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Original Research

Oral Hygiene Behavior of Acrylic Removable Partial Denture

Usage in Seuneubok District, West Aceh: A Cross-sectional
Study
Liana Rahmayani, Pocut A. Sofya, Poppy Andriany, Cut S. Jingga
Faculty of Dentistry, Universitas Syiah Kuala-Aceh, Indonesia

Abstract
Aim: To evaluate the relationship of oral hygiene behavior and maintenance with gender, age, and duration of acrylic removable
denture usage in Seuneubok District community, West Aceh. Materials and Methods: An analytic descriptive research was conducted
with the sample of 97 people as research subjects. The subjects comprised 65 women and 32 men who were selected using purposive
sampling technique and measured using questionnaire. The subjects signed informed consent and then continued by interviewing
the questionnaire question. Pearson’s chi-squared test value was obtained at P ≤ 0.05 for the relationship between the behavior of
maintaining oral hygiene in removable partial denture users between men and women. Results: The results showed that 14 subjects
(15%) were good for maintaining dental and oral hygiene, 74 subjects (76%) were poor, and only 9 subjects (9%) were not good. It
showed that the value of P was 0.038 (significant difference P ≤ 0.05) for the behavior relationship with the duration of removable
partial dentures usage and P  =  0.597 was associated with age. Conclusion: Community maintenance of oral hygiene was poor in
studied population. There was a relationship between the behavior of maintaining oral hygiene with gender and duration of dentures
usage, but there was no significant relationship with the age.

Keywords: Acrylic Removable Partial Denture, Behavior, Maintenance, Oral Hygiene

Received: 21-07-2018, Revised: 02-11-2019, Accepted: 06-11-2019, Published: 28-03-2020

Introduction leading to excessive alveolar bone pocket and resorption

Tooth loss is a major problem that can cause impaired
mastication, phonetic, and esthetic function. The loss
of some of the original teeth from the dental arch can
be replaced by placing removable partial denture.[1]
According to Ferro et  al.,[2] partial removable denture is
an artificial tooth replacing one or more teeth that have
been lost and supported by teeth and mucosa that may
remove and inserted by the patient. The continuous use of
partial dentures and unsaved cleansing of the oral cavity
and denture may cause plaque accumulated on both the
original tooth directly contacting with the surface of the
artificial tooth and the original tooth in the opposite
arch.[3] The accumulation of plaque which may be left
can lead to caries and inflammation of periodontal tissue
and lesions of the oral mucosa.[4]
When a person decides to use artificial teeth, the awareness
to keep dental and oral hygiene should not be forgotten.
Regular daily denture cleansing should be done to prevent
plaque to accumulating and also to clean the food debris
from the surface.[5] Artificial teeth should be removed from
the mouth at night to allow adequate resting of the mouth
supporting tissue.[6] Continuous denture wearing may cause
some reactions to the tissues because the mucosa beneath
Address for correspondence: Dr. Liana Rahmayani, Sp.Pros,
Department of Prosthodontic, Faculty of Dentistry,
Universitas Syiah Kuala-Aceh, Indonesia, Kopelma Darussalam,
Banda Aceh-23111. Telp: 0651-7555183, Phone: +6185220138456.
E-mail: liana.rahmayani@unsyiah.ac.id

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How to cite this article: Rahmayani L, Sofya PA, Andriany P,

DOI: Jingga CS. Oral hygiene behavior of acrylic removable partial denture
10.4103/jioh.jioh_177_18 usage community in Seuneubok District, West Aceh: A cross-sectional
study. J Int Oral Health 2020;12:163-7.

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Rahmayani, et al.: Oral hygiene behavior of RPD usage in Aceh
the denture will be covered for a long time period, thus
blocking the oral mucosal clearance by the tongue and saliva
whereby result in the attachment of microorganisms.[7]
Gulcan et al.[5] stated that of 69 people, who maintained
oral hygiene by brushing their teeth with toothbrushes
and toothpaste incidences of 36.2% once daily, 31.9%
did so three times daily, 21.8% once a week, and 10.1%
rarely. But this study was conducted on the general public,
whether it is denture users or not. According to another
research, about 73.6% of patients with denture maintained
oral hygiene by brushing the remaining teeth using water,
brush tooth, and toothpaste performed twice daily, and 46
denture wearer patients controlled to dentist after denture
installation to maintain oral hygiene and soft tissue.[8,9]
The denture hygiene and oral cavity of the removable denture
remained to be considered in order to achieve maximum
hygiene and to support overall oral health.[10,11] Maupome
et al.[3] stated that young patients have good oral hygiene and
also in patients receiving support from the family, friends,
and companions. Use of artificial teeth not accompanied
by maintenance any remaining teeth will have a significant
impact on oral health, such as caries, inflammation of
the periodontal tissues, and lesions of the oral mucosa.
Therefore, people with denture should pay attention to oral
hygiene and denture.[11-13] This situation is no exception to
people with denture in Seuneubok Aceh Barat.
Based on the observations made, many community lived
in there wearing acrylic removable partial denture but have
not been studied. Therefore, the purpose of this study is to
know how the maintenance of dentures and oral hygiene
behavior in community with acrylic removable partial
denture in Seuneubok Aceh Barat.
Materials and Methods
An analytical descriptive retrospective study was made
among removable partial denture wearers from April to
May 2015. The population in this study was the entire
community resided in Seuneubok District, Meulaboh,
West Aceh.
Determination of the subject using purposive sampling
technique, subjects’ selection conducted on the basis
of consideration of the researchers themselves. In the
Seuneubok District, there are 4367 people and are divided
into five hamlets. Subjects were taken as many as 97 subjects
and the subjects comprised 65 women and 32 men. The
inclusion criteria of the study included subjects who were
residing in Seuneubok District, subjects who were using
acrylic removable partial denture, and subjects who were
willing to fill out informed consent sheet. The exclusion
criteria of the study included the subjects who had physical
limitations and subjects who manufactured the acrylic
removable partial denture other than in dentist practice. For
the type of data taken from this study is the primary data
obtained directly by the researchers using questionnaires.
164 164  Journal of International Oral Health ¦ Volume 12 ¦ Issue 2 ¦ March-April 2020
The standard questionnaire designed and studied refers to
a reference conducted by the Peracini et al.[10]
Questionnaires were framed to see the description of a
situation objectively and to determine the relationship
of oral hygiene behavior and maintenance with gender,
age, and duration of acrylic removable denture usage in
Seuneubok District community, West Aceh.
Collecting data begin by searching the data of research
subjects in accordance with inclusion criteria on dentist
practices in West Aceh. Informed consents were taken
from participants by explaining the purpose of this
research. Subsequently the subject will be continued by
interviewing the questionnaire question. In this study,
subjects were asked to answer the questionnaire to see
whether behavior is good or not good in maintaining oral
hygiene during the use of denture.
Statistical analysis
Data analysis used Pearson chi-square test and continued
with Fisher’s Exact (2-sided) test, with alpha p value 0.05
(IBM, Chicago, Version 16). The data analysis was used
to determine the relationship of oral hygiene behavior
and maintenance with gender, age, and duration of
acrylic removable denture usage in Seuneubok District
community, West Aceh.
Results
The research subjects were the Seuneubok community who
used removable partial dentures of 97 subjects according
to the inclusion criteria.
Table 1 shows that of the 97 subjects 65 (67%) were women
with most dentures in Gampong Seuneubok Meulaboh
Aceh Barat, whereas 32 (33%) were men.
Table 2 shows that there were total 74 (76%) subjects
who used removable partial dentures with less good
maintenance, 14 (15%) subjects who were with good care,
and 9 (9%) subjects who were not good.
Subjects of male gender have no subjects with good
maintenance (0%) in maintaining dental and oral hygiene,
poor maintenance as much as 25 people (78.1%), and poor
maintenance as much as 7 people (21.9%). The subjects
of female gender with good maintenance as much as 14
people (21.5%), poor maintenance as much as 49 people
(75.4%), and poor maintenance as much as 2 people
(3.1%). Pearson’s chi-squared test value was obtained at
P  =  0.001 for the relationship between the behavior of
maintaining oral hygiene in removable partial denture
users between men and women [Table 3].
Table 4 shows that six (27.3%) subjects aged 20–30 years
were found with good maintenance. Twenty-three (79.3%)
subjects aged between 41 and 50  years were mostly
found with poor maintenance. Four (19%) subjects aged
51–60 years were found with poor maintenance. The value
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Rahmayani, et al.: Oral hygiene behavior of RPD usage in Aceh

of P = 0.597 showed no significant relationship between Discussion

oral hygiene behavior and the age.
Removable partial dentures are a device that serves to
Table 5 shows that subjects with good behavior of restore one or more of the original tooth that has been lost,
maintenance were found to be highest in subjects who used supported by the remaining original tooth and mucosa
partial dentures for 1 year of 7 people (26.9%). Subjects beneath the denture base.[4,12] Partial acrylic denture is the
with not good behavior were most prevalent in subjects most widely used for denture today because of the same
who had used denture for 5 years (20.8%). Behavior was color as the gingiva color and not toxic.[13,14] However, the
less good found as many as 19 people (73.1%) on the use unauthorized use of denture hygiene of the oral cavity and
of denture for 1 year. The value of P = 0.038 showed a denture can lead to the buildup of food scraps in both the
significant relationship between behavior and duration of original and artificial teeth, which will be a contributing
denture usage. factor in the formation of plaque and a site for the growth
of microorganisms that will lead to caries, stomatitis,
serostomia, and periodontal disease. The placement of
Table 1: Distribution of research subjects by gender the prosthesis in the oral cavity also results the change of
Gender Total Percentage (%) environmental conditions in which the prosthesis becomes
Men 32 33 the site of colonization of oral microorganisms. Microbial
Women 65 67 plaque on removable prostheses covering the palate area
Total 97 100 causes denture stomatitis in 69% of denture wearers.
Therefore, the maintenance of dental and oral hygiene
and denture is very important in maintaining healthy
Table 2: Oral hygiene behavior during the use of removable surrounding tissue in the oral cavity.[15,16]
partial denture
Behavior Total Percentage (%) Based on Table 1 in this study subjects 65 women (67%)
Good 14 15
who mostly use acrylic removable partial denture than
Less good 74 76 men who only 32 people (33%). This is in line with
Not good 9 9 research in 2010, Magdarina states that women are more
Total 97 100 using artificial teeth than men. Women are more likely to

Table 3: Oral hygiene behavior during the use of removable partial denture by gender
Behavior Total P
Good Less good Not good
Gender Men Count 0 25 7 32
% within gender 0.0% 78.1% 21.9% 100.0%
Women Count 14 49 2 65
% within gender 21.5% 75.4% 3.1% 100.0% .001*
Total Count 14 74 9 97
% within gender 14.4% 76.3% 9.3% 100.0%
Significant difference (*P ≤ 0.05)

Table 4: Oral hygiene behavior during the use of removable partial denture by age
Behavior Total P
Good Less good Not good
Ages 20–30 years Count 6 15 1 22
% within ages 27.3% 68.2% 4.5% 100.0%
31–40 years Count 3 18 1 22
% within ages 13.6% 81.8% 4.5% 100.0% .597*
41–50 years Count 3 23 3 29
% within ages 10.3% 79.3% 10.3% 100.0%
51–60 years Count 2 15 4 21
% within ages 9.5% 71.4% 19.0% 100.0%
>61 years Count 0 3 0 3
% within ages 0.0% 100.0% 0.0% 100.0%
Total Count 14 74 9 97
% within ages 14.4% 76.3% 9.3% 100.0%
Significant difference (*P ≤ 0.05)

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Rahmayani, et al.: Oral hygiene behavior of RPD usage in Aceh

Table 5: Oral hygiene behavior during the use of removable partial denture by length time
Behavior Total P
Good Less good Not good
Length time 1 year Count 7 19 0 26
% within length time 26.9% 73.1% 0.0% 100.0%
2 years Count 2 12 0 14
% within length time 14.3% 85.7% 0.0% 100.0% .038*
3 years Count 3 17 1 21
% within length time 14.3% 81.0% 4.8% 100.0%
4 years Count 0 9 3 12
% within length time 0.0% 75.0% 25.0% 100.0%
5 years Count 2 17 5 24
% within length time 8.3% 70.8% 20.8% 100.0%
Total Count 14 74 9 97
% within length time 14.4% 76.3% 9.3% 100.0%
Significant difference (*P ≤ 0.05)

use artificial teeth because they have more attention to
appearance and aesthetic importance.[4,17] In addition, the
women population in Seuneubok District is equal to 2204
people as compared to men of 2163 people. The subjects
who used partial dentures were more commonly found
between the ages of 41–50 years as many as 29 people (30%)
with the length time 1 year use in the 1–5 years range. In
the age group of 41–50 years including adulthood where
tooth loss occurs more commonly in that age group, so
partially removable partial dentures are most needed to
replace some of the missing teeth.[17,18]
Table 2 shows that the majority of subjects in this study
were poor in maintaining dental and oral hygiene during
using acrylic removable partial dentures, as many as 74
people (76%). Many people have received instructions
from the dentist, but do not care about the denture’s
hygiene and oral cavity. But the lack of instructions from
the dentist will also cause the subject does not understand
in maintaining the hygiene of teeth, mouth and denture.
The poor of oral hygiene can have an effect on the soft
tissue of the denture user, one of which is the occurrence of
denture stomatitis because of the attachment of Candida
to the less clean denture. According to Mubarak et al.[16]
denture-related stomatitis associated with Candida is the
most common form of candidiasis, which is of about
60%–65% in a subject wearing denture. Clinically found
in the poor oral hygiene that the number of Candida sp.
colonies showed differences In the subject of RPD users,
self-cured acrylic resins contain more colonies of Candida
sp. than the subjects of heat-cured acrylic resin users.[15,19]
Table 3 shows that male subjects were absent with good
maintenance (0%) in maintaining dental and oral hygiene,
less poor maintenance as 25 people (78.1%), and not
good or poor maintenance as 7 people (21.9%). Female
subjects were found with good maintenance as 14 people
(21.5%), less poor maintenance as 49 people (75.4%),
and poor maintenance as 2 people (3.1%). There is a
significant difference between gender and oral hygiene
and denture hygiene. This is because women are more care
and thorough in maintaining the hygiene of the oral cavity
and denture. This study is in accordance with Rahmayani
et  al.[20] who concluded that women are more concerned
than men about looking for a denture treatment. This is
because women are more concerned about esthetics.[19,21]
In Table 4 most of the subjects by age group tend to
be less well in maintaining the dental and oral hygiene
and most common in the 41–50  years of age group as
23 people (24%), whereas poor maintenance was most
prevalent between the 51 and 60 years of age group as four
people (4%), due to reduction in motoric ability, impaired
vision or physical condition that has been weak so that
the subject has difficulty in maintaining oral hygiene and
denture hygiene and affect their habit in maintaining the
hygiene of their mouth.[5]
The results of this study indicate that subjects with acrylic
removable partial denture with 1–5 years of usage tend to be
less good in maintaining denture hygiene and oral hygiene,
most found in subjects who have been using denture for
1 year as many as 19 people (73.1%), poor maintenance was
most prevalent in 5 years of usage. There was a significant
relationship between oral hygiene behavior and duration
of denture usage. However, good or poor dental hygiene
does not depend on the duration of denture wear, but it
depends on the individual’s knowledge and awareness
in maintaining oral hygiene during the use of removable
partial denture. It is also important to acknowledge that
the patient’s personal hygiene procedures and motivation
together with a supervised oral hygiene program may
also play an important role for preventing any possible
deterioration effects on the health of the oral tissues.[22]
Limitations of this study are that the data obtained
were not collected based on educational background
and occupation which could identified as the factors
that affected the maintenance of oral and dental hygiene
during the use of acrylic removable partial denture.

      
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Rahmayani, et al.: Oral hygiene behavior of RPD usage in Aceh
Conclusion
Maintenance and oral hygiene behavior of community
with acrylic removable partial dentures was in West Aceh
Seuneubok mostly in less good category. Maintenance
of oral hygiene in women is good as compared to men,
whereas by age, the age group between 20–30 years with
good maintenance. There was a relationship between
the behavior of maintaining oral hygiene with gender
and age, but there is no significant relationship with the
duration of dentures usage. Suggest the improvement in
coordination between dentist and other health personnel
in order to provide health promotion on the importance
of maintaining oral hygiene in denture users. It is also
advisable to the dentist to provide instructions on how
to keep the hygiene of the denture properly. It is hoped
that people who use removable partial denture further
raise awareness and care in maintaining denture hygiene,
remaining teeth and soft tissues of the mouth.
Ethical policy and institutional review board statement
Ethical approval for this study was obtained from the
Faculty of Dentistry, Syiah Kuala University, Aceh,
Indonesia (Protocol no. 105/KE/FKG/2015).
Acknowledgement
We would like to thank village head who has given
permission for this research and our subject for their
participation in this study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. Tyson K, Yemm R, Scott B. Understanding Partial Denture Design.
New York (NY): Oxford; 2007. p. 4.
2. Ferro  KJ, Morgano  MS, Driscoll  CF, Freilich  MA, Guckes  AD,
Kent L. The glossary of prosthodontic terms ninth edition. J Prosthet
Dent. Available from: https://www.academyofprosthodontics.org/_
Library/ap_articles_download/GPT9.pdf.
3. Rathee  M, Hooda  A, Ghalaut  P. Denture hygiene in geriatrics
persons. Internet J Ger Gerodont 2009;6. Available from: https://
print.ispub.com/api/0/ispub-article/12364.
      Journal of International Oral Health ¦ Volume 12 ¦ Issue 2 ¦ March-April 2020
4. Patel  IB, Madan  G, Solanki  K, Chavda  R. Behaviors and hygiene
habits of a sample population of complete denture wearers in
Ahmedabad. J Int Oral Health 2012;4:29-38.
5. Akar  GC, Ergül  S. The oral hygiene and denture status among
residential home residents. Clin Oral Investig 2008;12:61-5.
6. Jones  JD, Turkyilmaz  I, Garcia  LT. Removable partial dentures––
treatment now and for the future. Tex Dent J 2010;127:365-72.
7. Loney RW. Removable Partial Denture Manual. Canada Dalhousie
University Faculty of Dentistry: Nova scotia, Canada; 2008. p. 68.
8. Dikbas  I, Koksal  T, Bal  B, Ozkurt  Z, Kazaoglu  E. A survey of
dentist’s attitudes toward denture cleansing. OHDMBSC 2006;5:10.
9. Barreiro DM, Scheid PA, May LG, Unfer B, Braun KO. Evaluation
of procedures employed for the maintenance of removable dentures
in elderly individuals. Oral Health Prev Dent 2009;7:243-9.
10. Peracini  A, Andrade  IM, Paranhos  HF, Silva  CH, de  Souza  RF.
Behaviors and hygiene habits of complete denture wearers. Braz
Dent J 2010;21:247-52.
11. Carr  AB, McGivney  GP, Brown  DT. McCracken’s Removable
Partial Prosthodontics. 11th ed. Missouri, United states: elsevier/
Mosby; 2005. p. 370.
12. David  J. Prosthetic and Implant Dentistry, Instructions for
Patients with Partial Dentures; 2014. Available from: http://www.
davidkachelmeyerdds.com. [Last accessed on 2014 Oct 21].
13. Phoenix RD, Cagna DR, DeFreest CF. Stewart’s Clinical Removable
Partial Prosthodontics. 3rd ed. Quintessence Pub Co: Chicago (IL);
2003. p. 6-7.
14. Taiwo  JO, Arigbede  AO. Denture hygiene of the elderly denture
wears in south east local government area in Ibadan, Nigeria. J Biol
Agric Healthcare 2012;2:22.
15. Coulthwaite  L, Verran  J. Potential pathogenic aspects of denture
plaque. Br J Biomed Sci 2007;64:180-9.
16. Mubarak  Z, Rahmayani  L, Nasution  AI, Bunjamin  P. Original
research comparison of Candida sp. colonies in gargling-volume
culture from subject wearers of heat-cured and self-cured acrylic
resin removable partial dentures. World J Dent 2017;8:471-6.
17. Bekiroglu  N, Çiftçi  A, Bayraktar  K, Yavuz  A, Kargul  B. Oral
complaints of denture-wearing elderly people living in two nursing
homes in Istanbul, Turkey. Oral Health Dent Manag 2012;11:107-15.
18. Kanli A, Dimerel F, Sezgen Y. Oral candidosis, denture cleanliness
and hygiene habits in an elderly population. Ankara, Turkey: Faculty
of Medicine, University of Hacettepe; 2005. p. 502-7.
19. Ozkan  Y, Ozcan  M, Kulak  Y, Kazazoglu  E, Arikan  A. General
health, dental status and perceived dental treatment needs of an
elderly population in Istanbul. Gerodontology 2011;28:28-36.
20. Rahmayani  L, Novita  CF, Ahya  W. Original research emotional
impact survey of dental patients with tooth loss in Unsyiah Dental
Hospital, Banda Aceh, Indonesia. World J Dent 2018;9:24-8.
21. Amjad M, Azad AA, Ayub MM, Qureshi MA, Jave MU. Denture
hygiene habits in complete wearers at Armed Forces Institute of
Dentistry. Pak Armed Forces Med J 2010;4:13-8.
22. Ezawi  AAE, Gillam  DG, Taylor  PD. The impact of removable
partial dentures on the health of oral tissues: A systematic review.
Int J Dent Oral Health 2017;3:1-8.
167