|Year : 2018 | Volume
| Issue : 2 | Page : 98-102
Denture care practices and perceived denture status among complete denture wearers in Guntur, Andhra Pradesh: A cross-sectional study
Vikram S Bommireddy1, Ramya Malireddy2, Asha Lodagala1, Viswa C Chandu1, Nandita R Kothia1, Ambica Reddy1
1 Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
2 Department of Prosthodontics, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
|Date of Web Publication||6-Jun-2018|
Dr. Vikram S Bommireddy
Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Background: With an increase in the prevalence of edentulous individuals the need for conventional dentures has also been increasing to improve the quality of life of such individuals as they are associated with aesthetic, psychological, functional, and social impacts of life. However, if proper denture care practices are not followed, there is a risk of developing a multitude of problems. The aim of this study is to assess the denture care practices among complete denture wearers attending a dental institution in Guntur district, Andhra Pradesh.
Materials and Methods: A cross-sectional study was conducted in the department of prosthodontics at SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. A sample of 543 denture wearers aged 45 and above was requested to complete a self-administered questionnaire on denture care practices followed by clinical examination of denture status by the dentist.
Results: Most study participants reported cleaning their dentures once a day with brush and water and had a habit of removing the dentures at night. 82.7% of the individuals reported their denture status as good. Clinical examination revealed that slightly more than half of the participants had poor denture status.
Conclusion: The actual denture status of individuals in this study is poor which highlights the need for denture hygiene reinforcement among them.
Keywords: Denture care, denture hygiene, edentulism, self-perceived
|How to cite this article:|
Bommireddy VS, Malireddy R, Lodagala A, Chandu VC, Kothia NR, Reddy A. Denture care practices and perceived denture status among complete denture wearers in Guntur, Andhra Pradesh: A cross-sectional study. J NTR Univ Health Sci 2018;7:98-102
|How to cite this URL:|
Bommireddy VS, Malireddy R, Lodagala A, Chandu VC, Kothia NR, Reddy A. Denture care practices and perceived denture status among complete denture wearers in Guntur, Andhra Pradesh: A cross-sectional study. J NTR Univ Health Sci [serial online] 2018 [cited 2018 Aug 19];7:98-102. Available from: http://www.jdrntruhs.org/text.asp?2018/7/2/98/233848
| Introduction|| |
In dentistry, there is an increasing emphasis on maintaining oral health in old age when alterations in oral tissues are associated with various conditions. Edentulism is a biological sequence of human aging, with dental caries and periodontitis as the most common etiological factors. Millions of these edentulous people can be considered physically impaired as per the criterion of World Health Organization (WHO). Rehabilitative treatment with its main objective of establishing functionality should be rendered to these individuals. This can be accomplished with the help of conventional dentures. Conventional dentures are the most common alternative in restoration of lost teeth enabling individuals in improving oral function, enhancing phonetics, facilitating social engagement, and in leading an aesthetically acceptable life.
Immediately after edentulous patients receive dentures, the important phase of oral and denture aftercare begins. Correct denture usage and care are of great importance not only for aesthetic and functional reasons but also for the maintenance of health of the supporting tissues and appropriate conservation of the prosthesis itself.
Cleansing and disinfecting dentures are essential for the maintenance of oral soft tissue health and successful use of removable dentures. It helps in the prevention of undesirable circumstances such as denture stomatitis and halitosis. Denture-induced stomatitis is the most common fungal infection in elderly patients wearing dentures. Inappropriate habit of wearing complete dentures at night and poor cleaning have proved to be closely associated with the prevalence of denture-related stomatitis.
Despite patient education and instructions concerning oral and denture hygiene, there remain a significant number of edentulous patients who cannot adequately clean their dentures and who wear them even while sleeping in the night which could be due to negligence and/or lack of knowledge on denture hygiene.
This study aimed to assess the denture care practices among complete denture wearers who underwent denture treatment in the department of prosthodontics in a private dental college, Guntur district, Andhra Pradesh. The objectives were to determine the denture cleanliness of patients as well as to investigate denture-cleaning habits and the attitudes involved.
| Material and Methods|| |
A cross-sectional study was conducted among the patients aged above 45 years who had received complete or single complete dentures from the department of prosthodontics of a private dental college in Guntur over a period of 10 years (January 2006 to December 2016). Patient details were extracted from the patients' register which included their demographic details and the type of treatment they had undergone. In total, 1520 complete and single jaw edentulous patients had visited the department during the study period. Out of these, 64 patients had discontinued seeking treatment and had never reported back for further procedures and 56 patients, having systemic illness such as diabetes were excluded. From the remaining 1400 patients who received complete treatment, 700 were selected randomly, and in person home visits were conducted by three dental examiners with the help of addresses available in the register for a period of three months (February 2017 to April 2017). Only 543 patients were included in the final sample since the remaining had migrated/not available at home during the time of visit/not willing to participate/ expired/were not able to understand the questionnaire.
A self-administered, validated questionnaire in the local language (Telugu) which has been tested for reliability was given to the patients. The questionnaire included information on demographics such as age, gender, education and time of wearing of dentures, method and frequency of cleaning, and self-perceived denture status. After completion of the questionnaire, clinical examination was conducted including examination of the status of existing dentures by the examiners who were well trained and having a good interexaminer agreement (kappa value = 0.86) in the clinical rating of denture status.
Ethical clearance was obtained from the institutional review board of SIBAR Institute of Dental Sciences. A written informed consent was taken prior after explaining the purpose of the study in detail to the participants.
Data analysis was done using SPSS, version 20 software (IBM Corp. IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp; 2011). Descriptive statistics, Spearman's correlation test, and Chi square test were employed. The level of significance was set at 5%, and the statistical data was summarized in tabular form.
| Results|| |
Descriptive statistics of the study population is presented in [Table 1]. Of 543 denture wearers who participated in the study, males were in greater proportion (56.5%). Majority of the participants belonged to the age range of 45–64 years, were illiterates (40.9%), residing in rural areas (59.9%), and had less than 2 years of experience in wearing dentures (49.7%). [Table 2] depicts the differences in denture hygiene practices, self-perceived denture status, actual denture status based on the gender and age of the patient. Majority of the participants reported cleaning their dentures once daily which showed statistically significant difference according to age (P = 0.002) but not gender (P = 0.321). Water and toothbrush were the most common materials used for cleaning dentures which showed statistically significant difference according to age (P = 0.027) and gender (P < 0.001).
|Table 2: Denture care practices and denture status based on gender and age groups|
Click here to view
Majority of the participants had the habit of removing dentures during night and placing them in water. 41.3% of the study participants perceived their denture status to be good whereas clinical examination of these dentures by the dentists revealed that more than half of the participants had poorly maintained dentures. [Table 3] shows correlation between self-perceived denture status, actual denture status, duration of wearing dentures, and the frequency of cleansing dentures. There was a significant weak positive correlation between self-perceived denture status and the actual denture status. Duration of denture wear was found to be negatively correlated with both self-perceived denture status and actual dental status. A weak negative correlation was found between the duration of denture wear and frequency of cleansing dentures, which was statistically significant. Frequency of cleansing dentures was found to have a significant positive correlation with both self-perceived denture status and actual denture status. [Table 4] shows the association between denture hygiene practices and self-perceived, actual denture status. The variable of removal of denture during night and media in which they were placed during nights showed a statistically significant difference with self-perceived and actual denture status.
|Table 3: Correlation between self-perceived denture status, actual denture status, duration of wearing dentures, and the frequency of cleansing dentures|
Click here to view
|Table 4: Association between denture care practices and self - Perceived, actual denture status|
Click here to view
| Discussion|| |
For healthy maintenance of dentures, and thereby oral tissues, cleansing and disinfection of dentures plays a vital role since there is development of biofilm and plaque on their surface similar to natural teeth. In this study, most participants (82.5%) reported cleaning their dentures once a day, irrespective of the method used. However, this was not reflected in the clinical examination of dentures as 52.7% of the dentures were rated as having poor hygiene. This finding could be due to different methods of cleansing the dentures or due to the over-response of the participants to be socially desirable. The percentage of participants who reportedly clean their dentures once daily was more in the present study (82.5%) when compared with the studies conducted by Saha et al. (52.5%) and Apratim et al. (44.7%). As most of them were from rural areas, there could be lack of awareness on how to clean their dentures.
The most common method of denture cleaning was using water and brush (58.5%) which is more when compared to those in a study by Dikbas (3.84%), Peracini et al. (3.7%), Azad et al. (22%), Polyzois (10.3%), Saha et al. (47%), and Apratim et al. (31.3%). This could be because of the easy availability of these Aids (brush and water). Denture care practices relating to the removal and placement of dentures at night were found to be associated with actual denture status as clinically examined by the investigators [Table 4]. The actual status of dentures of the individuals who were placing their dentures in water during night was found to be good, which highlights the beneficiary of better knowledge on the cleanliness of denture.
More than half of the individuals have poor denture status on examination (52.7%), which was in accordance with the study done by Saha et al. (60%) and not in line with the study done by Apratim et al. where most (50.3%) of the study participants maintained their dentures in a good condition. The weak positive correlation between self-perceived denture status and the actual denture status explains social desirability on part of the participants. Increase in the duration of denture wear showed a decrease in frequency of cleaning denture which may be due to loss of interest by the wearers.
| Conclusion|| |
Denture hygiene practices are poor among the study population. Denture fabrication with utmost precision is not the end of the job of dentist but thorough reinforcement of hygiene practices to them completes it. The poor status of dentures in the current study highlights the need for improvement in patient education and counselling with respect to the maintenance of dentures and upkeeping of denture hygiene. It also emphasizes on the need for educating patients on how to evaluate the status of their dentures as well. It must also be realized at this juncture that majority of complete denture wearers are elderly who usually have compromised immunity, which emphasizes on the need to more thoroughly maintain denture hygiene to avoid unwanted consequences.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Peltola MK, Raustia AM, Salonen MA. Effect of complete denture renewal on oral health-asurvey of 42 patients. J Oral Rehabil 1997;24:419-25.
Azad AA, Butt MM, Ahmed A, Malik AS. Denture hygiene habits among edentulous patients seen at Armed Forces Institute Of Dentistry, Rawalpindi. Pak Oral Dent J 2015;35:735-7.
Sadig W. The denture hygiene, denture stomatitis and role of dental hygienist. Int J Dent Hyg 2010;8:227-31.
de Castellucci Barbosa L, Ferreira MR, de Carvalho Calabrich CF, Viana AC, de Lemos MC, Lauria RA. Edentulous patients' knowledge of dental hygiene and care of prostheses. Gerodontology 2008;25:99-106.
Takamiya AS, Monteiro DR, Barao VA, Pero AC, Compagnoni MA, Barbosa DB. Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil. Gerodontology 2011;28:91-6.
Dikbas I, Koksal T, Bal B, Ozkurt Z, Kazaoglu E. A survey of dentists' attitudes toward denture cleansing. Oral Health Dent Manage Black Sea Ctries 2006;5:7-11.
Saha A, Dutta S, Varghese RK, Kharsan V, Agrawal A. A survey assessing modes of maintaining denture hygiene among elderly patients. J Int Soc Prevent Community Dent 2014;4:145-8.
Apratim A, Shah SS, Sinha M, Agrawal M, Chhaparia N, Abubakkar A. Denture Hygiene Habits among Elderly Patients Wearing Complete Dentures. J Contemp Dent Pract 2013;14:1161-4.
Dikbas I, Koksal T, Calikkocaoglu S. Investigation of the Cleanliness of Dentures in a University Hospital. Int J Prosthodont 2006;19:294-8.
Peracini A, Andrade IM, Paranhos Hde F, Silva CH, de Souza RF. Behaviors and Hygiene Habits of Complete Denture Wearers. Braz Dent J 2010;21:247-52.
Polyzois GL. Denture cleansing habits. A survey. Aust Dent J 1983;28:171-3.
[Table 1], [Table 2], [Table 3], [Table 4]