Dr. Alisa Kauffman, a dentist specializing in geriatric care, shares her expertise to help caregivers become more confident in providing daily oral care to seniors — whether by brushing, flossing and using picks, or removing and cleaning full or partial dentures. Below is the second in a two-part series of a caregivers guide to oral care focusing on denture and partial denture care. To read part one, click here.
Part Two: A How to Guide for a Patient with Dentures or Partial Dentures
by Dr. Alisa Kauffman – Geriatric House Call Dentistry, an ALCA Corporate Partner
Caring for an endetulous patient – that is, a patient who lacks teeth – may sound like an easy task, but if they have some form of dementia, it can be extremely difficult.
If the person you care for wears dentures or partial dentures, you must remove and clean the dentures at night, storing them safely in a see-through glass or specified denture case. Dentures are extremely expensive to replace and very difficult to re-fabricate on a patient with dementia. It’s not easy for any elderly patient to get used to a new prosthetic device and almost impossible for a patient with dementia.
If dentures are lost, that patient’s ability to eat, especially foods they enjoy, becomes compromised. So here are some important reminders about dentures:
- Do not wrap dentures in napkins or paper towels. Most dentures are thrown out and lost this way.
- Remove dentures from someone is sick. I’ve replaced many dentures that were flushed down the toilet after vomiting.
- Remove dentures from the patient before getting into an ambulance. When in crisis mode, oral health and dentures may not be top of mind, but remember the emergency medical team and first responders have one job only – to keep the individual experiencing a health crisis alive. Things happen quickly and they will remove the dentures (full or partial) if they need to.
Regarding ambulances and hospital stays: Ambulances are NOT responsible for lost dentures, but hospitals ARE responsible. Regardless, it is best for you and your loved one to keep the dentures safe and not need replacements. Take them out and store them somewhere safe. This also applies to partial dentures.
Treat dentures like valuable jewelry. Would you bring your diamonds to the hospital? No, you would remove them for sure. Dentures are even more important and much more difficult to replace.
Removing Dentures & Cleaning the Mouth
When caring for an aging adult, make sure you know if the person wears complete or partial dentures. Partial dentures means they have some real teeth as well as a denture replacing missing teeth.
Often, when a patient is complaining of oral pain, it is from dentures that haven’t been removed for a while. If dentures are not removed every night, the tissue in the mouth can grow around the denture, causing tissue overgrowth – known as hyperplasia of the tissues – causing painful infection and/or swelling. Sometimes the patient will need to stop wearing the dentures, and this can affect their quality of life. While the denture can sometimes be adjusted to end the rubbing, you want to adjust only as a last resort.
So, remember to remove the complete or partial dentures at night and let the mouth and tissues rest!
Removing full dentures:
- Complete dentures are removed by placing your index finger between the denture and the gum line midway back on the cheek side
- Pull it down quickly if it is a top denture or pull it up quickly if it is on the bottom.
- The suction is broken, and the denture usually pops off.
If the individual uses a denture adhesive, it may be more difficult to remove the dentures. But do not despair – quickly pull down or up repeatedly, and it will come out.
Removing partial dentures:
- Similar as above, but use your thumb or index finger under the clasp and pull down if it is an upper partial denture or under the clasp and pull up for a lower partial.
Dentures are made of a special type of plastic and are extremely fragile. Be careful not to drop them because they could break in half. Should that happen, DO NOT ATTEMPT TO REPAIR THEM YOURSELF. Self-repair kits sold online or at your local pharmacy sound great, but the dentures become irreparable. Dentures should only be repaired by a professional laboratory technician, so please call your dentist… it’s a quick and affordable repair.
Partial Dentures and Oral Health
To clean partial dentures, brush the remaining real teeth and remove the partial dentures as described above. You can use denture cleaning paste to brush their natural teeth and partial denture, or regular toothpaste for the natural teeth, but never use regular toothpaste on a partial denture!
There are different types of partial dentures you may see as a caregiver. One type is a denture where the base material is predominantly metal. Patients find it the most comfortable, as it fits like a glove. You clean it by brushing it completely with a soft or extra-soft toothbrush brush and/or soaking it for 20 minutes in an approved cleaner.
Valplast – a soft, flexible partial denture – is also a very popular choice of partial denture. No metal shows, sometimes the clasps are clear, and it looks very natural in the mouth. Its softness means it is kinder to the tissues, making it easier for a patient to get used to wearing. However, due to the porous material, this partial attracts a bit more food and bacteria.
Why it matters
If you do not remove it and only brush the remaining teeth, food and bacteria will collect around and under the clasps that hold it in on their real teeth, eventually leading to decay and possible tooth loss.
Occasionally, I get calls about a patient’s partial denture that is loose. I usually arrive intending to tighten a clasp but find the unfixable clasped tooth rotted and broken off. This can only be repaired by extracting the broken-off root left in the gum and adding a new clasp on a different healthy undecayed remaining tooth. This can be done bedside, but it’s best to avoid it if you can.
Summary
- Brush teeth at least twice a day. If you can only brush their teeth once, do it at nighttime. At night there is a huge buildup of collected food AND a full day’s worth of bacteria.
- If full or partial dentures are used worn, remove it, soak it in Liquid Crystals in a Sonic Cleaner for 20 minutes and leave it in a clear glass or denture container. Never wrap a denture in tissue or napkin, lessening the chances of mishap.
- Use a mouthwash if the patient is not at risk for swallowing it. Or use a xylitol gel if swallowing toothpaste occurs.
- Use soft picks to clean under crowns and or bridges (especially after eating anything stringy like chicken, meat, corn…) and consult with a dentist if bleeding gums persist.
- Never attempt to repair a broken denture. Leave it to the professionals.
- ID’s should be placed in every denture no matter where they reside.
- Take out dentures before going to the hospital or in the ambulance.
I hope that this series will help you improve the oral health of the individual you care for. For a how to guide for brushing teeth of an elderly person, check out part one of this two-part series.
About the author: Dr. Kauffman limited her practice in 1995 to Geriatrics and is currently the Director of Geriatric Dental Care at three nursing homes. She also lectures in Geriatrics at Penn Dental Medicine and is the founder of the Dental LIFE program at the University of Pennsylvania School of Nursing. Geriatric House Call Dentistry is proud to be an ALCA Corporate Partner. Visit our website to learn more about our team, our dentists, and our resources: www.geriatrichousecalldentistry.com
Disclaimer: This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.