Denture Adhesives are available in these forms – Creams, Powders, gels and soluble or insoluble Strips. The use of Denture Adhesive has been mis represented and not preferred by Dentists as it tends to reflect the practioner’s skills in poor form in the mind of a patient. Use of Denture Adhesive helps in improving the retention, stability and function of the Denture, it can be used in a Properly fitting denture as well as it provides the adhesive seals to prevent any food particles from settling down under the denture leading to foul smell and irritation to the gums.
Denture adhesive can be used in cases of Full or Partial Dentures. Denture adhesives were first used in late 18th century and upto 19th century Denture adhesives were used for holding base plates in position while recording jaw relations, immediate denture construction until a well-fitting denture in fabricated. Asking the patient to use a Denture Adhesive immediately helps in achieving initial retention and gives confidance to the patient. There are certain Natural Denture Adhesives like Aloe Vera Gel, Miglyol or glycerine, etc.
Ideal Chareacteristics of Denture Adhesives:
According to ADA a Denture Adhesive in any form should pocess the following characteristics
- Product composition should be supplied
- Should not affect the integrity of the denture
- Biologically acceptable
- Effective function as adherent
Composition of Denture Adhesives:
- Carbonyl methyl cellulose (CMC)
- Vegetable gums – Karaya (food additive) Tragacanth, Xantham acacia
- Vinyl methyl ether / maleic anhydride compounds (PMV/MA salts)
- Polyethylene oxide polymers
- Cationic polyacryl amide polymers
- Polyvinyl pyrrolidone (povidone)
- Gantrez salts (Ca-2n Gantrez) are long acting less soluble salts which display molecular cross linking.
Preservatives: Sodium borate, Methyl paraffin, polyparaffin
Plasticizers: This imporves the handling properties of the material Ex: polyethylene, mineral oil or petrolatum
Dispersion agents: Used to prevent powder from clumping. Magnesium oxide, Sodium phosphate, calcium silicate, calcium stearate and silicone dioxide.
Colouring agents: Red dye
Flavoring agents: Menthol, peppermint, etc.
Mode of Action of Denture Adhesives:
The primary reaction of denture adhesives is expansion of the material due to water aborption which swells from 50 to 100 percent by volume when in contact with water. Due to expansion, anions are produced which are attracted to the cationic particles in the mucous membrane achieving the stickiness.
The chemical reaction is the Bio-adhesion by Carbonyl groups (Carbonyl methyl Cellulose) which provide bio-adhesion and bio-cohesive forces to improve the retention of the denture. PVM/MA and Zinc and Calcium salts with CMC have superior retention due to the dtronger covalent bond that develops due to its divalent interaction.
How to Use Denture Adhesives:
The Denture surfaces – both inner and outer must be cleaned thoroughly before applying the material. The application of the Denture adhesive will be different depending on the type of Adhesive being used.
How to use Denture Adhesive Cream:
After cleaning the inner surface place small dots of the cream all over evenly distributed or you can place a thick line in the midline and two dots on each side Molar region and a single dot on the front end (Incissors) of the denture.
How to use Denture Adhesive Powder:
- Clean the inner surface of the Denture
- Moisten the inner surface of the denture
- Dribble the powder evenly across the surface of the denture and wipe out any excess powder
- Slightly moisten the powder before placing it in
How to use Denture Adhesive Strips:
- Peel the Strip open from its cover and moisten it in water
- Place it on the undersurface of the denture and press
- Now place the Denture in your mouth and bite down to secure the denture in
Indications of Denture Adhesives:
- Denture adhesive can be indicated for both well fitting and moderately ill fitting dentures.
- Unstable Dentures or poorly retained dentures
- To Improve Retention and Stability for a New Denture and a First time denture wearer to help in his/her confidance
- For Handicapped patients, patients with Dry Mouth or Xerostomia, Geriatric patients,
- Patients with poor muscle tone as in Parkinsons disease, Dysarthria, Tardive dyskinesia.
- To provide psychological sense of security in public speakers like teachers, actors, politicians, etc.
Contraindications of Denture Adhesives:
Patients with worn out dentures
Patients with drug-induced Xerostomia as saliva is a must to acheive adhesion with denture adhesives
Should not be used as a substitue to Relining or Rebasing
Should not be used in patients with physical disabilites unable to clean dentures
Should not be used in pateints who are allergic to components of denture adhesive. E.g. Karaya an additive derived from vegetables which some people are allergic to.
Advantages of Denture Adhesive:
- It helps in reducing irritation to new Denture wearers
- Increase Retention and Stability initially for first time Denture wearers, it helps in adjusting to chewing, speaking and swallowing
- Psychological security to the wearer who are more into public appearances
- It can be used to apply medications to the oral mucosa
Disadvantages of Denture Adhesive:
- Denture pads or synthetic wafers can sometimes lead to tissue damage on using insoluble adhesives
- If not cleaned properly it can lead to bacterial growth which can cause Halitosis or ulcers too in some cases
- Overuse of Denture Adhesive can lead to Over Resorption of the Denture in ill fitting Dentures.
We keep getting asked about which is the Strongest denture Adhesive available to be used in loose Dentures, but one thing to remember is that if the Denture becomes loose you need to get it checked at the Dentist. There is regular bone loss going on in the alveolar ridges of both the maxilla and mandible, in such cases more than an Adhesive your Denture requires Relining or Rebasing.