Do we care for our patients' dentures as much as we care for their teeth?

It is well known that oral health status decreases with age and, therefore, the need for dentures increases with age. In 2009, the Adult Dental Health Survey reported that nearly one in five adults (19%) wore removable dentures, either partial or complete, this equates to nearly 15 million people-the death of the denture is still some time away (Health and Social Care Information Centre, 2009).

We routinely give oral hygiene instruction to our patients, but how often do we provide denture hygiene instruction? Many studies have demonstrated that plaque biofilm accumulates on removable prosthesis and have even shown that certain pathogens preferentially colonise these prosthesis over oral tissues. Just like teeth, dentures accumulate plaque, stain and calculus, but as a profession we neglect the importance of looking after these surfaces. Poor denture hygiene is associated with denture stomatitis, caries and periodontitis in patients who wear partial dentures. Dentures can also act as a reservoir for microorganisms that have a potentially systemic effect; these bacteria have been implicated in bacterial endocarditis, aspiration pneumonia, gastrointestinal infection and chronic obstructive pulmonary disease (COPD). One study that tested the pathogens in denture plaque found evidence of respiratory microorganisms in 69% of cases tested. Potentially most importantly from a patients perspective, poor denture hygiene is associated with malodour and halitosis (most recently discussed in our April edition). Currently there is no standardised method of recording denture hygiene, as we currently do for oral hygiene.