Brushing removable dentures with a paste product might be the best way to keep them clean, suggests a new review of the limited dental literature that exists on the topic (Cochrane Database of Systematic Reviews, 2009, Issue 4).
The scarcity of studies on real-life patients was surprising, said lead author Raphael Freitas de Souza, D.D.S. Most studies of denture cleaning methods happen in the laboratory. "We need clinical trials," he said in a press release.
Dr. de Souza, with the RibeirĂŁo Preto Dental School of the University of SĂŁo Paulo, and colleagues evaluated six randomized controlled studies. In some studies, the denture wearers were in institutions, while other studies involved patients at university dental clinics. The studies compared different denture cleaning methods to one another or a placebo.
Cleaning methods included soaking dentures in enzyme solutions, soaking in effervescent solutions, routine brushing with a paste product, and a combination of brushing and soaking. The studies examined the effects of each method on outcomes such as irritation in the mouth or inflammation of the gums and other oral tissue, the presence of bad breath, and how much plaque was on the dentures.
Although it is impossible to draw a strong conclusion on what method works best, Dr. de Souza said, the reviewers found weak evidence that, among chemical cleaners, enzyme-cleaning products were more effective than a placebo.
"We cannot be pretty sure what the most effective methods for denture cleaning are. But we can infer possibly that brushing can give better results," he said. A patient with poor manual dexterity who cannot brush well might be better off using chemical cleaners and soaks, he added.
The results of the review are interesting but might have little effect from a practical standpoint, said Susan Brackett, D.D.S., director of public and professional relations for the American College of Prosthodontists. She is in private practice as a prosthodontist in Oklahoma City.
"We give our patients a sheet of instructions and recommend that they mechanically clean the dentures by brushing with dishwashing soap to get the major debris off," Dr. Brackett said. All dentures should be stored in water or a cleaning solution overnight because dentures should not dry out, she noted. "If they like, patients can soak the dentures in an effervescent solution overnight. You can do both mechanical and chemical, but it is not absolutely necessary," she added.
Professionals usually do not recommend boiling dentures because it can cause them to deform, Dr. de Souza said. Similarly, heating dentures in water or another solution in a microwave oven can cause damage to the dentures, according to Dr. Brackett. If using household bleach, do so carefully because it can cause discoloration in gum-colored portions of dentures, she noted. "We do recommend a solution of water, bleach, and Calgon to treat a yeast infection, but that is not something for routine basis," she added.
Another cleaning method is an ultrasound device that vibrates the water the dentures are in. Battery-operated ultrasound cleaners are available for about $10, but the professional models used by prosthodontists' offices to clean dentures are better, Dr. Brackett said. In her office, dentures undergo ultrasonic cleaning when the patient comes in for an annual checkup, which is advisable to check for fit and wear and tear on the dentures, as well as to screen for head and neck cancer.
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