| As China has gradually entered the aging society stage, proportion andnumber of elderly population are increasing, so the number of patients withdentition defect or edentulous is also increasing for various reasons. Because oflow prices, extensive applications and other reasons, removable partial denturesand complete dentures are still one of the main restoration methods currently.But due to physical and chemical characteristics of base materials andcomplexity of denture structure, removable denture surfaces in the oralenvironment are vulnerable to dental plaque, calculus or stain, even malodor,leading to bad dental hygiene status. These are a result of the interaction ofvarious factors, and are closely related with local oral and general health, suchas oral odor, dentures stomatitis, dental caries, marginal gingivitis andperiodontitis, even as some potential risk factors for systemic diseases.Objective: Our study is an epidemiological survey on hygiene status of removabledenture of patients in Xi’an area. By collecting associated information onpatients and their dentures, we can analysis relative factors of denture plaque，stain and malodor status and filter out the main influencing factors throughmultiple logistic regression. Also combinating with evaluating the sustainableantibacterial effect of three cleaning methods, we can provide thedecision-making basis and enrich relevant epidemiological information aboutdenture cleaning and maintenance which are of great significance for oral andsystemic health of patients.Materials and methods:1.226paitents with removable dentures who received treatment in thedepartment of prosthodontics of our hospital from March to July in2011wereselected as survey objects to collect relative information through questionnaireand clinical examination. Statistical analysis of the related factors of dentureplaque, stain and malodor status was conducted by SPSS17.0.2. We selected40patients with new removable denture made in ourhospital as volunteers, who were randomly divided into the toothbrush group,cleanser immersion group, combination group and water control group. Then weevaluated the sustainable antimicrobial activity of three kinds of cleaningmethods after a week.Results:1. Cognition investigation on denture cleaning attitude of patientsThere were226paitents with removable denture wearer,119(52.7%) weremen and107(47.3%) were women, ranging from29t088years old withaverage age of68.03±11.07.215patients(95.1%) thought dentures needed toclean at least once a day, but11patients（4.9%） didn’t think so.168patients (74.3%) thought denture cleanliness had an impact on body health, but18(8%)thought there was no effect and40(17.7%) were not clear about this. There werethree kinds of awareness on the importance of cleaning dentures and naturalteeth.142patients (62.8%) thought cleaning dentures was as important asnatural teeth,57(25.2%) thought cleaning natural teeth was more important and27(12%) thought cleaning dentures was more important.2. Analysis on the influencing factors of denture plaque statusThe mean plaque score of removable dentures of226patients was10.47±3.20. Monofactorial analysis showed that plaque scores among different levelsof denture conservation methods at night, denture base abrasion, wearing timeand cleaning methods all had significant difference(P＜0.05); Plaque scoresabout other factors among different levels showed no significant difference（P＞0.05）. Multifactorial logistic regression analysis showed the main affectingfactors of denture plaque score were wearing time, cleaning dentures with waterrinsing and toothbrush scrubbing (using cleanser as control group), OR valuesrespectively were2.076,15.254and3.217.3. Analysis on the influencing factors of denture stain statusThe mean stain score of removable dentures of226patients was5.96±3.46. Monofactorial analysis showed that stain scores among different levels ofgender, smoking habit, habit of drinking tea, denture conservation methods atnight, denture base abrasion, malodor status, denture base materials, wearingtime and cleaning methods all had significant difference(P＜0.05); Stain scoresabout other factors among different levels showed no significant difference（P＞0.05）. Multifactorial logistic regression analysis showed the main affectingfactors of denture stain score were smoking habit, denture base abrasion,wearing time, base materials, cleaning dentures with water rinsing and toothbrush scrubbing (using cleanser as control group), OR values respectivelywere7.937,6.529,2.459,0.361,93.776and22.075.4. Analysis on the influencing factors of denture malodor statusRemovable dentures of173paitents in226paitents had malodor, and therate of malodor was76.5%. Monofactorial analysis showed that malodor ratesamong different levels of age, the degree of education, monthly income,smoking habit, babit of drinking coffee, cleaning methods and dentureconservation methods at night all had significant difference(P＜0.05); Malodorrates about other factors among different levels showed no significant difference（P＞0.05）. Multifactorial logistic regression analysis showed the mainaffecting factors of denture malodor status were age and cleaning dentures withtoothbrush scrubbing (using cleanser as control group), OR values respectivelywere5.092and29.451.5. Evaluation of sustainable antimicrobial effect of three cleaning methodsPlaque scores of removable dentures of toothbrush group, cleanser group,combination group and water control group were respectively7.30±1.83,6.30±1.42,5.20±0.92and10.80±2.15. Variance analysis revealed plaque scoresof four groups had significant difference (P<0.001). LSD-t test showed thatplaque score of combination group was significantly lower than that oftoothbrush group, and plaque scores of toothbrush group, cleanser group andcombination group were all significantly lower than that of water controlgroup(P＜0.05). Plaque scores between toothbrush group and cleanser groupshowed no significant difference as well as between cleanser group andcombination group（P＞0.05）.Conclusion:1. Most patients had correct cognition about denture cleaning and maintenance, but there was still a part of patients lacking proper relativeknowledge. Health education for patients should be strengthened by medicalworkers to help them establish a correct concept of hygiene, improve poorhealth habits, and help them adopt the proper behavioral way which is good tooral health.2. In terms of denture plaque control, professional cleanser for cleaningdentures is the best way, but unconditional patients should at least use a softtoothbrush to scrub dentures. It is also recommended that patients shouldregularly replace their dentures after a certain period of use.3. In terms of denture stain control, it is recommended that dentures ofpatients shloud use metal base and cleansers, regularly replace or polish denturesafter a certain period of use, and persuade paitents with smoking habit to giveup.4. In terms of denture malodor control, it is recommended that patients,especially elderly patients, should use professional cleansers to clean dentures toavoid malodor.5. The effect of toothbrush combination with cleanser to clean dentures wassignificantly better than that of toothbrush to scrub dentures, which could reducethe attached plaque to the greatest extent, so it is recommended that conditionalpatients should use this combination way to clean dentures and unconditionalpatients could use a soft toothbrush to scrub dentures. |
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