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Materials and methods for cleaning dentures- a review

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 E-ISSN :0975-8437 P-ISSN: 2231-2285

RESEARCH REVIEW
Materials and methods for cleaning dentures- a review
Mansour Oussama, Hamdan Ahmad

Abstract
Todays dentists and patients has the awareness that accumulation of plaque on dentures has an impact on patients
general health. Patients are willing to learn proper oral hygienic techniques and use of advanced materials for the main-
tenance of the dentures. Dentists have an obligation to motivate and instruct the patient and provide the means and
methods for plaque control. This review paper discuss current materials and methods for cleansing dentures and differ-
ent ways for maintaining oral hygiene.
Keywords: Dental Plaque; Denture; Oral Hygiene; Patient Education; Public Health

Introduction duce an effervescing action, and so the cleanser may exert a

The process by which denture accumulate plaque, stain, and mechanical ability to remove loss debris. Peroxide cleansers
calculus is approximately similar to that process which take seem to be more effective on new plaque and stain but they

I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S
place on natural teeth.1,2 The calcareous deposits which form are not better than brushing with soap.7-9 These products are
on dentures are consisting specially of inorganic and organic not effective when soaking period is limited. Denture should
particles.3,4 The organic particles form about 15% to 30% of to- be soaked in the chemical solution for several hours over-
tal calcareous deposits. They consist basically of glycoprotein night.10-12
and are responsible for binding the deposits to the denture. It
is presumed that these glycoproteins are similar in nature to There are no side effects from the use of peroxide cleansers
the organic matrix of plaque that form on natural teeth. according to recent electron microscopic studies. Prolonged
immersion of heat or chemically cured acrylic resin in peroxide
Beside the esthetic and malodor problems, the layer of plaque cleansers did not affect the surface.12-14 However, there is some
which forms on the surface of the denture, has a great clin- evidence that peroxide cleansers used for denture cleansing
ical significance. It induces a variety of soft tissues changes may cause bleaching of acrylic resin.15 Soft resilient denture
like denture stomatitis, inflammation, papillary hyperplasia, liners are very susceptible to the harmful effects of peroxide
or chronic candidiasis.2-4 A routine denture cleaning regimen cleansers.16 Peroxide cleansers have a pleasant odor and show
should be followed by patients to remove mucin, food debris, little harmful effect on the metal components of partial den-
calculus, and exogenous discoloration and to prevent re-accu- tures.12
mulation of microbial plaque. The purpose of this article is to
review current materials and methods designed for cleansing A.2. Alkaline Hypochlorite: Alkaline Hypochlorite solutions
dentures and to discuss special differences between them. such as mersene, are useful as denture cleansers because they
remove stains, dissolve mucine and other organic substanc-
Commercial denture cleansing products can be divided into es.7,17 They are bactericide and fungicide It is believed that hy-
two large categories, chemical materials and mechanical pochlorites act directly on the organic matrix of plaque. Hypo-
methods ( Table 1). chlorites remove light stains and food debris with a bleaching
action due to hypochlorite ion (ClO) and chlorine molecule
A. Chemical Denture Cleansers (Cl2 ) which attack the organic matrix .7

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A.1. Alkaline peroxide: Such as efferdent and polident which

2014 Volume 6 Issue 2

are the most commonly used denture cleansers. They include Hypochlorites do not dissolve calculus but it may inhibit cal-
powders or tablets which dissolve in water to form an alkaline culus formation on dentures. Alkaline hypochlorite is reported
solution.5,6 This type of cleanser acts by reducing the surface to tarnish and corrode the metal chromium-cobalt framework
tension and releasing oxygen. The released oxygen can pro- and the gold plated nickel pins in porcelain teeth.18,19 The
addition of anti-corrosive agents such as sodium hexameta-
A. Chemical Denture Cleansers phosphate or an excess of alkaline helps overcome this disad-
1. Alkaline peroxide. vantages. However, the anti-corrosive additives settle out and
2. Alkaline hypochlorite. loss their effectiveness.10,2 Hypochlorite salts are effective with
3. Dilute organic or inorganic acids. overnight immersion but they should not be used more than
4. Disinfectants. once a week because they bleach the resin.
5. Enzymes.
A.3. Dilute organic or inorganic acids: Commercial solution
B. Mechanical Denture Cleansers cleansers of dilute acids are affective against calculus and
1. Brushing. stain on dentures. Their effect depends upon the dissolution
2. Paste and powder. of organic part of denture deposit.19 The acid cleansers are
3. Ultrasonic devices. commonly a 5% solution of hydrochloric acid, or phosphoric
acid. A combination of both acids may be used to enhance the
Table 1. Classification of Commercial denture cleansing products

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E-ISSN :0975-8437 P-ISSN: 2231-2285 E-ISSN :0975-8437 P-ISSN: 2231-2285

Oussama et al Materials and methods for cleaning dentures- A Review

action of the cleanser. Acetic acid can also be used to dissolve disks which had been incorporated into maxillary dentures. The American dental association council on dental materials 9. Harrison A, Basker RM, Smith IS. The compatibility of temporary
calculus. These products should only be used in weekly or bi- The disks then were immersed in either the enzyme solution and devices suggest that the ultrasonic cleansers do enhance soft materials with immersion denture cleansers. The Interna-
weekly intervals because they will cause corrosion of metal or in a commercial peroxide solution cleansers for 15 minutes the cleaning capacity of a detergent solution. However, they tional journal of prosthodontics. 1988;2(3):254-8.
components in the denture. Lots of attention should be taken or 8 hours. After 8 hours, enzyme cleansers were more effec- indicate that the cleaning of the denture is mostly due to the 10. Veres E, Wolfaardt J, Hnizdo E. Denture cleansers: Part III--A
in handling and storing these products since they may dam- tive in plaque removal than the commercial cleanser. Also, no chemical activity of the solution rather than to the mechanical survey of materials and methods employed by denture wear-
age clothes and be harmful to eyes and skin. unwanted or harmful effects have been reported from the use properties of the devices themselves. The ADA found that ul- ers. The Journal of the Dental Association of South Africa Die
of enzyme containing denture cleansers. trasonic devices are more effective than the sonic action ma- Tydskrif van die Tandheelkundige Vereniging van Suid-Afrika.
A.4. Disinfectant: Commercial solution cleansers of dilute ac- chines. 1985;40(10):591-4.
ids are affective against calculus and stain on dentures. Their B. Mechanical Denture Cleansers
11. Budtz‐Jörgensen E, Kelstrup J. Enzymes as denture cleansers. Eu-
effect depends upon the dissolution of organic part of den- B.1. Brushing: The most common method for routine denture Proper hygienic care of removable dentures is important for ropean Journal of Oral Sciences. 1977;85(3):209-15.
ture deposit. Immersion of denture for a few minutes daily in cleansing is brushing. It has been reported that this technique maintaining a healthy oral mucosa in denture wearers.16, 36 12. Berger JC, Driscoll CF, Romberg E, Luo Q, Thompson G. Surface
dilute solution of chlorhexidine gluconate or salicylate caused is effective when used meticulously for removing discolor- Patients should be instructed to brush meticulously, and a rou- roughness of denture base acrylic resins after processing and af-
a significant reduction in the amount of denture plaque and ation and plaque from acrylic resin dentures.6,28,30 tine denture cleaning regimen should be designed by dentists ter polishing. Journal of Prosthodontics. 2006;15(3):180-6.
brought an improvement in the denture bearing mucosa in to remove and prevent re-accumulation of microbial plaque
Acrylic resin has been shown to damage progressively with 13. Sharp E, Verran J. Denture cleansers and in vitro plaque. The
patients with Candida-induced denture stomatitis13,21,22 How- and to remove mucin, food debris, calculus, and exogenous Journal of prosthetic dentistry. 1985;53(4):584-5.
ever, a relapse was seen after sustained treatment. prolonged brushing specially when improper brushes or sev- discoloration.16 Mechanical cleansing is effective for improv-
2014 Volume 6 Issue 2

I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S
er abrasives are used. Also, the damage on dentures increases ing denture cleanliness and maintaining a healthy mucosa.16 14. Budtz-Jorgensen E, Knudsen AM. Chlorhexidine gel and
Nightly immersion of denture in a 0.2% solution of chlorhexi- with increasing diameter of the bristles, and decreases with Steradent® employed in cleaning dentures. Acta Odontologica.
Efficient chemical denture cleansers might be important alter-
dine gluconate prevents recurrance of the infection although increasing length of the bristles. To avoid excessive damage, a 1978;36(2):83-7.
natives to mechanical cleansing, especially among geriatric or
the yeast were not eliminated from the oral cavity.17,23,24 All relatively soft denture brush should be recommended to pa- handicapped denture wearers. 36 Cleanliness is often poor due 15. Pisani MX, Macedo AP, Paranhos HdFO, Silva CHLd. Effect of ex-
studies reported a heavy discoloration of dentures by chlor- tients, the brush’s bristles should be stiffer than those used for to improper mechanical cleansing and to the relative ineffi- perimental Ricinus communis solution for denture cleaning on
hexidine solution which makes this method unsuitable for ordinary tooth brushing. Although there is no experimental the properties of acrylic resin teeth. Brazilian dental journal.
ciency of the most commercial chemical products.36
routine denture cleansing. Brushing denture with 1% chlor- evidence that brushing with a tooth paste or polishing paste is 2012;23(1):15-21.
Conclusion
hexidine gel (Hibetane gel) caused less staining.25 But there more efficient than using soap,23 a paste with low abrasiveness 16. Budtz-Jørgensen E. Materials and methods for cleaning den-
was no clinical evidence that chlorhexidine solution has any (polymethyl-methacrylate, or sodium bicarbonate) should In conclusion, future researches should be directed to develop tures. The Journal of prosthetic dentistry. 1979;42(6):619-23.
effect since plaque accumulations were similar in the group of also be recommended to avoid denture damage.7,31 The pa- cleanser solutions, which can maintain plaque-free dentures 17. Budtz-Jørgensen E. Prevention of denture plaque formation
denture wearers brushing with placebo gel. A 0.05% salicylate tient should be instructed to brush meticulously because like with a daily soaking period of 15 to 30 minutes and do not by an enzyme denture cleanser. Journal de biologie buccale.
solution used for denture immersion was found to be less ef- dental plaque, denture plaque is hard to remove.31,32 affect the color and surface luster of the denture acrylic resin. 1977;5(3):239-44.
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fective than a 0.2% solution of chlorhexidine gluconate in the Authors Affiliation 18. Pipko D, El-Sadeek M. An in vitro investigation of abrasion
I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S

treatment of denture stomatitis. However salicylate solution B.2. Paste and Powder: All powder and pastes increase the and staining of dental resins. Journal of dental research.
1. Mansour Oussama,PhD, Faculty of Pharmacy, Department of Phar-
did not stain the dentures.26 damage of dentures. Products containing insoluble calci- maceutical Chemistry and Quality Control, Al Andalus University for 1972;51(3):689-705.
um carbonate are highly abrasive, whereas those containing Medical Sciences, Syrian Arab Republic, 2. Hamdan Ahmad, MD, DDS,
Faculty of Dentistry, Department of Dental Hygiene, Al Andalus Uni- 19. Saunders TR, Guillory VL, Gregoire ST, Pimsler M, Mitchell MS.
A combination of 0.1% solution of sodium salicylate with en- soluble sodium bicarbonate or polymethyl-methacrylate are
versity for Medical Sciences, Syrian Arab Republic. The effect of bioburden on in-depth disinfection of denture
zyme-based solution cleansers may have good results, using a less.32,33 A specially developed denture cleanser paste con- base acrylic resin. Journal of the California Dental Association.
15 minutes immersion period, which is more readily accepted taining zirconium (a zr5io4-zros system) has been found to 1998;26(11):846-50.
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