% and 20%) and to be in pain (42% and 21%). Treatment need was similar for both groups with regard to restorative and extraction needs. However, the retirement group were more likely to have deep periodontal pockets (33% and 8%) and a greater normative need for denture care.

A socioeconomic comparison of patients receiving prostheses in a two-tier delivery system

It has been theorized that the legalization of providers of denture care other than dentists would make dentures more affordable to and therefore more often obtained by individuals of lower socioeconomic status. The delivery of dental prostheses by nondentists (denturists) has been legalized in Arizona, Colorado, Idaho, Maine, Montana, and Oregon. This study compares the socioeconomic and utilization patterns of two groups of patients receiving prostheses: (1) those whose prosthetic services were provided by dentists and (2) those whose services were provided by denturists. The sample included 135 participants; 31 individuals with 54 prostheses made by denturists and 104 individuals with 165 prostheses made by dentists. Application of the chi-square test and the Hollingshead Two-Factor Index of Social Position revealed no statistically significant correlation, ( p < 0.05) between the provider-based groups and standard socioeconomic variables. The history and pattern of choice of provider as well as level of satisfaction were also remarkable for the similarity displayed by the two groups. It would appear that the two groups are actually one homogeneous group served by two levels of providers.

Effect of a geriatric educational experience on graduates activities and attitudes

Clinical geriatric dentistry has not been an important part of most dental curricula. However, changes in demographic and patient expectations signify that geriatric oral health care can no longer be equated with supplying dentures for an aging population, but must be understood as treatment of the complex needs of a dentate population. The 1975 to 1985 graduates of the University of Iowa College of Dentistry were surveyed to evaluate the influence on dental practice of a comprehensive geriatric dental curriculum introduced in 1980. The post-1980 graduates were more likely to be practicing in larger population centers and less likely to be treating patients over 75 years of age. The dentists who graduated before 1980 were more likely to be consultants in nursing homes and carrying out examination, emergency care, and/or denture care, whereas the group of dentists who graduated after 1980 and had geriatric clinical experience with frail and functionally dependent older adults were more likely to be carrying out comprehensive care. When given a list of 18 geriatric dental and gerontological topics, few differences were found between cohort groups in terms of knowledge and confidence in carrying out procedures.

How to promote and maintain good oral health in spite of wearing dentures

A frank discussion at the beginning of treatment will inform the patient of what is possible in denture fabrication as well as in proper and responsible denture care and oral hygiene for the life of the patient. Dentures and mouths need examination and care for life. Only by regular visits to the dentist can this be accomplished. Dentures seldom change: mouths do Regular visits allow professional evaluation of the oral tissues and the functioning jaw-joint mechanism to detect early treatment needs of the tissue and/or the denture. This interface must be intimate, vibrant, healthy, clean, and comfortable. To this end only, the professional person with a depth of knowledge, total education, keen insight to the anatomy, physiology, total body health, and the psyche and its interrelations to the inanimate prosthesis can make the denture an integral part of the living being. The dentist can keep it that way with the patient's cooperation. Dentures can be one of the best replacements of human body parts; but professional care and good home care are essential.

Modifications of the superstructure for the staple implant

Two techniques have been described to expedite fabrication and reduce the cost of prostheses made for staple implants. The techniques permit placement of a simulated transosseous pin within the master cast. At the time of denture placement in technique No. 1, the coping-bar attachment assembly is cemented (Fig. 12). In technique No. 2 the superstructure is placed over the transosteal pins and secured between the locknuts to maintain the base of the lower locknut 1.5 mm from the crest of the alveolar ridge (Fig. 13). Technique No. 2 permits removal of the superstructure as desired. Patients should be instructed in proper oral hygiene and denture care.

Clinical Evaluation of the Wax Trial Denture

A complete denture is a mechanical object, much of which is fabricated outside the dental operatory. Its specific fabrication, however, is dictated by clinical facts, as outlined in instructions provided by the dentist. This mechanical object must function in a biologic atmosphere, and every effort must be made to assure a harmonious relationship between the mechanical and the biologic. The wax trial denture stage becomes a critical phase of complete denture care in evaluating this relationship. The wax trial denture should be evaluated relative to trial base stability, vertical dimension, centric and protrusive jaw relationships, tooth selection, the level of the occlusal plane, buccolingual and anteroposterior tooth position, and occlusal articulation. Although all of these factors should be further evaluated at the denture insertion stage as well as at each recall visit, only at the wax trial denture stage can significant changes be easily accomplished. The wax trial denture evaluation should receive adequate consideration in any complete denture technique.

Materials and methods for cleaning dentures

Proper hygienic care of removable dentures is an important means of maintaining a healthy oral mucosa in denture wearers. Denture cleanliness is often poor due to improper mechanical cleansing and the relative inefficiency of most commercial products for chemical cleansing of dentures. Dentists and patients should realize that microbial plaque on dentures may be harmful to both the oral mucosa and the patient's general health. It is the responsibility of the patient to maintain oral hygiene through a daily home care routine. It is the obligation of the dentist to motivate and instruct the patient and provide the means and methods for plaque control. Future research should be directed to developing solution cleansers which can maintain plaque-free dentures with a daily soaking period of 15 to 30 minutes and not affect the color and surface luster of the denture acrylic resin.

Post-Placement Care of Complete and Removable Partial Dentures

In line with the guidelines established by the American Dental Association, the American Prosthodontic Society, and materials presented in this paper, a few recommendations can be presented in regard to the post-placement care of complete and removable partial dentures. Accumulations of plaque and food should be removed daily, if not more often. This is most quickly and efficiently accomplished with a denture brush and mild soap. In addition dentures should be rinsed thoroughly after all meals. Where a brush cannot reach, and for sterilization or stain removal, a dilute solution of commercial bleach can be sparingly swabbed over the denture surface. The soaking of any appliances with chrome metal parts in solutions of sodium hypochlorite for lengthy periods of time must be avoided owing to the corrosive potential of the solution. Soaking agents are generally useful for freshening dentures, removing or masking odoriferous compounds, and to a lesser degree for removing accumulations of stain and calculus. If a patient has been or desires to use commercial cleansers, the precautions previously described should be observed. Certain special situations may require the prescription of denture cleanser use on a regular, even daily, basis. Handicapped, aged, or ill patients cannot realistically be expected, at times, to carefully employ a denture brush in any home care program. Soaking agents can be of great benefit to them in that they easily reach all surfaces of the prostheses, and present the least possibility for accidental damage as a result of mishandling. It is clear that post-placement instructions should be tailored to the individual. Physical coordination, age, the materials from which the dentures are made, and smoking and eating habits are just a few of many aspects that should be considered when developing an intelligent hygiene program. The chemistry involved in keeping dentures clean has been and continues to grow more complex. What was once a problem routinely left to a patient's own better judgment has now, owing to advertisement pressure and advances in materials science, increasingly become the dentist's responsibility. Information on many commercial products to patients is lacking and until more of this information is made available to the profession through research or through the manufacturers themselves, we will for the most part have to rely on time-tested materials and methods for denture hygiene.

Guidelines for professional quality dentures for the financially disadvantaged

The purpose of this project was to evaluate and report on the timing of procedures involved in complete denture service based on criteria for assessment of quality and to determine the effectiveness of a model of such a delivery system in terms of success of treatment and reduction of cost. It can be concluded that the denture care system may and can be used as a model to provide the base line reference to compare with other denture care delivery systems; the use of criteria for assessment of quality is not only efficient, but is also practical; and a complete denture treatment service of the quality defined by the criteria developed for this model can be provided to patients.

Instructions for patients—a positive factor in removable partial denture service

Studies have shown that improper wearing and care of removable partial dentures may adversely affect abutment teeth and associated periodontal tissues. A comprehensive removable partial denture service should include not only accurate construction of the prosthesis, but also printed instructions for the patient. Printed instructions help to inform the patient that delivery of removably partial dentures is only a part of our health service designed to maintain good oral health. A text of such concise printed information and instructions for the patient is presented.

Denture Cleansers and Retaining Devices

Proper hygienic care of removable dentures is an important means of maintaining a healthy oral mucosa in denture wearers. Denture cleanliness is often poor due to improper mechanical cleansing and the relative inefficiency of most commercial products for chemical cleansing of dentures. Dentists and patients should realize that microbial plaque on dentures may be harmful to both the oral mucosa and the patient's general health. It is the responsibility of the patient to maintain oral hygiene through a daily home care routine. It is the obligation of the dentist to motivate and instruct the patient and provide the means and methods for plaque control. Future research should be directed to developing solution cleansers which can maintain plaque-free dentures with a daily soaking period of 15 to 30 minutes and not affect the color and surface luster of the denture acrylic resin.

Instructions for the use and care of removable partial dentures

Instructions for the use and care of removable partial dentures