As a dental hygienist who works with senior patients who have few or no remaining teeth, I can tell you that oral hygiene is still important regardless. People often think that they no longer need to take care of their mouth or see the dentist if they are edentulous (have no teeth), however they still need regular check ups and to keep up with their oral care.
Oral hygiene care for elderly people with no teeth consists of:
- Gently brushing gums and tongue twice per day to remove bacteria
- Keeping the mouth moist by drinking water or frequent rinsing
- Keeping the lips moist by applying a water-based moisturizer
- Removing dentures overnight – every night – and sleeping without wearing them, so the oral tissues can “breathe”
- Seeing a dentist annually, at minimum, to check for fungal infections, proper fit or issues with the dentures, and an oral cancer screening.
The American College of Prosthodontists (*prosthodontists specialize in making dentures and other oral appliances) reports that, “More than 36 million Americans do not have any teeth, and 120 million people in the U.S. are missing at least one tooth. These numbers are expected to grow in the next two decades.”
Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%). Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.” – Centers For Disease Control and Prevention (CDC)
You may not realize it, but having no teeth can severely impact a senior’s quality of life. The American College of Prosthodontists also says the “consequences of missing teeth include significant nutritional changes, obesity, diabetes, coronary artery disease, and some forms of cancer.”
Don’t be surprised if the dentist wants to take a panoramic radiograph (xray) every few years, regardless of whether you have teeth or not. These xrays go from ear to ear and are great for showing such things as cysts in the bone or sinuses, infections, any remaining teeth and problems associated with them (some people who wear full dentures still have an impacted tooth or root tip far under the bone). In addition, the ADA says these radiographs can find, “Other less
common conditions also may be detected: bony spicules along the alveolar ridge, residual cysts or infections, developmental abnormalities of the jaws, intraosseous tumors, and systemic conditions affecting bone metabolism.”
Can You Get Gingivitis If You Have No Teeth?
The American Academy of Periodontology says that, “Gingivitis is the mildest form of periodontal disease.” It affects the gums, not the teeth – which means you can still get gum disease – regardless of not having teeth.
The plaque that causes gingivitis produces toxins that inflame and irritate the gums, so the healthier you keep your mouth, the healthier you keep your body overall.
Chronic gingiva inflammation has been thought to be associated with some systemic diseases such as respiratory disease, diabetes, coronary artery disease, stroke and rheumatoid arthritis. Some research suggests that the bacteria responsible for periodontitis can enter your bloodstream through gum tissue, possibly affecting your heart, lungs and other parts of your body. – Mayo Clinic
Gum Care After Dentures – Should You Brush Your Gums If You Have No Teeth?
You betcha. You still need to gently brush your gums when you take out your dentures (which you should do every night before going to bed). Also brush your tongue, the inside of your cheeks, and the roof of your mouth so that you have thoroughly removed all plaque.
Be sure to schedule regular dental exams. During the exam, the dentist will check to be sure your dentures are still fitting well and will look for signs of oral cancer and fungal infections.
And don’t struggle with dentures that are loose or are chipped or broken. Instead, visit your dentist to see if they can reline or repair the denture.
Denture Care For Seniors
Believe me, dentures, partials, and appliances like snore guards or bite guards can build up tartar, plaque, and stains the same as teeth. I see it all the time. Bacteria and fungi hide under the denture and in the nooks and crannies. They must be removed in order to avoid possible mouth problems.
The American Dental Association (ADA) provides resources about denture care on its website, MouthHealthy.org. To take care of dental appliances, they say that, “Like your teeth, your dentures should be brushed daily to remove food particles and plaque. Brushing also can help keep the teeth from staining.”
To care for dentures and other dental appliances, the ADA recommends that you:
- Rinse your dentures before brushing to remove any loose food or debris.
- Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don’t get scratched.
- Clean the denture while holding it over a soft towel or over a sink that is partially filled with water (and preferably lined with a washcloth). Dentures can break if you drop them on a hard surface like the sink, counter, or floor.
- When brushing, clean your mouth thoroughly—including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath.
- When you’re not wearing your dentures, put them in a safe place covered in water to keep them from warping.
- Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives; look for products with the ADA Seal of Acceptance. Products with the ADA Seal have been evaluated for safety and effectiveness.”
- Be wary of using dental adhesives for a long period of time if your dentures aren’t fitting well. The Food and Drug Administration (FDA) cautions that, “…an excess of zinc in the body can lead to health problems such as nerve damage, especially in the hands and feet. This damage appears slowly, over an extended period of time. Overuse of zinc-containing denture adhesives, especially when combined with dietary supplements that contain zinc and other sources of zinc, can contribute to an excess of zinc in your body.”
Additionally, the main ADA website says:
- Placing a denture in water (or a denture cleanser solution) when it is not being worn helps the denture retain its shape, remain pliable and keeps it from drying out.
- Dentures should never be placed in hot or boiling water, which could cause them to warp.
- Denture adhesives are not a remedy for ill-fitting dentures, which may need to be relined or replaced to prevent oral sores from developing.
This care routine applies to both full dentures or partials, and dentures and appliances made from acrylic or metal or both.
Can You Soak Dentures In Mouthwash?
Did you know that dentures and partials have “pores” in the acrylic that makes up the denture? You can’t see them, but these pores are places that bacteria colonize and reproduce in. RDH Magazine (a professional publication for dental hygienists) notes that “research has isolated Staphylococcus aureus, Streptococcus mutans, Klebsiella pneumoniae, Escherichia coli, and hundreds of other garden-variety germs in acrylic dentures.”
The microporous surfaces of an acrylic denture provide a wide range of environments to support microorganisms that can threaten the health of a physically vulnerable patient. – Shay K.: J Contemp Dent Pract. 2000 Feb 15;1(2):28-41.
Brushing alone will not remove enough bacteria, so you should soak your dentures in mouthwash or a denture cleanser and you should do so overnight. RDH Magazine says this will “kill up to 99.9 percent of the bacteria that colonizes on their prostheses.”
Denture Cleansers and Mouthwash For Denture Wearers
In my dental office, we recommend Polident Overnight Whitening Antibacterial Denture Cleanser because laboratory tests have shown that it does reach the 99.9 percent bacterial kill rate. In addition, it helps to remove stains and brighten dentures. While the Polident 3-Minute Whitening Cleanser won’t kill as much bacteria, it can be helpful for reducing plaque and eliminating microbes if you are in a hurry.
Don’t forget to rinse the denture cleanser off before putting your dentures in your mouth – the chemicals in the cleansers can cause burns or ulcers in your mouth or vomiting if you swallow them. Also, use the denture cleanser in a container that is big enough to hold the denture and water – never put the denture cleanser tablet in your mouth!
In addition to soaking a denture in a cleanser overnight, you should brush the denture with a denture brush – not with a regular toothbrush. These brushes are specifically designed for cleaning dentures. They have stiffer brushes and are shaped to help you clean the underside ridge of the denture.
If you have a dry mouth from medications or simply from age, you will have a higher bacteria count in your mouth. This can lead to a compromised immune system and bad breath, so it is particularly important to keep your denture clean to reduce yeast and bacteria in your oral environment.
A good mouthwash choice is Listerine Naturals. It is a non-alcohol version of Listerine and is free of fluoride, dyes, and artificial sweeteners. It eliminates 99 percent of gingivitis-causing germs if it is used twice daily, for 30 seconds of swishing each time.
In my office, we also recommend Biotene Moisturizing Mouth Spray as a saliva replacement. The spray instantly relives dry mouth. It’s good for carrying in a purse if the senior goes out or for keeping it on the nightstand by the bed for relief at night. In a 28-day study, Biotene provided relief from dry mouth symptoms for up to 4 hours after application.