Two things to look after, not one
People are usually told how to clean a denture and much less often told about the tissue underneath it. Both matter. A denture accumulates plaque exactly as teeth do, and the ridge of gum it sits on is soft tissue that spends most of the day covered, warm and undisturbed.
Inflammation of the tissue beneath a denture is common, particularly where the appliance is worn continuously and cleaning is irregular. It often causes no pain at all, which is why it is generally found by someone looking rather than reported by the wearer.
There is also an assumption worth correcting early. Losing the natural teeth does not end the need for a daily routine or for regular examination — it changes what the routine consists of. The mouth still has tissue that can become inflamed, ulcerated or infected, and it still needs looking at by someone who knows what a healthy ridge should look like.
Cleaning the appliance itself
The usual advice is to remove and rinse the denture after eating, and to clean it thoroughly once a day over a basin of water or a folded towel, since a dropped denture on a hard floor frequently breaks. A soft brush kept for the purpose, used with water or a cleaner intended for dentures, is the common approach.
Ordinary toothpaste is more abrasive than most denture materials tolerate and can leave a scratched surface that then holds plaque more readily. Hot water can distort the material. Bleach and household disinfectants can damage components, particularly any metal parts, and can leave residues that irritate tissue.
Soaking solutions have their place and the instructions on them are worth following, including rinsing thoroughly before the denture goes back in. If you’re unsure what suits your particular denture, the practice that made it is the right place to ask, since materials differ.
The tissue underneath
Most dentists advise leaving dentures out overnight, or for some part of every day, so the tissue is uncovered and exposed to saliva. Continuous wear is associated with inflammation of the underlying tissue and with fungal overgrowth, and giving the mouth a period without the appliance is a simple preventive measure.
The ridge, the palate and the tongue should be cleaned too — a soft brush or a cloth over the gum ridges, and attention to the tongue. This is easily forgotten by someone who no longer brushes teeth, and the mouth still requires a daily routine.
A denture stored overnight should be kept in water or a solution as advised, since some materials should not be allowed to dry out completely. Again, this depends on what yours is made of.
Fit changes, and the temptation to compensate
The bone ridge that supports a denture gradually resorbs after teeth are lost, which is a normal and continuing process. A denture that fit well when it was made may become loose over years, and that looseness isn’t evidence that it was badly made.
Adhesives have a legitimate role and are widely used, but increasing reliance on them to hold a denture that no longer fits is a signal to have the fit assessed rather than a solution. A poorly fitting denture rubs, and areas of persistent rubbing produce sore spots.
Never attempt to adjust or reline a denture yourself, and be wary of kits sold for the purpose. Altering the fitting surface without knowing what the tissue underneath looks like can create pressure points and cause damage that’s harder to correct than the original problem.
What needs looking at
A sore spot that has not settled within a few days of the denture being adjusted, and certainly any ulcer or sore area lasting more than about two weeks, needs examining. This applies with particular force to denture wearers, because chronic irritation from an appliance isn’t something to live with and because persistent lesions need proper assessment.
Redness of the palate, a burning sensation, soreness at the corners of the mouth, or a white coating that does not wipe away are all reasons to be seen rather than to change cleaning product.
And denture wearers still need regular check-ups even with no natural teeth remaining. The examination covers the soft tissues, the fit of the appliance and the condition of the ridges — none of which anyone can assess for themselves in a mirror.
Common questions
Should dentures be worn overnight?
Most dentists advise leaving them out for part of every day, commonly overnight, so the tissue is uncovered. There are individual situations where continuous wear is recommended for a period, and if you have been given that instruction it should come from the clinician who is treating you.
How long should a denture last?
They wear, and the mouth changes underneath them, so they are not permanent. Rather than a fixed lifespan, the useful measure is whether it still fits, functions and looks right, which is assessed at a routine appointment.
My denture makes me gag. Is anything possible?
Sometimes, depending on the design and the cause, and it is worth raising rather than enduring. Adjustments to the extension of the appliance help some people, and gradual adaptation helps others. It is a common complaint and not a trivial one.
Dental Surgeon, Dr. Shruti Goel
Dr. Shruti Goel is a dental surgeon in practice since 2006 — around 20 years of clinical work — at Advanced Dental Clinic in Faridabad. She writes here about hygiene and prevention: the part of dentistry that happens at home, between appointments, and that decides how much of the rest is ever needed.