DHCP recommendations and denture wearer habits are diverse, with no consensus on the most appropriate denture cleaning methods. This reflects a lack of clear, systematic evidence upon which to base recommendations.
Objective: Robust scientific and clinical evidence of how to appropriately manage denture plaque is lacking. This two-part study (i) developed an in vitro model of denture plaque removal, and (ii) assessed effectiveness of these approaches in a randomised clinical trial.Method: (i) a complex denture plaque model was developed using the dominant microbial genera from a recent microbiome analyses. Biofilms formed on polymethylmethacrylate were brushed daily with a wet toothbrush, then either treated daily for 5 days or only on Days 1 and 5 with Polident® denture cleanser tablets (3 min soaking). Quantitative and qualitative microbiological assessments were performed. (ii), an examiner-blind, randomised, crossover study of complete maxillary denture wearers was performed (n = 19). Either once-daily for 7 days or on Day 7 only, participants soaked dentures for 15 min using Corega® denture cleansing tables, then brushed. Denture plaque microbiological assessment used sterilized filter paper discs.Results: The in vitro model showed daily cleaning with denture cleanser plus brushing significantly reduced microbial numbers compared to intermittent denture cleaning with daily brushing (p < 0.001). The clinical component of the study showed a statistically significant reduction in denture plaque microbial numbers in favour of daily versus weekly treatment (aerobic bacteria p = 0.0144). Both in vitro and in vivo studies showed that denture plaque biofilm composition were affected by different treatment arms.Conclusions: This study demonstrated that daily denture cleansing regimens are superior to intermittent denture cleansing, and that cleansing regimens can induce denture plaque compositional changes. Clinicaltrials.gov registration: NCT02780661.
Introduction: A key purpose of denture provision is to enable eating, yet the body of evidence pertaining to the impact of dentures on wide-ranging nutritional outcomes has not been systematically reviewed. Objectives: To systematically review published evidence pertaining to the effect of wearing removable dental prosthesis on dietary intake, nutritional status, eating function, and eating related–quality of life (ERQoL). Methods: Eight questions relating to the impact of wearing dentures on nutritional outcomes were addressed. The target population was healthy adults aged ≥18 y. Data sources included Medline, Embase, CINAHL, and PubMed. Included were all human epidemiologic studies. The Newcastle-Ottawa score was used for appraisal of study quality. Harvest plots, vote counting, and accompanying narrative provided the basis for synthesis. Results: Of the 1,245 records identified, 134 were retrieved and eligibility assessed by 2 reviewers, and 41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor). The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake. The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate. Data showed that ERQoL was also compromised in denture wearers as compared with the dentate (3/3 studies). However, data showed a positive impact of wearing dentures on ERQoL (5/5 studies) as opposed to wearing no dentures. Conclusion: The balance of evidence shows that despite no clear pattern on impact of wearing dentures on measured dietary intake, in those with tooth loss, wearing dentures can have a positive impact on nutritional status and enjoyment of eating. Knowledge Transfer Statement: The results of this systematic review can be used to advocate for health care services to address prosthodontic need to benefit nutritional outcomes. The findings will be of use in educating health care professionals on the impact of wearing dentures and not addressing prosthodontic need on nutritional outcomes.
The findings of a subjective questionnaire showed that an experimental moisturizing mouthwash provided greater relief than water only from dry mouth symptoms over 8 days.
The base fit between a removable partial denture (RPD) and the underlying soft tissue plays a significant role in its performance. The application of a denture adhesive is hypothesized to result in better retention of RPDs and, as a result, contribute to lower stress on the oral mucosa. The objectives of this study were to observe and compare the distribution of simulated bite forces applied to the RPD through the abutments and soft tissue for models with and without the use of a denture adhesive. Furthermore, we evaluated the possible benefit of using a denture adhesive in lowering stresses on the oral mucosa. The RPD, mandible, oral mucosa, abutment teeth supporting the RPD, and the corresponding abutment periodontal ligaments (PDLs) were modelled as 3D volumes based on computer tomography (CT) datasets. A viscoelastic adhesive layer between the RPD and oral mucosa was incorporated into this base model using Prony series approximation. The layer was developed as a volume extract using the denture surface. Finite element (FE) simulations were performed for the bite force on one of the RPD segments, with the resulting force and moments experienced by the dental structures and oral mucosa compared between the model with the adhesive layer and the base model without. As a result, the contact pressure on the oral mucosa for the model with the denture adhesive decreased to 0.15 MPa as compared to 0.25 MPa for the model without the adhesive. The potential role of denture adhesives in leading to a better fit between the RPD and oral mucosa as well as lowering contact pressures could be used to improve comfort in patients wearing RPDs.
Introduction Due to a rising prevalence of removable partial denture (RPD) use, there is an unmet need to explore the psychological impact on patient wellbeing.Aim To assess the psychological effects of consumers losing teeth and receiving partial dentures to better manage their needs.Design Four market research surveys, undertaken on behalf of GlaxoSmithKline Consumer Healthcare, are described.Setting Surveys were conducted across the US, Japan, Malaysia, Colombia, Brazil, Poland and Italy.Materials and methods Quantitative/qualitative methods were used to gain knowledge regarding patients' experiences living with partial dentures.Results In a global market research survey involving 3,952 RPD wearers (RPDWs), 54% said that losing teeth was difficult to accept, 40% were concerned about their appearance, 32% were embarrassed about wearing dentures and 62% wished that more oral care education was available when they were younger. In another survey of >1,000 RPDWs, self-esteem was negatively impacted in 51% of respondents and 57% reported anxiety around dental visits.Conclusions Global market research confirmed that RPDWs can have emotional and practical needs that are not well understood/documented by dental healthcare professionals (HCPs). Consumer research can enhance understanding of patients' needs by dental HCPs and provide suggestions about how they may address them.
Only adhesive 1 was significantly better than the negative control, and its performance did not match that of the positive control. Adhesives 1 and 2 showed the largest number of oral adverse events.
Objective: A scoping review of available advice to address eating problems experienced by people who wear dentures was conducted in accordance with the PRISMA statement. The objective was to identify and map type, volume, and content of the available eating advice. Methods: Medline, CINAHL, and grey literature databases and Google were searched. Relevant content pertaining to study type, peer-review vs. grey literature, country of origin, advice content, and methods to evaluate effectiveness was mapped. Results: Of the 4591 records identified from peer-reviewed literature, 56 full papers underwent duplicate screening, resulting in 26 papers (from Germany (n = 1), Europe (n = 1), India (n = 2), Japan (n = 7), UK (n = 6), USA (n = 6), or other (n = 3)) being included in the review. These yielded 18 different items of relevant eating advice. Of the 258 screened websites, 63 were included, yielding 30 different items of eating advice. The most-cited advice was to eat soft food and avoid hard and sticky food, cut food into bite-sized pieces, and chew on both sides of the mouth and chew slowly and thoroughly. The identified advice was not supported by reference to peer-reviewed evidence. Advice included some conflicting messages and some advice was non-compliant with authoritative nutritional advice (e.g., avoid red meat, take a vitamin supplement). Conclusion: There is support for providing eating advice at the time of denture provision. A broad range of advice based on clinical experience to support people who wear dentures to overcome the functional limitations exists. However, the efficacy of this advice in improving diet and eating experience has not been tested.
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