Minor denture deficiencies
An indispensable domestic device is the vacuum cleaner. Cleaning filth and dust from carpets would become quite a laborious task if it were not for the invention of this powered cleaner.
by Karen Kaiser, RDH
An indispensable domestic device is the vacuum cleaner. Cleaning filth and dust from carpets would become quite a laborious task if it were not for the invention of this powered cleaner. The vacuum cleaner uses simple suctioning intake principles caused by modifications in internal air pressure, using a pump to lessen pressure in the appliance. Air and dirt are suctioned upward and propelled into tubes, fine filters, and collection cylinders or canisters at great speeds.
The same basic mechanism of suction power is at work for the wearer of a full denture. There is a pressure plunge sandwiched between the denture and the gum tissue as the denture is seated and pushed upward allowing the denture to snuggly settle and seal into position.
If improper fit leads to a sizeable amount of space between the oral mucosa and the denture base, dentures will become increasingly loose and may dislodge without the needed suction ability. An ill-fitting denture causes problems and discomfort for the tissues. Denture teeth are commonly made of acrylic and will wear as a result of mastication. Denture base resin will be affected by changes in the oral structure (especially if the patient experiences weight loss) and may shift under shrinking tissues. This wear-and-tear will affect the overall fit. Underlying tissues may become thin, inflamed, and sore as a result of a poor fit. When dentures float in the mouth and are not resting evenly upon the foundation of alveolar bone, resorption of the ridge can occur.
Early intervention with dentures
Various evaluations are needed during a regular recare treatment with a complete denture wearer. First, examine the tissues very carefully for any areas of redness or for any compression sore spot development on the ridge. Ask the patient how the denture functions. It is critical that any uneven wear areas on the denture are evaluated and needed modifications are made to the removable.
Early intervention by the dental professional will enable the denture to function properly. Commonly, the denture wearers may be shy about taking the denture out and may experience some anxiety upon doing so.
Showing the patient this discreet removal process is just between the patient and practitioner, and the denture wearer will feel more at ease. Assure them as soon as the cleaning process and evaluation of tissues is complete, the denture will quickly be placed back in the mouth.
Regardless of whether it’s a complete denture or a full complement of teeth, the temporomandibular joints go through some bone remodeling in a course of one’s lifetime. When removable dentures are not adjusted to compensate for these bone changes, an improper bite relationship may occur, contributing to the denture wearer’s experience of pain and impaired function. A balanced bite is needed, so even wear on the contact teeth is desired.
Furthermore, during the maintenance exam, the clinician will have a unique opportunity to spot any suspicious areas of serious oral pathologies, and review home-care instructions.
Sometimes denture wearers who have an ill-fitting denture will apply over-the-counter creams, powder, or paste adhesives to cope. A newer addition to the lineup is the adhesive strip. GlaxoSmithKline has developed the PoliGrip® Comfort Seal™ Strips. These strips are unflavored, pre-cut, and premeasured so the denture wearer just needs to merely apply three moistened strips to the maxillary and two strips to the mandibular for application. The strips will maintain shape when wet and not spread (which can occur with creams and pastes) because of the product’s waxy cellulose base.
Adhesives can help alleviate tissue discomfort especially on sensitive mucosa and act as a cushion. These products expand and become sticky. Because of the gelatin, cellulose, and gum-type properties of the product when the substance comes into contact with moist aqueous oral fluid, the adhesive agent is activated. The material’s volume swells and fills
the denture space to facilitate with improving the denture’s retention. Saliva assists with the adhesion so when denture wearers experience xerostomia, consider recommending saliva substitutes and moisture-enhancing products to help with denture lubrication.
When dentures fit properly, patients have an undeniable increase in comfort, security, and confidence. Adhesives
increase retention, especially for challenging food chewing.Applying the adhesive products properly is simple but needs to be done appropriately.
- Tissues must be wiped free of previously hardened adhesive, saliva, and debris from lingering food particles.
- The denture needs to be moist, so wet it prior to the application of adhesives. Apply small amounts of adhesive to avoid overfilling it. The patient will become familiar with the required amount of adhesive to make certain a seal between the denture and tissues is maintained for retention.
- Maxillary placement of adhesive should be applied to the center of the posterior and hard palate and anterior portion of the alveolar ridge. Mandibular placement is applied to the crest sulcus of the ridge beginning in the anterior area to the distal flange areas.
- Next, instruct the patient to firmly place and hold the denture in position for 10 seconds. Then have the patient close the mouth several times as the adhesive is thinly spread between the tissue and impression surface.
Aside from the above benefit of using adhesives, there is also an antimicrobial aspect to the products. With creams, antimicrobial agents are able to be incorporated directly into the composition of the product. Although dentures will build up calculus deposits when not cleaned properly, avoid suggesting standard toothpastes that contain abrasives, which over time will dull and mar the surface of the denture. A scratched, irregular denture surface contains grooves that promote a harboring recess area for odiferous bacteria to build up.
Denture cleaners remained unchanged for years until recently. Polident fresh cleanse™ is an antibacterial foam cleanser. This foaming formula attacks offensive bacteria that cause odor and works to freshen the denture crevices. Daily cleaning of dentures is a must since it controls plaque by-products, stain, and odor.
Denture adhesives and strips safely increase denture suctioning retention, improving chewing function, reducing denture wobble, improving wearer comfort, and helping to reduce the amount of food particles collected underneath the dentures. Furthermore, adhesives undoubtedly provide patients an increased sense of confidence and security.
While adhesives augment denture performance, adhesives and strips should not be utilized to compensate for denture deficiencies.
The author did not receive compensation for products mentioned. Visit www.mydenturecare.com or www.dental-professional.com for more information on dentures.
Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at firstname.lastname@example.org.