Developing a schedule of normative denture treatment need

Objectives: The aim of the study is to assess the reliability and validity of a schedule to determine the normative denture treatment needs of older people. Design: The design used assessed inter‐examiner reliability (criterion validity), test‐retest reliability, and content and face validity of the schedule. Setting: The inter‐examiner reliability study took place in a Department of Prosthetic Dentistry, the remainder of the work took place in a community setting. Results: The results showed that the schedule in terms of an index performed well with reasonable inter‐examiner and test‐retest reliability. Difficulties however were encountered with regard to subjective judgements about denture quality and design; consequently, there was modest inter‐examiner agreement for stability, retention, and occlusal balance. Conclusions: The findings from this preliminary work suggest that the schedule may be useful in the assessment of normative denture treatment need in a community setting. Nevertheless more work will be required to obtain further information on the validity of this new assessment measure.     

Food choices and eating difficulty among elderly edentate patients in Greece

Aims: To evaluate food choice and eating difficulty experienced by older Greek edentate patients. Subjects: Three samples of patients seeking provision of replacement dentures were studied. A primary study of urban mainland U1 (n=54) and island rural R1 samples (n=84) was followed by a mainland urban U2 sample (n=119) in the Secondary study. Setting: Greek dental clinics. Intervention: Semi‐structured interviews (SSI) were employed, using both open and closed questions. Design: The primary study used SSI to identify eating difficulty experienced by two culturally different Greek groups. The secondary study established patterns of difficulty for comparisons between an urban Greek population and northern European urban studies. Main Outcome Measures: The prevalence of eating difficulty, the degree of difficulty eating specified foods and the exclusion of foods because difficult. Results: Most patients expressed difficulty eating at least one type of food, a high percentage of these patients were willing to eat foods found difficult, while others use particular methods of food preparation that make food easier to eat. Chicken illustrated the importance of specifying the method of cooking when questioning eating difficulties. Roast meats provided insight into the more difficult end of the food range. Raw vegetables were rated difficult. Apples and oranges were also food of particular interest. Conclusions: The semi‐structured interview method provides a succesful method to identify eating difficulty and food choices by older Greek complete denture wearers. Differences, probably largely cultural, were identified between Greek island rural and mainland urban communities. Greek food choices differed favourably from an English sample, strikingly in that Greek patients report continuing to eat difficult foods despite difficulty eating them. This may be relevant to health data on Greek populations that show better mortality statistics despite adverse factors such as high prevalence of smoking.     

The effect of variation of the lingual shape of mandibular complete dentures on lingual resistance to lifting forces

Increasing life expectancy, age related reduction in adaptability and progressive severe mandibular resorption all add to the importance of any factor improving the prosthetic success. Objective : To investigate the effect of two different lingual shapes of lower dentures on patients' ability to resist lifting forces. Design : Tongue pressures on the lingual surface of complete mandibular experimental dentures were recorded from mid-line, premolar and molar transducers. Two experimental prostheses were fabricated for each subject: one conventionally contoured, the other formed by piezography. Setting : A clinical research laboratory. Subjects Five experienced complete denture wearers between age 64 and 82 years. Intervention Lifting forces were applied at the midline, left and right premolar sites in random order. Main outcome measures : Peak resistance to lifting forces and lingual pressures used during these tests. Results : Lingual pressures exerted anteriorly were dramatically higher than those on premolar and molar surfaces. Significantly higher pressures were used to resist lifting forces applied to piezographically than conventionally formed contours; correspondingly, significantly higher lifting peak forces were, on average, resisted. Conclusions : Providing a lower denture with a piezographically produced lingual surface was shown, in this preliminary study, to enhance tongue retentive ability over a conventional design. It seems reasonable to maximise retentive potential with oblique sublingual polished surfaces and minimise the adaptive demand, particularly for older patients, by using a piezographic technique which “customises” the contour and precludes over-extension.     

Oral mucosal lesions in denture wearers

doi:10.1111/j.1741‐2358.2009.00289.x
Oral mucosal lesions in denture wearers Objective: To determine the prevalence of oral mucosal lesions (OMLs) and denture‐related mucosal lesions (DMLs) in denture wearers and to co‐relate the prevalence with age, gender, type of denture and any systemic conditions. Materials and methods: Dental records of 380 denture wearers were retrospectively reviewed for OMLs and DMLs. Results: We found 45% of the denture wearers had DMLs and 60.8% had OMLs not related to denture wearing. Although the prevalence of DMLs was higher in complete denture wearers than in partial denture wearers (49% vs. 42.2%), this difference was not significant. The most common DMLs were traumatic ulcer (19.5%) and denture‐induced stomatitis (18.1%). When analysed by type, traumatic ulcer, denture hyperplasia, frictional keratosis and candidiasis were more common in complete denture wearers, whereas denture‐induced stomatitis was more common in partial denture wearers. Frictional keratosis was more common in men than in women. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers, and the most common OML was fissured tongue (27.6%). No association between DMLs and systemic conditions or xerostomic drugs was noted. Conclusion: No differences in the prevalence of DMLs in association with denture type were found. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers. This difference was affected by age, and the data were similar to the findings observed in the elderly.     

Genetic diversity of gamma-hexachlorocyclohexane-degrading sphingomonads isolated from a single experimental field

Aim:  To determine the effect of the surface roughness of denture acrylic on the attachment of Streptococcus oralis .
Methods and Results:  Roughened denture acrylic samples were assessed for bacterial attachment, over time, using microscopy. The area of the image covered by bacteria was calculated and converted into a percentage of the total area sampled. The results showed an increasing bacterial coverage with time of incubation and increasing roughness. Differences were seen between heat cured acrylic and cold cured acrylic.
Conclusion:  This study successfully demonstrated a system for the assessment of the amount of attached bacteria on denture acrylic varying roughness. The system was able to discern the difference in surface area coverage by attached bacteria over a roughness range relevant to brushing dentures with dentifrices.
Significance and Impact of Study:  This study provides strong support for the scratches caused by brushing dentures with dentifrice encouraging bacterial attachment. This is likely to have a significant effect on efficacy of denture cleaning, general hygiene and biofilm re-formation between cleaning regimens and may indicate that alternative low abrasive cleaners, such as antimicrobial denture-cleaning tablets, offer a more appropriate regimen.     

Patients' experiences with partial dentures: a qualitative study

Objective: The aim of the study was to gain insight into people's experiences of being given and using partial dentures. Methods: In‐depth semi‐structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day‐to‐day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. Results: The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. Conclusions: Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients’ experiences and may help promote effective use and appropriate help‐seeking by partial denture wearers.     

Oral health related quality of life of edentulous patients after denture relining with a silicone-based soft liner

doi: 10.1111/j.1741‐2358.2011.00503.x Oral health related quality of life of edentulous patients after denture relining with a silicone‐based soft liner Background: Knowledge of benefits caused by a treatment on quality of life is very relevant. Despite the wide use and acceptance of soft denture liners, it is necessary to evaluate the patient’s response about the use of these materials with regard to improvement in oral health related quality of life (OHRQoL). Objectives: The aim of this study was to evaluate the influence of denture relining in the OHRQoL of edentulous patients. Materials and methods: Thirty‐two complete denture wearers had their lower dentures relined with a silicone‐based material (Mucopren soft, Kettenbach, Germany) according to chairside procedures. OHRQoL was assessed before and after 3 months of relining by means of OHIP‐EDENT, and the median scores were compared by Wilcoxon test (p ≤ 0.05). Results: After 3 months of relining, participants reported significant improvement of their OHRQoL (p ≤ 0.01). Conclusion: Denture relining with a soft liner may have a positive impact on the perceived oral health of edentulous patients.     

Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00353.x
Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers Background: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. Objective: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). Materials and methods: Thirty edentulous subjects with adequate neuromuscular co‐ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5 years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student’s t‐test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman’s rho correlation test. Results: TN–C distance had an improved correlation with the changes in intraoral alterations than SN–C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. Conclusion: While facial measurement is not a good predictor of OVD, TN–C distance appears to be more reliable than SN–C distance.