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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1119-1123  

Denture hygiene awareness, attitude and practice among complete denture wearers during COVID-19 lockdown pandemic: A questionnaire based survey


1 Department of Prosthodontics, Crown Bridge, Aesthetic Dentistry and Oral Implantology, Government Dental College, Dibrugarh, Assam, India
2 Rupaichari PHC, Sabroom, Tripura, India
3 Department of Prosthodontics and Crown and Bridge, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
4 Department of Public Health Dentistry, Dr. B.R. Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
5 Department of Prosthodontics, Crown Bridge, Aesthetic Dentistry and Oral Implantology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
6 Department of Prosthodontics, Crown Bridge, Aesthetic Dentistry and Oral Implantology, Dental Institute, RIMS, Ranchi, Jharkhand, India

Date of Submission29-Mar-2021
Date of Decision22-Apr-2021
Date of Acceptance22-Apr-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Surender Kumar
4B Block-F Shree Vrinda Green Apt., Kusum Vihar, Road No 9, Morabadi, Ranchi - 834 008, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_272_21

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   Abstract 


Objective: To determine the denture hygiene habits in complete denture wearers during Covid-19 lockdown in Assam state. Materials and Methods: In this study, a self-administered structured questionnaire was developed to know the attitude of the patients regarding denture hygiene. The study sample consisted of 150 subjects, which included 63 (42%) males and 87 (58%) females. Results: 50.7% of individuals said that they have knowledge about denture cleansing methods, while only 40% individuals clean their dentures once daily. After education through an online survey, most individuals started practicing three times or at least two times. After educating two members in the same family, all subjects were cleaning either twice or thrice. All subjects were either using brushing or combination methods. Conclusion: Poor condition of complete dentures seen in the population is mainly due to lack of knowledge and irregular cleansing habits. Dentists must give proper instructions and do regular follow-up regarding maintenance of denture hygiene.

Keywords: Cleansing habits, complete denture, denture care, denture hygiene


How to cite this article:
Dwivedi H, Paul N, Banerjee KL, Singh S, Jain R, Kumar S. Denture hygiene awareness, attitude and practice among complete denture wearers during COVID-19 lockdown pandemic: A questionnaire based survey. J Pharm Bioall Sci 2021;13, Suppl S2:1119-23

How to cite this URL:
Dwivedi H, Paul N, Banerjee KL, Singh S, Jain R, Kumar S. Denture hygiene awareness, attitude and practice among complete denture wearers during COVID-19 lockdown pandemic: A questionnaire based survey. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Dec 7];13, Suppl S2:1119-23. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1119/330057




   Introduction Top


The loss of natural teeth is a common health problem and various attempts have been made to replace the lost dentition with artificial teeth (prosthesis) that can fulfill the functional and esthetic requirements of the patients. However, the awareness and knowledge about proper hygiene and maintenance of dentures is still lacking to the general population of our Assam state and we, dental professionals, owe a huge responsibility toward spreading it to the community and nationwide. For any professional community, it is important to assess whether the patient understands and executes the hygiene protocol in their daily regime.

Removable dentures are often aggregated with dental plaque which exhibits bacterial growth in tiny pores of the dentures leading to foul odour, un-aesthetic appearance, denture stomatitis and finally may result in denture fracture.[1] Research has shown micro-organism associated with unhygienic dentures can even lead to various systemic ailments like endocarditis and diabetes.[2] Hence regular denture hygiene practice is recommended throughout life not only for function and esthetic purpose but for the wellbeing of the surrounding periodontal status.[3],[4] Public health awareness programmes should be conducted for patient awareness towards denture hygiene.[5]

The purpose of this study was to evaluate the differences in denture hygiene knowledge and practice among different age, gender, level of education as similar studies has not been performed previously in the population of Assam.


   Materials and Methods Top


A descriptive, cross-sectional survey was conducted in complete denture wearers visiting the outpatient department (OPD) of Government Dental College and various private clinics of Assam, India. The study was approved by an institutional ethical committee. The subjects enrolled in the study were explained the nature and procedure of the study and informed consent was obtained.

A self-administered questionnaire consisting of 19 closed ended questions including an educational poster was designed to gather the demographic information (level of education) and assess the level of awareness, attitude and practice towards denture hygiene. The questions were related to denture storage medium, nocturnal denture wearing habits, and denture hygiene practices. A sample size of 150 subjects was taken by consecutive sampling method. The questionnaire validation was done after performing pilot study on 10 subjects. This study included male and female subjects of age group 45-85 years wearing complete denture prosthesis.

Due to COVID-19 pandemic, it was not possible to recall patients in dental clinics and college so it was decided to conduct online survey and the participants were asked to fill the questionnaire through Google form, keeping the words simple to ease in understanding. After evaluating the survey form, a video conference meet was organised to educate and motivate them through a good YouTube video having 20 subjects per meet. After one month of motivation through Google meet, a second round of online survey with the same questionnaire was conducted and the result was evaluated. Those whose denture hygiene practice had still not improved. They were educated separately with a family member again through Google meet followed by a third round of online questionnaire after a month only on those subjects and the result was analysed.


   Results Top


A total of 150 individuals were approached for participation in our survey, out of which 63 (42%) were males and 87 (58%) were females. Education wise, 62 (41.3%) subjects were either uneducated or educated below high school, 40 (26.7%) were graduate, and 48 (32%) were postgraduate [Table 1].
Table 1: Demographic distribution according to gender and education level

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Regarding denture hygiene practice, 18.7% of males and 20% of females store their dentures in normal water, while the rest of the subjects in open air or wrapped in cloth or plastic bags. 31.3% slept with dentures in mouth, 12.7% of individuals did not clean their dentures even once daily. 58% of subjects never used mouthwash [Table 2]a.


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52% of individuals experienced bad smell from their denture, 50.7% of individuals told that they have knowledge about denture cleansing methods, 12.7% of individuals did not know about any consequence [Table 2]b.

After this survey (66%) were willing to clean dentures daily, and 31.3% evaluated as unsatisfactory [Table 2]c.

After educating through Google meet, 78.7% started keeping their denture in water, while all individuals started removing dentures during sleeping. Most subjects started denture cleaning two to three times daily, 21.3% were still cleaning it only once. 39.3% subjects were now cleaning with tooth brush and water, 60.7% were using combination method and 92.7% were now willing to clean dentures daily [Table 3]a and [Table 3]b.


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After educating two members in the same family, all subjects were cleaning either twice or thrice. All subjects were either using brushing or combination methods. Most of the subjects were using mouthwash now [Table 4].
Table 4: Effect of gender on denture hygiene practices 1 month after educating two members of same family including one female

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   Discussion Top


It has also been observed that the majority of denture wearers do not pay the necessary attention toward the denture hygiene. This may be due to the denture wearer's negligence or lack of dentist to provide denture-cleaning instructions.[3],[6]

According to Shankar et al.[1] 64.8% subjects stored their dentures in normal water whereas 38.9% was found in this study. 31.3% subjects were wearing their dentures during sleep while Shankar et al.[1] and Baran and Nalçaci[7] reported 13.2% and 55.2%. This may be due to negligence in listening, understanding and following post denture delivery instructions.

40% subjects cleaned their dentures at least once daily which was in agreement with Apratim et al.[8] 44%, Ozcan et al.[9] 45.7% but was lower as compared to Aoun G and Gerges E.[2] 93.1% and Peracini et al.[10] 99.06%. In the present study 52% subjects used brushing their dentures with water only which was in congruence with Aoun G and Gerges E.[2] 45.4%, Dikbas et al.[6] 40.59%, Kulak-Ozkan et al.[11] 57.1% however Patel et al.[12] reported 100% and Ogunrinde and Opeodu[13] 90.9%. The high values of mechanical brushing techniques found in most studies reflects the consistent habit of brushing teeth prior to becoming edentulous. In the present study 30% used combination method which was in line with Aoun G and Gerges E.[2] 25.75%. In this study, 42% subjects used mouthwash for cleaning dentures while in Aoun G and Gerges E.[2] study, antiseptics were not used for denture immersion by any of their participants due to their high cost and un-esthetic brown stains on the acrylic resin [Table 2]a.

52% of subjects experienced bad smell. In this study, 49.3% subjects don't have knowledge about denture cleansing methods while Shankar et al.[1] reported 10.2%, Dikbas et al.[6] 82.9%, Peracini et al.[10] 51.89%, Evren et al.[14] 82.9% Hoad Reddick et al.[15] 86.3% and Marchini et al.[16] 77.5%, of subjects were never advised denture cleaning methods by their dentist [Table 2]b.

In the present study, 12% subjects were willing to clean dentures if they get time whereas 22% were not satisfied with the information provided through this survey [Table 2]c.

After one month of Google meet, second round questionnaire survey result showed that 78.7% subjects started storing their denture in water. All subjects were removing their dentures while sleeping. Most of the subjects started denture hygiene practice two to three times daily using combination method and 92.7% were now willing to clean dentures daily. After reviewing this survey, a pattern was observed that female denture hygiene performance has increased more than Males [Table 3]a and [Table 3]b.

After analysing the result, 67 subject's denture hygiene had still not improved, were educated again with a family member and after one month, a third round questionnaire survey was conducted only on them. As each participant was removing denture during sleep therefore, this question was omitted from this survey. As compared to individual education, if males are educated along with female family member, their denture cleaning practice improved tremendously. Now every subject was storing dentures in water and frequency of denture cleaning increased two to three times daily. The use of denture cleanser along with brushing and mouthwash also increased [Table 4].

The limitations of this study were small sample size due to inclusion of only those subjects having smart phones. Secondly, the knowledge and practice of denture hygiene could have been compared after the physical evaluation of their dentures. Participants purposely try to give expected answers during the survey is one of the major drawbacks of a questionnaire survey.


   Conclusion Top


Further research is suggested for a thorough understanding of denture hygiene, attitude of denture wearers, and soft tissue changes. motivation through video conferencing has greater impact than questionnaire survey alone. In addition, when dual member of same family including one female are educated together, compliance is better. Dentist must spend time in providing post denture delivery hygiene instructions to each patient and recall visits should be done to evaluate denture status.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Shankar T, Gowd S, Suresan V, Mantri S, Saxena S, Mishra P, Panday P. Denture Hygiene Knowledge and Practices among Complete Denture Wearers attending a Postgraduate Dental Institute. J Contemp Dent Pract 2017;18(8):714-21.  Back to cited text no. 1
    
2.
Aoun G, Gerges E. Assessment of Hygiene Habits in Acrylic Denture Wearers: a Cross-sectional Study. Mater Sociomed 2017;29(3):216-18.  Back to cited text no. 2
    
3.
Suresan V, Mantri S, Deogade S, Sumathi K, Panday P, Galav A, et al. Denture hygiene knowledge, attitudes, and practices toward patient education in denture care among dental practitioners of Jabalpur city, Madhya Pradesh, India. J Indian Prosthodont Soc 2016;16:30-5.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Turgut Cankaya Z, Yurdakos A, GokalpKalabay P. The association between denture care and oral hygiene habits, oral hygiene knowledge and periodontal status of geriatric patients wearing removable partial dentures. Eur Oral Res 2020;54(1):9-15  Back to cited text no. 4
    
5.
Saha A, Dutta S, Varghese RK, Kharsan V, Agrawal A. A survey assessing modes of maintaining denture hygiene among elderly patients. J Int Soc Prev Community Dent 2014;4(3):145-8.  Back to cited text no. 5
    
6.
Dikbas I, Koksal T, Calikkocaoglu S. Investigation of the cleanliness of dentures in a university hospital. Int J Prosthodont 2006;19:294 8.  Back to cited text no. 6
    
7.
Baran I, Nalçaci R. Self-reported denture hygiene habits and oral tissue conditions of complete denture wearers. Arch Gerontol Geriatr 2009;49(2):237-241.  Back to cited text no. 7
    
8.
Apratim A, Shah SS, Sinha M, Agrawal M, Chhaparia N, Abubakkar A. Denture hygiene habits among elderly patients wearing complete dentures. J Contemp Dent Pract 2013;14(6):1161-4.  Back to cited text no. 8
    
9.
Ozcan M, Kulak Y, Arikan A, Silahtar E. The attitude of complete denture wearers towards denture adhesives in Istanbul. J Oral Rehabil 2004;31(2):131-4.  Back to cited text no. 9
    
10.
Peracini A, Andrade IM, ParanhosHde F, Silva CH, de Souza RF. Behaviors and hygiene habits of complete denture wearers. Braz Dent J 2010;21(3):247-52.  Back to cited text no. 10
    
11.
Kulak-Ozkan Y, Kazazoglu E, Arikan A. Oral hygiene habits, denture cleanliness, presence of yeasts and stomatitis in elderly people. J Oral Rehabil 2002;29(3):300-4.  Back to cited text no. 11
    
12.
Patel IB, Madan G, Patel B, Solanki K, Chavda R. Behaviours and hygiene habits of a sample population of complete denture wearers in Ahmedabad. J Int Oral Health 2012;4(2):29-38  Back to cited text no. 12
    
13.
Ogunrinde TJ, Opeodu OI. Denture care practice among patients attending the prosthetic clinic in a Nigerian teaching hospital. Niger Med J 2015;56(3):199-203.  Back to cited text no. 13
    
14.
Evren BA, Uludamar A, Işeri U, Ozkan YK. The association between socioeconomic status, oral hygiene practice, denture stomatitis and oral status in elderly people living different residential homes. Arch GerontolGeriatr 2011;53(3):252-7.  Back to cited text no. 14
    
15.
Hoad Reddick G, Grant AA, Griffiths CS. Investigation into the cleanliness of dentures in an elderly population. J Prosthet Dent 1990;64:48 52  Back to cited text no. 15
    
16.
Marchini L, Tamashiro E, Nascimento DF, Cunha VP. Self reported denture hygiene of a sample of edentulous attendees at a University dental clinic and the relationship to the condition of the oral tissues. Gerodontology 2004;21:226 8.  Back to cited text no. 16
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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