Denture Cleansing: An Essential Part of Patient Care, 5th Edition

Course Overview
Most denture patients, as well as patients with removable orthodontic appliances, tend to be haphazard in practice when it comes to cleansing their dental appliances. Dental professionals and patients alike appreciate that cleansing of removable partial dentures (RPDs), complete dentures (CDs), and orthodontic appliances is essential to remove particulate matter as well as stains arising from food, beverages, and tobacco products. Ideally, cleansing ensures a fresh and odor-free mouth.

Effective denture cleansing is imperative to maintaining oral health and possibly preventing systemic diseases by removing the dental plaque biofilm and the microorganisms from the denture and other oral appliances (Brown et al., 2022; Galvan et al., 2021; Mousa et al., 2020; Rocha et al., 2021; Rodriguez-Archilla & Garcia-Galan, 2020). In fact, there is a strong positive correlation between denture cleanliness and lower bacterial colonization of dentures, as quantified by both the total anaerobic count and total aerobic count (Brown et al., 2022).
Patients may be less concerned with the disease implications of contaminated dental appliances than with sequelae such as appearance and odor. Effective denture cleansing therefore requires both the rapid and efficient removal of debris and stains and elimination of denture plaque and any bacterial colonization. The cleansing agent, however, must not cause any damage to the denture base resin, liner materials, or orthodontic appliances, nor can it leave toxic, malodorous, or unpleasant-tasting deposits on any surface.

The two approaches most commonly used to cleanse dentures are immersion in a chemical cleaning agent and/or brushing with a toothbrush and dentifrice. Denture base materials do not resist accretion of oral bacteria and fungal organisms, given the porosities in the denture acrylic base, which is conducive to the development of a biofilm that promotes microbial growth (Duymus & Aydiner, 2021; Garcia-Galan, 2020; McReynolds et al., 2023; Rodriguez-Archilla & Garcia-Galan, 2020). Soft liners, tissue conditioners, and denture adhesives are very susceptible to microbial growth (Malhorta et al., 2020; Sartawi et al., 2021; Srivastava et al., 2020). These findings clearly indicate that denture hygiene is significant in terms of both oral and systemic pathology.

Dental professionals, most notably dental hygienists, play an important role in controlling denture contamination and in instructing patients in the proper care and sanitization of removable dentures and orthodontic appliances. In this course, attention is directed primarily to complete and removable partial dentures, although the discussion applies equally to all removable dental appliances and devices. This basic-level course is appropriate for all dental professionals. The course reviews the diverse colonization of microorganisms found on dentures and the associated oral and systemic health risks, the correlation between candidal infestation of dentures and denture-induced stomatitis, and the pros and cons of various denture cleansing methods.

Learning Outcomes 
Upon the completion of this course, the learner should be able to:

• Describe the diversity of microorganisms that can be found on dentures and the associated health risks.
• Discuss the relationship between yeast infestation of dentures and both oral and systemic health.
• Describe the correlation between candidal infestation of dentures and denture-induced stomatitis.
• Describe the different denture cleansing modalities, including manual brushing and effervescent cleansers

About the Author/Presenter 
Mark J. Szarejko, DDS, received his dental degree from the State University of New York at Buffalo in 1985 and received Fellowship in the Academy of General Dentistry in 1994. He has practiced general dentistry for 38 years, with the last 16 years of his career involved in Correctional (county jail) Dentistry, from which he retired in 2023.  He received the Certified Correctional HealthCare Professional (CCHP) designation from the National Commission of Correctional Healthcare. He has authored and edited several dental continuing education courses and has given presentations on varied topics to local, regional, and national audiences. He has been an examiner for the dental and dental hygiene licensure exams for the Northeastern Regional Boards (NERBS; now the Commission on Dental Competency Assessments) since 1994. He has reviewed standard of care cases for the state of Florida and for private companies.

Audience/Accreditations and Approvals 
TRC Healthcare/ NetCE 
In support of improving patient care, this activity has been planned and implemented by TRC Healthcare/ NetCE. TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 
This course is designed for the following healthcare professions (select your profession for details): 
Dental AGD Code: 670

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