A significant number of older people have partial or full dentures. Plaque can easily build up on dentures. If partial dentures are worn, it is important that oral hygiene is well maintained or the plaque will accumulate and encourage gum disease and tooth decay.
If the person loses all their natural teeth, they may need to start using full dentures. They may have difficulty coping with their new set of dentures, and will need to be encouraged to persevere. This can also be an issue if the person loses their dentures and needs to start using a new set.
Dentures also need to be replaced when they become loose. Replacement dentures are best constructed using the dimensions of the old set. For this reason, the old set should always be retained and taken along to the dentist when the new ones are being constructed.
The person with dementia should be encouraged to wear their dentures, and offered help with putting them in, for as long as possible. Dentures are important for maintaining dignity and self-esteem. If a person does not wear them it may affect their appearance, diet and ability to speak.
Denture loss is common when people with dementia are in unfamiliar environments, for example, when they spend time in a residential home for respite care. Replacing lost dentures can present problems (see ‘Denture marking’). If the person is without their dentures for any length of time they may forget how to wear them, or they may lose their ability to adapt to a new set. The person may also be unable to co-operate with the dentist during the several visitsrequired to make the new dentures. However, sometimes intervention by the carer (for example, hand-holding or distraction through talking) may be all that is needed. If co-operation is limited, a realistic approach may be to provide an upper denture only, for the sake of appearance.
It can sometimes be difficult and distressing for relatives and carers when they are told that it will not be possible to successfully make a set of new or replacement dentures for the person with dementia. The decision not to provide new or replacement dentures would only be made after an individual assessment and if it is in the person’s best interests.
Eventually, many people with dementia reach a stage where they will no longer tolerate dentures in their mouth, even if they have worn them without problems in the past.
A person with memory problems associated with dementia may be more likely to lose their dentures. Marking a person’s name on dentures means that lost dentures can often be returned. New dentures should be permanently marked during their manufacture. Existing dentures can be temporarily marked using a simple technique that will last for 6–12 months. This can be done using a small piece of new kitchen scourer, a pencil (or a pen that uses safe alcohol-based ink) and clear nail varnish. The process takes about ten minutes and can be carried out by a dentist, a dental hygienist or a carer.
The process is as follows:
- Clean, disinfect and dry the denture.
- Select an area near the back of the mouth on the outer surface of the denture just large enough to have the person’s name on it, and use a new piece of scourer to remove the surface polish from this area.
- Print the person’s name on the denture using a pencil or a pen that uses safe alcohol-based ink.
- Paint over the name with a thin coat of clear nail varnish and allow it to dry.
- Apply a second thin coat of varnish and allow it to dry.
It is important to clean, disinfect and dry the denture thoroughly before marking it. Dentures should be checked periodically to ensure the name is still legible, and the marking renewed as necessary.