Brushing Dentures Might Be Best Cleaning Method
08 October 2009
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Brushing removable dentures with a paste product might be the best way to keep them clean, better than soaking in effervescent or enzyme cleaning solutions, suggests a new review of what little dental literature exists on the topic.c Keeping dentures clean and free from plaque buildup can help prevent oral infections and gingivitis; however, few clinical studies focus on the best way to clean partial or complete dentures.
This scarcity of studies on real-life patients was surprising, said lead review author Raphael Freitas de Souza, D.D.S. Most studies of denture cleaning methods happen in the laboratory. "We need clinical trials," he said.
Dr. de Souza, with the Ribeirão Preto Dental School of the University of São Paulo in Brazil, 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. Studies compared different denture cleaning methods to one another or to 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 not possible to draw a strong conclusion on what method works best, de Souza said, there was 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 new review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews such as this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
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," she said. All dentures should be stored in water or a cleaning solution overnight because dentures should not dry out, she added. "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."
De Souza said that professionals usually do not recommend boiling dentures because it can cause them to deform. Similarly, heating dentures in water or another solution in a microwave oven can cause damage to the dentures, Brackett said. If using household bleach do so carefully, because it can cause discoloration in gum-colored portions of dentures, she added. "We do recommend a solution of water, bleach and Calgon to treat a yeast infection, but that is not something for routine basis," she said.
Another cleaning method is an ultrasound device that vibrates the water the dentures are in. Brackett said that battery-operated ultrasound cleaners are available for about $10, but that the professional models used by prosthodontists' offices to clean dentures are better. In her office, dentures undergo ultrasonic cleaning when the patient comes in for an annual check-up, which is advisable both to check for fit and wear and tear on the dentures and to screen for head and neck cancer.
The Cochrane Library contains high quality health care information, including Systematic Reviews from The Cochrane Collaboration. These reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.