DENTURE CLEANSER

&
DENTURE ADHESIVE

BY,
R.VENKATESHWARAN
Contents:
Introduction
Requirements
Classification
Composition
Mode of action
Special scenario
Denture maintenance
Conclusion
Reference
Introduction:
The purpose of using denture adhesives.

 Improved fit
 Comfort
 Improved chewing ability and confidence.
Requirements:
 Neutral or slightly basic pH
Minimal toxicity to the oral mucosa
Adhesive bond strength for 12 to 16 hours
Easier to clean off oral tissues
Easier to clean off denture
Less messy
More readily available in shops
Less expensive
Better taste and fit
 Classification:
Based on components:
 Natural gum - Karaya gum.
 Synthetic gum - Grantez polymer.
Based on duration of action:
 Long acting - Poly vinyl methyl ether maleat
 Short acting – carboxy methyl cellulose
Based on forms:
 Paste.
 Powder.
Composition:
Components Action
Poly vinyl methyl ether Swell and are
maleate, responsible for
Karaya gum, adhesive properties.
Methyl cellulose,
Hydroxy methyl cellulose,
Carboxy methyl cellulose
sodium.
Sodium borate, Antimicrobial agent
Sodium tetra borate,
Hexa chlorophene.
Propythy-hydroxy benzoate Preservative and
anti fungal
Sodium lauryl sulfate Wetting agent

Magnesium oxide Filler

Silicon-di-oxide, calcium To minimize

stearate clumping
Petrolatum, mineral oil, poly Binder
ethylene oxide
Menthol, Pepper mint oil & oil Flavoring agent
of winter green
Mode of action:
Swell to obliterate the space between
the base of denture and the oral mucosa.

Influence:
Increase the coefficient of surface tension
of the fluid
Forms a viscous gel on contact with water
Increases cohesiveness of the film of
saliva by increasing viscosity of the film.
 Viscous gel

Before applying adhesive After applying adhesive

Indications:
 Patient’s perceived retention and
stability expectations
 Salivary dysfunction or neurological
disorders
 Xerostomia due to medication side
effects
 Head and neck irradiation
 Systemic disease or disease of salivary
gland
 Cerebro-vascular accident (stroke)
Contraindication:
 For the retention of improperly
fabricated denture or poorly fitting
prostheses
Toothpaste as denture adhesive:
 Poor retention of complete denture
trial bases can interfere with jaw
relation record-making and clinical
evaluation of tooth arrangement.
? Not a denture adhesive
 Difficult to remove from the bases
and the patient's mouth,
 Potentially spread infectious material
or lead to contamination of dental
casts, which may result in the
adhesive being incorporated into the
final denture base.
? To a tooth paste
 Toothpastes are similar in viscosity
to denture adhesive pastes
 Toothpaste placed in denture bases,
as if it were an adhesive, forms a
seal that will provide a temporary
improvement in retention
 Provide the opportunity to make
inter-occlussal records or evaluate
phonetics and esthetics of trial tooth
arrangements
Advantage:
 Pleasant taste and are water soluble,
permits easy cleaning
 Risk of adhesive contamination is
reduced
 Cost is not a factor
Disadvantage

 Mandibular dentures lined with

toothpaste are not as retentive as
maxillary dentures, so an adhesive
might still be the material of choice.
Direction for use:
 Choice between cream and powder is
largely subjective for individual
 Least amount of material that is used
should be 0.5-1.5g / denture unit (more for
larger alveolar ridge, less for small ones)
 Prosthesis should be moistened and then a
thin adhesive sprayed onto denture surface
Paste form:
Comes in a tube and is squeezed onto
the impression surface of the denture
Denture paste is probably the most
preferred type of adhesive
 Paste also comes in a variety of
flavors and strengths
Method to use paste form:
Two approaches to apply paste form:

Thin beads
Small spots
Thin bead technique:
On maxilla:
Beads of adhesive placed in
the
 Depth of dried denture in
incisor region and molar
regions.
 An anteroposterior bead
along mid palate.
On mandible:
 Apply three small lines
into the into impression
surface of denture.
 Spot technique:
 Small spots of cream
are placed at 5-mm
intervals throughout
the fitting surface of
dried denture
uniformly in both
maxilla and
mandible.
Powder form:

 Powders are
sprinkled over the
impression surface
of denture.
 The saliva in
mouth, it activates
the powder into
sticky viscous gel
holding denture in
position.
 Inadequate or absent saliva, the
denture should be slightly moistened
with water before being inserted.
 Easier to clean off the tissue surface
after the dentures are removed.
Powder form Vs Paste form
Powder formulation Paste formulation

 Degree of hold is  Degree of hold is high

less.  Duration of action is
 Duration of action is long.
short.  Requires more
 Can be used in material.
smaller quantities.  Difficult to clean of
 Easy to clean of denture and tissue.
denture and tissue.  Initial hold is achieved
 Initial hold is comparatively late.
achieved soon.
Denture maintenance
 Daily removal of adhesive product from
tissue surface
 Prosthesis soaked in water over night, so
readily rinsed off.
 Running hot water over tissue surface of
denture while scrubbing with a hard
toothbrush.
 Adhesive on ridge is removed by rinsing
with warm or hot water and then firmly
wiping the area with gauze or a washcloth
saturated with hot water .
References:
Books:
 Prosthodontic treatment for edentulous
patients Zarb, bolender.
  Applied dental materials-John.F.McCabe
  Anusavice, Phillip’s science of dental
materials – Tenth edition
  Craig 12th edition – restorative dental
materials
  Dental materials properties and selection –
William j.o’brein 
 Clinical dental materials – Michael bagby
Journals:
 Denture adhesive: cyto-toxicity, microbial
contamination and formaldehyde content;
Journal of prosthetic dentistry; vol:69 issue
:3; 314-317;1983.
 Effect of denture adhesive on maxillary
denture stability; Journal of prosthetic
dentistry; vol:72; 399-405;1994.
 A method of studying the effect of adhesives
on denture retention. Journal of prosthetic
dentistry; vol:50; issue :3;332-337;1983.
Laboratory evaluation of a new denture
adhesive; Journal of Dental Materials; vol:
20; 419–424; 2004.
Tooth paste used as short acting denture
adhesive; Journal of prosthetic dentistry;
vol:74; 119. 1995.
Usage of denture adhesives; Journal of
Dentistry; vol:28; 137–140;2000.g
Conclusion
 A useful adjunct in denture prosthesis
services, with specific roles in both
fabrication and post insertion phases.
 They also indicated that the dual
goals of maximizing the beneficial
aspects of denture adhesive use while
minimizing the misuse of denture
adhesives be achieved.
DENTURE CLEANSER
Contents:
 Introduction
 Composition
 Types
 Denture debris
 Advances
 Conclusion
Introduction
 Growth in the aging population has
resulted in an increasing number of
older persons requiring dentures. 
 Proper cleansing of dentures is an
essential daily routine in order to
ensure the safety and satisfaction of
the edentulous patient.
 To maintain an esthetic, odor-free
appliance.
Denture debris
 Every surface in the oral cavity,
natural or synthetic, becomes
covered within about 30 minutes with
a 0.5-1.5 µ-thick precipitate of
salivary glycoprotein and
immunoglobulin that is termed
"pellicle”.
 Calculus is also readily stained by
tobacco, tea, coffee, certain
medications (particularly iron
supplements), and numerous other
ingested materials.
Composition
 Alkaline perborate -compounds
for oxidizing,
 Perborate and/or carbonate -
effervescing,
 Edta -chelating,
 Silicone polymer,
 Detergent,
 Color, and fragrance agents.
Types:
 Mechanical method.
 Chemical method.
 Combination method.
 Ultrasonic cleanser.
Mechanical method
 use of a brush in
the presence of
either hot or cold
water
 Toothbrushes and
nailbrushes are
also effective in
removing gross
material. 
Place paper towel or
wash cloth in sink to
prevent breakage if
dropped
Clean under cool water
to prevent warping
Scrub all areas with
denture brush
Denture Brushes
 Should have
pointed side
 Should be discarded
or sterilized
following illness or
infection
 Replaced when
frayed or dirty
Boxes
 Cleaned weekly
 Sterilized
following illness
or infection or
replace
Disadvantage:
 Microbiologic assays and scanning
electron microscopic images
demonstrate that use of a denture
brush with water is ineffective at
removing an unacceptably large
proportion of adherent
microorganisms.
Chemical methods:
 Most chemical means of disinfection
is accomplished through exposure of
the organisms to oxygen tension
levels greater than oxygen tension
levels in the mouth. 

2H2O2 2H2O + 2[O]

(nascent oxygen)
Advantage:
 Are potentially an effective for the
control of common oral bacteria.
 Significant reductions of microbial
populations were achieved without
the mechanical disruptive action of
brushing in as little as 90 seconds.
 Level of antimicrobial efficacy was
comparable for a diverse range of
microbes.
Disadvantage
The color stability of denture base
acrylic resins was influenced.
The presence of bleach is that metallic
elements of removable partial
dentures acquire a tenacious black
stain after soaking in the bleach
solution for more than 10 minutes
daily.
Effervescent cleansing tablet
Ingredient Function
25–40% Primary bleaching agent, effective at
DuPont Oxone room temperature and at pH 6–10.
10–20%
Sodiumperborate
monohydrate Secondary bleaching agent
(SPBMH)
10–20% Sodium Buffer and carbonate source for
bicarbonate effervescence
10–15% Sodium Buffer and carbonate source for
carbonate effervescence
10–15% Citric acid Acid source for CO2 effervescence
1–3% Binder
Polyvinylpyrrolidone
1% Detergent Emulsifier
1% EDTA Chelant and detergency builder
1–2% Sodium Preservative
benzoate
0.5% Flavor Fragrance
0.1–0.3% Magnesium Mold release agent
stearate
0.1% Color
Sodium sulfate Filler
 Ultra sonic denture cleanser
 Sonic Denture Cleaner is an
effective and simple way to
clean dentures
 The Sonic Denture Cleanser
effectively removes
discolouration caused by
coffee, tea, red wine and
tobacco.
 It also removes lingering
food odours, such as smells
of onions and garlic.
Mode of action
 The Sonic Denture Cleaner is
integrated with UV sterilization and
nano silver bacteriostasis.
 It utilizes the latest electronic
technology and does not require any
consumables or special cleaning
fluids.
 The inner compartment becomes
nano silver mixture holder as soon as
you fill it with cold tap water.
 Sonic waves vibrate 8000 times per
minute, removing tartar and food
debris lodged between individual
denture teeth and around the gum
plates.
 The sterilizing UV light and the
bacteriostatic action of the nano-silver
destroy bacteria. Stains are removed
and your dentures are fresh, clean
and bright again!
Vinegar as an anti-microbial agent
 Candida albicans strains are associated
with denture-induced stomatitis.
 Dentures immersed in a 10% vinegar
solution (pH less than 3) overnight.
 A significant reduction was verified in
counts of Candida after treatment.
 Reduced amounts of Candida spp. in
the saliva and the presence of denture
stomatitis in the patients.
Nystatin anti-fungal suspension
 A useful adjunct in the management
of denture stomatitis. 
 Banting and colleagues found that a
10% dilution of 1:100,000 suspension
of nystatin was no more effective
than distilled water in reducing
organisms on the denture surface.
 Air drying
 Not a widespread acceptance denture
cleaning technique for two reasons.
 Drying an unclean denture will make the
adherent material stick ever more
tightly even as it fails to remove
microbial surface antigens and
exotoxins. 
 Dentists have historically been told that
air drying an acrylic denture will distort
its contours. 
Danger in denture cleanser
Symptoms of an allergic reaction
 Irritation
 Tissue damage,
 Rash,
 Hives,
 Gum tenderness,
 Breathing problems, and
 Low blood pressure.
Misuse of denture cleansers
 Some cleansers may list mouthwash
as an ingredient, but consumers
should never chew, swallow, or
gargle with denture cleansers.
 Dentures should be thoroughly rinsed
with water before they are placed in
the mouth.
Advances
Silicone Polymer
 A component of commercial denture
cleanser,silicone polymer to which
oral bacteria are unable to adhere.
 The component floats on the surface
of the denture bath, and when the
denture is removed from the solution,
a thin layer (constituting 0.1-0.8 mg)
of the material coats all surfaces of
the prosthesis. 
Microwave radiation
 They found the method to be
effective at significantly reducing the
number of cultivable organisms on
the dentures, but non-viable
organisms and their by-products still
present after exposure to the
radiation will still able to elicit an
unwanted host response. 
Conclusion
 Dental professionals must have a
current knowledge of denture cleansing
strategies in order to maximize the
service offered to denture patients.
 Care and cleaning of dentures is more
than a strictly esthetic concern
 References:
 Books:
 Anusavice-Phillip’s science of dental
materials(tenth edition)
 Craig 12th edition-Restorative dental
materials
 Michael bagby-Clinical dental materials
 William J. o’brein-Dental materials
properties and selection
Journals:
 "Allergic Contact Cheilitis Due to
Effervescent Dental Cleanser:
Combined Responsibilities of the
Allergen Persulfate and Prosthesis
Porosity," Conracr Dennariris.
41(5):268-271, November 1999.
 The attitude of complete denture
wearers towards denture adhesives in
Istanbul; Journal of Oral
Rehabilitation vol 31; 131–134 2004
The Evaluation of Denture Retention and Ease
of Removal from Oral Mucosa on a New Gel-
Type Denture Adhesive; J Jpn Prosthodont Soc
52 ： 175-182, 2008
Vinegar As An Antimicrobial Agent For Control
Of Candida spp. in complete denture wearers; J
Appl Oral Sci. 2008;16(6):385-90
A Clinical Study to Assess the Breath
Protection Efficacy of Denture Adhesive The
Journal of Contemporary Dental Practice,
Volume 3, No. 4, November 15, 2002
DENTUR ADHESIVE
Journal References

BY,
R.VENKATESHWARAN
Effect of denture adhesive on the retention
and stability of maxillary dentures.
JPD 1994,
Vol:74,Issue:4.Joseph.E.Grasso
 This study to measure effectiveness of denture
adhesive.It used qualitative method to measure the
effects of a denture adhesive on retention and stability of
maxillary denture.
 Improvement of retention was greatest for vertical
dimension because ridge serve as a physical boundary,
limiting movement in anterior/posterior/lateral
movements.
Cont…
 Maximum adhesive property was seen at 2-4hours
after application.
 Use of adhesive reduced minor denture movements to
0.9-1.3mm in vertical dimension and 0.2-0.5mm in
anterior/posterior/lateral dimension for both type of
dentures.
 Increase in incisal bite force from 20-35N at base line
to a maximum of 54N at 8 hours after application.
Use of denture axdhesive as an aid to denture
treatment.JPD 1994,Vol.62

History of denture adhesive :

 Began only in age of modern dentistry, no reference available
in text till late 18th century.
 Adhesive used in the beginning of 19th century.
 First patent was issued in 1913.
 First ADA reference came from accepted dental remedies in
1935.
 Allwrith found first non water soluble adhesive
Cont..

 Initially adhesive were formulated by an

apothecary who mixed vegetable gums to produce
a material that absorbed moisture from saliva and
swelled to mucilaginous substrate that adhered to
mucosa and denture
Denture adhesives and uses, JADA 1996,
Vol:127

 In 1945 adhesive were used only to hold base plate

while “recording dental relation”.
 In immediate denture construction until well fitting
denture were completed.
Denture adhesive: Choosing the right
powder, JADA 1991,Vol 122

 Shay described that the material swells 50%-150%

by volume in presence of water filling in space
between prosthesis and tissue. As water is absorbed
by adhesive agent, the resulting anions are attracted
to cations in mucous membrane protein producing
stickiness.
Cont..
 The physical forces are based on a principle
derived by Stefan over a century ago, which states
force required to pull two discs or plates apart is
directly proportional to viscosity of liquid between
them.
 Saliva increases viscosity there by increasing the
force required to separate prosthesis from oral
mucous.
 Modern adhesive have increased adhesive property
by increase bio adhesive and cohesive forces.
Mechanism of action
 Most adhesive ingredient provide bio adhesion via carboxyl
group.
 As adhesive hydrates free carboxyl group from electrovalent
bond that produce stickiness.
 Poly methyl vinyl ether maleic anhydride is a co polymer
synthetic compound widely used because of its high level of
carboxyl group.
 As most of oral cavity is of anionic charge it readily adheres with
calcium cation formed by adhesive.
Cont..
 In 1970’s divalent salts of PVM-MA in addition
with carboxyl methyl cellulose (CMC).
 There is a quick upfront hold through CMC and
long duration through PVM-MA divalent salt.
 The presence of divalent salt reduced rate of
dissolution.
 Increased overall material by developing a highly
cross linked matrix between CMC,PVM-MA
copolymer and divalent calcium ion.
Relation to oral prosthesis
 In 1940-Bartel’s-Adhesive did not inhibit presence
of micro organism.
 In 1950-Kelly’s-Did not support bacterial growth.
 In 1970-Stafford and Russell-adhesive supported
some microbial growth (candida abicans). But
were unable to demonstrate that adhesive have
inhibitory effect on oral mucosa.
Cont..
 Abdelmelak and Michael- Alter histology of oral
mucosa during the period adhesive got adapted to
adhesive. There was a marked decrease in surface
keratin.
 In 1980-Tarbet,Grossman-No incidence of
mucosal irritation.
 Shay quoted that “Misled by biased product
information, misinformed by anecdotal reports or
totally uninformed denture adhesive.
Professional attitude towards denture adhesive,
JPD,Vol:82,Issue:1.
 Many of dentist does not consider denture adhesive
as an useful adjunct to complete denture.
 Instead they considered use of denture adhesive as a
stigma in their practice and it also had some
physcological effects on patients that denture is ill
fitting.
 It was considered that denture adhesive can have
negative influence on both denture and dentist by
masking underlying denture problems, avoiding
necessary dental visit.
Cont..

 Can also contribute to occurrence of candida

albicans causing candidiasis and denture
stomatitis.
JPD 1989,Vol:69,Issue:3

 Microbial contamination was more pronounced

with use of natural gum raw materials.
 Denture adhesive containing karaya gum may
worsen any pre-disposition to caries.
IJPD 2005, Volume:14, Issue:2

 Use of denture adhesive significantly increased

the BFDD (maximum bite force until denture
dislodgement)
Adhesives for maxillo facial prosthesis,
JPD 2002,Volume:88, Issue 5

 Denture adhesive paste can also be used to retain

an extra oral facial prosthesis wax pattern for trial
placement.
 Because holding pattern with hand may disrupt in
assessing the angulations and placement and
assessment of prosthetic success.
 Is used for temporary retention of prosthesis.