Denture Care and Maintenance

More than 36 million Americans are edentulous (i.e., do not have any teeth), and 120 million people in the U.S. are missing at least one tooth.¹ Around 90% of edentulous persons have dentures and it is estimated that around 15% of the edentulous population has dentures made each year.¹

Denture prostheses can be nonimplant-retained (either complete or partial, depending on whether or not all teeth are missing) or implant-retained dentures.^2-4 The denture base can be made of resin or metal; the teeth may be made of porcelain or polymer (i.e., plastic).⁵ Examples of factors that may be considered when making the decision between denture options include bone loss, number of teeth being replaced, cost, and patient needs and preferences.^{3, 4}

In addition to directing the fabrication of the denture, dentists can provide information to patients on the proper care and use of their dentures. For example, placing dentures in water or a denture cleanser solution when they are not being worn helps the denture retain its shape, remain pliable and keeps it from drying out.^{6, 7} Dentures should never be placed in hot or boiling water as it could cause them to warp.^{6, 7}

Partial or full dentures can accumulate plaque, stains, and calculus in the same manner as the natural dentition.^{6, 7} If the denture is not cleaned appropriately, accumulated biofilm can contribute to the development of problems in the mouth such as denture-related stomatitis.^{6, 7} The American College of Prosthodontists (ACP) recommends that dentures be cleaned daily by soaking and brushing with an effective, nonabrasive denture cleanser to reduce levels of biofilm and potentially harmful bacteria and fungi.^{6, 7}

In 2015, the ACP developed a position statement (reaffirmed in 2018) on frequency of denture replacement.⁸ While not all-inclusive, they developed a list of example “red flags” signaling that a denture may need to be replaced. They recommend removable complete and partial dentures be evaluated by a dental professional for replacement when at least one of the following conditions occurs:

• If chronic irritation (inflammation) exists beneath the denture bases (including but not limited to epulis fissuratum, oral ulcerations, or treatment-resistant Candida-related denture stomatitis). If denture adhesives are required to eat, or to retain the dentures socially (i.e., when the dentures will not remain in place by themselves), or when adhesives must be used more than once daily.
• If the patient will not, or cannot, wear the removable prostheses.
• If the denture has degraded sufficiently so that it is not stable in the mouth, no longer matches the other dentition, no longer fits well or if the denture itself or the prosthetic teeth are discolored, cracked, broken, or missing.
• If there is a change in the teeth supporting a removable partial or overdenture.
• If it has been more than 5 years since the denture was fabricated.

Denture cleansers and denture adhesives are products patients and/or their caregivers may consider.

Like natural teeth, dentures should be cleaned daily to remove food particles and bacteria, and to help prevent dentures from becoming permanently stained.^{3, 4} In the case of implant-supported dentures, removing the denture allows for access to the implant abutments for cleaning.⁴

The first step in cleaning dentures is to rinse away loose food particles and remove any denture adhesive. Next, a commercial denture cleanser for removable dentures, which come as tablets, creams, pastes, gels and solutions, should be used. Denture cleanser tablets are dropped into warm water to create an effervescent solution into which the denture is placed. Soaking dentures in cleaning solution can help reduce the bacterial load which may reduce denture-related odor. Manufacturer instructions should be followed regarding the amount of time dentures should be soaked. Denture-cleansing creams, pastes or gels are typically meant to be brushed on the denture after it is removed from the mouth and then rinsed off according to the manufacturer’s instructions.^{6, 7} It is important to note that denture cleansers are not to be used while dentures are still in the mouth.^{6, 7}

In addition or as an alternative to commercial cleansers, dentures can be cleaned with toothpaste or soap (i.e., mild hand soap or dishwashing liquid) with warm water and a soft-bristle toothbrush.^{3, 4} However, denture wearers should avoid using bleach or powdered household cleansers for cleaning their denture, as this may damage the denture.^{6, 7}

Denture adhesives, also called denture adherents, are creams, powders, wafers or strips that are used to hold dentures firmly in place.⁹ The adhesive also helps form a seal that keeps food particles from sticking between the dentures and gums.^{6, 7} Adhesive is applied to clean dentures, which are then positioned in the mouth and held in place for a few seconds, according to the manufacturer’s instructions. The ACP recommends that denture adhesive be used only in sufficient quantity (i.e., 3 to 4 pea-sized dollops) on each denture to provide added retention and stability.^{6, 7} A 2021 systematic review and meta-analysis by Shu et al. found that denture adhesives can improve denture retention, bite force, and masticatory performance in patients with complete dentures. ¹⁰

A film of saliva is often all that is needed to hold dentures in place. Denture adhesives may be useful for those with dry mouth or xerostomia.¹⁰ Although, denture adhesives can help provide additional adhesion for well-fitting dentures, they may be only a temporary solution to the problem of an ill-fitting denture. A denture that fits poorly (i.e., feels loose or causes discomfort), may need to be relined or replaced.^{6, 7} Ill-fitting dentures can contribute to the development of mouth sores or, with prolonged use, bone loss. Dental examinations and appropriate care will often help reduce or eliminate the need for denture adhesive products.

Some dental adhesives contain zinc and their overuse could contribute to excessive levels of zinc in the body.⁹ The U.S. Food and Drug Administration⁹ recommends the following for consumers who use denture adhesive products:

• Follow the instructions provided with the denture adhesive. If the product does not come with instructions or the instructions are unclear, consult with a dental professional.
• Do not use more adhesive than recommended.
• Understand that some denture adhesives contain zinc, and that although they are safe to use in moderation as directed, if overused, they could contribute to harmful effects if overused.
• Know that manufacturers may not always list their product ingredients.
• Know that there are zinc-free denture adhesive products.
• Stop using the denture adhesive and consult a physician if symptoms such as numbness or tingling sensations develop in the extremities.
• Start with a small amount of adhesive—if the adhesive oozes off the denture into the mouth, that is likely too much adhesive.
• Know that a 2.4-ounce tube of denture adhesive used by a consumer with upper and lower dentures should last seven to eight weeks.
• Track the amount of denture adhesive used by marking on a calendar when a new tube is started, and when the tube is empty.
• Consider speaking to their dentist to see that the dentures fit properly. Dentures can become ill-fitting as a person's gums change over time.

The ACP recommends avoiding zinc-containing denture adhesives as a precautionary measure.^{6, 7}

During denture cleaning, adhesive should be removed with gentle scrubbing to avoid damaging the denture while being sufficiently thorough to best insure good fit of the denture. The ACP recommends daily removal of denture adhesives from the prosthesis and the oral cavity.^{6, 7}

Look for the ADA Seal—your assurance that the product has been objectively evaluated for safety and efficacy by an independent body of scientific experts, the ADA Council on Scientific Affairs.

Denture Cleansers

Denture cleansers with the ADA Seal have demonstrated that use of the product is both safe and effective, as evaluated according to objective requirements.

To qualify for the Seal, a company must disclose the ingredients in the product and purpose of those ingredients and provide evidence that:

• Substantiates the product does what it claims to do.
• In at least one clinical study, subjects achieved a high degree of denture cleanliness (lack of visible stains, deposits or objectionable odor) using the product without any supervision.
• Confirms that no hazards are expected when the product is used according to manufacturer’s instructions.
• Demonstration that the cleanser does not adversely affect the denture material or harm the oral tissues.

Denture Adhesives (Denture Adherents)

A company earns the ADA Seal for denture adhesives, or adherents, by producing scientific evidence demonstrating the safety and efficacy of its product, which is evaluated according to objective requirements.

To earn the Seal, manufacturers of denture adhesives must provide evidence that:

• Use of the product increases biting force.
• Use of the product increases denture retention.
• The adherent does not damage the denture.

A list of ADA Seal of Acceptance products can be found here.

1. American College of Prosthodontists. Facts and Figures. https://www.gotoapro.org/facts-figures/. Accessed April 12, 2023.
2. Doundoulakis JH, Eckert SE, Lindquist CC, Jeffcoat MK. The implant-supported overdenture as an alternative to the complete mandibular denture. J Am Dent Assoc 2003;134(11):1455-8.
3. Colgate Global Scientific Communications. Dentures 101. https://www.colgate.com/en-us/oral-health/dentures/all-about-dentures. Accessed April 12, 2023.
4. Colgate Global Scientific Communications. What Are Implant-Supported Dentures? https://www.colgate.com/en-us/oral-health/dentures/implant-supported-denture. Accessed April 12, 2023.
5. Rueggerberg F. Chapter 2: Dental Materials for Complete Dentures. Textbook of Complete Dentures. 6th ed: People's Medical Publishing House USA Ltd.; 2009. p. 7-23.
6. Felton D, Cooper L, Duqum I, et al. Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists. J Am Dent Assoc 2011;142 Suppl 1:1s-20s.
7. Felton D, Cooper L, Duqum I, et al. Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists. J Prosthodont 2011;20 Suppl 1:S1-s12.
8. Tuminelli FJ, Cooper LF, Campbell SD, et al. Position Statement: Frequency of Denture Replacement. American College of Prosthodontists 2015 (Reaffirmed 2018). https://www.prosthodontics.org/assets/1/7/The_Frequency_of_Denture_Replacement_Position_Statement.pdf. Accessed April 13, 2023.
9. U.S. Food and Drug Administration. Denture Adhesives. 2018. https://www.fda.gov/medicaldevices/productsandmedicalprocedures/dentalproducts/ucm274258.htm. Accessed April 13, 2023.
10. Shu X, Fan Y, Lo ECM, Leung KCM. A systematic review and meta-analysis to evaluate the efficacy of denture adhesives. J Dent 2021;108:103638.

For Dental Professionals:

• Search JADA for articles related to dentures
• ADA Library

For Patients:

• ADA MouthHealthy: Dentures, Removable Partial Dentures
• JADA “For the Patient” pages: Restoring Your Smile With Dentures; Oral Health Concerns for Older Adults; Shopping Smart: Looking for the Seal

American College of Prosthodontists:

• Position Statement: Frequency of Denture Replacement
• Evidence-Based Guidelines for the Care and Maintenance of Complete Dentures
• Dentures FAQs 

U.S. Food and Drug Administration: Denture Adhesives