Denture care - Brushing false teeth. -
Dentures aren't maintenance free. The same debris that accumulates on natural teeth (microorganisms, dental plaque, tartar, stain, food particles) will tend to accumulate on them too.
What kind of daily care is needed?
A two-stage cleaning approach is required. That's because neither step is totally effective on its own.
1) Mechanical removal of debris.
For the most part, "mechanical" cleansing simply means brushing your denture. And as unglamorous as this step seems, nothing is more important.
Brushing can quickly remove film and build up from the surface of your dentures, which helps to set the stage so the chemical cleansing (soaking) steps that follow will be as effective as possible.
But, as this page outlines, guidelines must be followed (choice of brush and cleanser) so damage to your false teeth doesn't occur.
b) Ultrasonic cleansing.
A second type of mechanical "scrubbing" can be added to your denture care routine via the use of an ultrasonic cleaner. These devices don't replace brushing but they do help to make your overall cleaning efforts more effective.
We explain these units in detail (what they do, how they work, what home models are available, costs) on this page.
2) Chemical cleansing.
Brushing can only accomplish so much.
As important as denture scrubbing is, it's not 100% effective at a microscopic level. That's because denture plastic is porous, thus providing innumerable nooks and crannies that are easily and tenaciously colonized by microorganisms.
Studies show that brushing does help to reduce rates of denture stomatitis (mouth irritation related to wearing false teeth). But they've also documented that it's more effective in controlling some types of organisms than others.
For example, Candida (an oral fungus that can cause yeast infections of the mouth) is resistant to removal by brushing. (Felton 2011) [References for this page.]
That's why chemical cleaning (soaking) is needed too.
After brushing, the next step of the daily care you perform needs to involve chemical cleansing and disinfection. You might choose to use a commercial (store-bought) preparation or a homemade alternative.
Both can be equally effective. For information about this aspect of denture care, use this link.
Instructions for brushing false teeth.
Any type of cleaning process should begin with brushing. It's the quickest, most effective way to remove large amounts of debris (dental plaque, residual food) from denture surfaces.
A) What kind of brush should you use?
You can use pretty much any type of brush you want. The only real requirements are:
- It should be moderately soft-bristled.
- Able to access all of your appliances' curves and recesses, both inside and out. (More than one size/shaped brush may be needed.)
Stiff bristles can scratch your denture.
Any method of brushing, even using just plain water, will tend to scratch up the polished surface of false teeth.
Keeping this damage to a minimum is important because microorganisms have an easier time of attaching to rougher denture surfaces (Verran 2014). Stain accumulation can be more of a problem too.
That means, in some cases, part of the difficulty a person has in keeping their false teeth fresh and clean is actually due to the way they clean them.
Look for a "soft" brush.
As you might expect, research suggests that the amount of wear and tear that takes place during denture brushing corresponds with the stiffness of the brush that's used. (Pascaretti-Girzon 2013)
Zilinskas (2013) evaluated the scratching effect of a "low abrasion" toothpaste when used for denture cleaning (a practice that is NOT recommended, see below) using "soft," "medium" and "hard" bristled toothbrushes (like those made for brushing natural teeth). Significantly more wear took place when a "hard" brush was used as opposed to a "soft" one.
Keep in mind, your goal is to be thorough. The main requirements for that are time and diligence, not a stiff-bristled brush.
A brush specialized for denture cleaning.
Using a denture brush makes a good choice. This type of product typically has a dual brush head design.
- One has a tapered form so it can fit into the internal (concave) aspect of dentures (the part that rests over your jaw's ridges). And, in the case of partial dentures, in and around its clasps.
- The other side of the brush features a broader, more conventional bristle design. This is intended for cleaning the convex and broad surfaces of appliances.
- The stiffness of the bristles are designed specifically for scrubbing plastic appliances.
- For people who have impaired manual dexterity, some denture brushes have thicker, easier to grip handles than others.
These brushes are not expensive items. We found "name brand" products listed online for less than $5.
Suction-cup dentures brushes.
For one-handed cleaning, we found several suction-cup designs for sale ranging from $10 to $40. (Online prices. Be sure to shop around, we saw seemingly the same model selling for up to twice as much from different vendors.)
Some placed the cups directly on the brush handle. Other, possibly more stable designs, mounted the brush upright on a plastic stand having 2 to 4 suction cups.
[We will say that it didn't seem that these designs were made by rocket scientists. You probably have a grandson or granddaughter who after a trip to the hardware store could devise a holder for you.]
Using a toothbrush as a denture brush.
Seemingly, most people end up cleaning their false teeth using a toothbrush. And evidently doing so makes a reasonable choice.
- Per our discussion above, it makes sense to choose a "soft" one.
[This seems to the the standard recommendation and choice of research studies: Pascaretti-Girzon 2013, Zilinskas 2013, Freitas-Pontes 2009, Silva-Lovato 2006.]
- It's important that you dedicate this toothbrush to just the task of denture cleaning. Residual particles of toothpaste will tend to scratch your denture's surface (see below).
- The size and shape of the brush you choose must be one that can access all surfaces of your denture, inside and out. (Using both a child-sized and large-sized adult brush can make a good choice.)
- Nishi (2011) found no difference in the overall level of microorganisms found on appliances maintained using a toothbrush vs. a denture brush. Silva-Lovato (2006) generally found no differences between using either type.
- If you have problems with manual dexterity, some toothbrushes come with oversized handles. Or large handles can be purchased that you then insert your brush into.
Using an electric toothbrush as a denture brush.
Some research studies have evaluated the use of electric toothbrushes for denture cleaning.
- Andrade (2013) concluded that both conventional manual and powered brushes were equally effective in removing biofilms from the surface of false teeth.
- While this paper did not evaluate surface roughness changes, it did state that Heasman (1999) found that brushing with an electric resulted in fewer surface scratches, due to the minimal pressure that's needed when one is used.
That's not to say that no abrasion takes place, or can't if the wrong cleaner is chosen.
- Pascaretti-Girzon (2013) used an Oral-B electric (utilizing its pressure control sensor, a soft brush head and 2 minute brushing durations) to study abrasion of denture plastics.
- This study found that this technique when used with water alone created "limited abrasion." When used with various cleaning pastes and powders, all did cause scratching.
Should you use an electric?
There doesn't seem to be any great clinical advantage, or disadvantage, to using a powered brush with false teeth.
Using one might be an asset for disabled persons. Given the cost of replacement brush heads, this method is more expensive than using a manual brush.
B) Denture brushing instructions / technique.
Here's a set of directions outlining how to brush dentures.
- As a first step, you should rinse your appliance thoroughly with cool water. This will wash away any loose debris. It will also provide the proper environment for your cleaning activities.
Important! - You should never scrub a dry denture, or use a dry brush. Only perform your cleaning activities in the presence of water. This helps to minimize surface scratching.
- With your moistened brush (or brush with cleanser applied to it, see below), gently scrub every surface of your denture both inside and out. Lightly and thoroughly is the key, as opposed to scrubbing harshly.
[In the case where a soft lining has been placed inside your denture, be gentle so you don't damage it. For temporary lining materials, using your finger or a cloth might make a better choice than a brush.]
- All remnants of denture adhesive should be removed, either before or as you perform your scrubbing. If it's not, as each new layer is applied, a thick layer of build up can form that's often very difficult to remove.
- Once you've finished brushing, thoroughly rinse your appliance off with cool water.
- As a general rule, dentures should not be allowed to dry out. If they do, their fit may change.
So, if you're not going to put your false teeth back into your mouth, they should be fully immersed in water. Or, as a next step of denture care, its soaking solution.
C) What type of cleanser should you use?
It's possible to increase the effectiveness of denture scrubbing by using some type of cleansing agent on your brush. But choosing the wrong type can cause damage.
1) What not to use -
It's bad practice to use toothpaste. That's because most contain abrasives (like particles of silica) that can scratch plastic denture surfaces. (Freitas-Pontes 2009, Zilinskas 2013)
b) Household cleansers.
Scrubbing powders like Ajax and Comet make exceedingly poor choices. These products are excessively abrasive to denture plastic and should never be used.
2) Better choices -
a) Dishwashing Detergent.
Cleaning your false teeth using some type of soap, like dishwashing liquid, makes a good, probably best, choice. It's cheap, non-abrasive and everyone already has some of this in their home.
- Make a mild soap solution by mixing a little dishwashing liquid with water.
- There's no reason not to prepare a quantity of this mixture ahead of time so you can just squirt it out on your brush and denture as you need it.
- Our reference Rathee (2013) states that: "There is no experimental evidence that brushing with a tooth paste or polishing paste is more efficient than using soap."
b) Store-bought products.
If you'll check the shelves of your local store, you'll find commercial pastes and powders specifically made for cleaning false teeth.
- These products are formulated to be "less" abrasive on plastic surfaces (as compared to toothpaste for natural teeth).
- That's not to say, however, that they're non-scratching. The formulations of most still contain abrasive particles because they enhance cleaning results.
- Our reference Oussama (2014) states: "All powder and pastes increase the damage to dentures."
As an advantage of using this type of product, Harrison (2004) observed that the actual scratch grooves created by denture paste were smoother and more rounded than those caused by toothpaste. (Sorgini 2012)
This is important because, as mentioned above, rougher denture surfaces are easier for microorganisms to adhere to.
It's a tradeoff.
Due to the abrasives they contain, commercial cleansers generally are better at removing stains than our dishwashing liquid recommendation above. But this comes at the expense of creating a higher level of surface damage, which may tend to make it harder to keep your dentures clean in the long run.
When only detergent is used, chemical cleansing after brushing, a step you should be taking anyway, can typically keep staining in check. (Especially bleach-based soaking solutions.)
c) Baking soda.
Beyond the use of soap, another homemade/natural alternative that's sometimes used for cleaning false teeth is baking soda (sodium bicarbonate powder).
- Just like with commercial products, using baking soda on your brush will cause some increased level of surface scratching.
- Zilinskas (2013) evaluated the abrasiveness of sodium bicarbonate powder on denture plastic (as measured by changes in surface reflection). It was found to be more abrasive than toothpaste due to the presence of sharp undissolved crystals.
- In comparison, Pascaretti-Girzon (2013) found that baking soda toothpaste scratched plastic surfaces less so than other types due to the easily dissolved nature of the sodium bicarbonate crystals it contained.
Together, these studies seem to suggest that if you choose to brush your denture with baking soda, it would be best to mix it with water first (dip your brush in the solution formed from fully dissolved crystals), as opposed to just dabbing a damp toothbrush in the power itself.
D) How often do you need to brush false teeth?
As you might expect, studies show a correlation between a person's cleaning habits and their incidence of denture-related stomatitis and traumatic ulcers (Baran 2009). So, practicing proper denture care is important.
- Ideally, all types of dentures (full, complete, partials) should be taken out and brushed after every meal.
- If circumstances prevent you from doing that, you should at least remove your appliances and thoroughly rinse them with cool water.
There should be one time during the day when you give your false teeth exceptional care. This should involve both meticulous brushing, as well as cleaning and disinfection via the use of a chemical soak.
Don't forget the rest of your mouth.
Besides just your dentures, there are other things that need cleaning too. (Remember to use a separate brush for these activities, see above.)
- The tissues that lie under your false teeth (jaw ridges, palate) need cleaning. After all, the same types of debris and microorganisms that build up inside your appliance accumulates on them too.
Cleaning and massaging can be accomplished via the use of a soft toothbrush, a moist cloth placed over your finger or even just your finger alone if need be.
- If you have any natural teeth, they need to be brushed and flossed.
If you wear a partial denture, pay particular attention to cleaning those teeth it clasps on to. Dental plaque will tend to accumulate in this protected location. If it causes problems with even a single tooth, the fit and function of your partial may be ruined.
- Even your tongue needs cleaning at least once a day. Here are instructions for doing that.
Precautions to take when cleaning dentures.
a) Preventing accidents.
It's easy enough to break false teeth by dropping them, even from a height of just a few inches. As a preventive measure, you should use a routine where if this does occur something will cushion their fall. Here are some suggestions.
- When brushing, hold your denture over a sink (or safer yet, a plastic dishpan) that's been filled with a few inches of water.
- If you brush over a hard counter top, cover its surface with a fluffy folded towel.
- If you have impaired dexterity and you're using a standing suction-cup denture brush (see above), anchor it first and then bunch a fluffy towel around it.
As an alternative, anchor your brush in the bottom of a plastic dishpan and then surround it with a few inches of water.
b) Other denture care precautions.
As generalized best practices for false teeth that have a plastic component -
- Your appliance should not be allowed to dry out. If it does its fit may change. False teeth should either be kept in your mouth or fully immersed in water or soaking solution.
- Don't expose your appliances to elevated temperatures. (This includes soaking or rinsing in hot water.) If you do, their fit may change.
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