The use of Denture Adhesives is Highly Beneficial for Some Patients
Patients who are new denture wearers. These patients go through a phase of adjustment where the muscles take time to get used to the foreign object in the mouth. These patients may appreciate the extra grip that a denture adhesive provides while the muscles are still adjusting. Once the patient is more comfortable with dentures, the use of adhesives may cease
Those who have always used adhesives and feel more confident with them.
Patients using immediate dentures. Immediate dentures are worn immediately after tooth extraction, while waiting for the permanent prosthesis to be made. The tissue around the extraction site may resorb quickly, making the immediate denture loosely adapted. Denture adhesives provide extra hold and eliminate voids underneath the immediate denture.
Patients who have severely resorbed alveolar ridges, particularly for the lower full denture wherein bone resorption is more aggressive.
Patients with xerostomia due to medication side effects, history of head and neck irradiation, systemic disease or salivary gland disease. These patients have difficulty managing dentures due to the lack of saliva that provides lubrication against ulcers and that increases retention of the prosthesis.
Patients with neurological problems such as Orofacial Dyskinesia, a movement disorder where the patient has uncontrollable muscular movements of the tongue, cheeks, lips and mandible that may often cause dislodgment of the denture.
cerebrovascular accident (stroke) victims that caused part of the oral cavity to have decreased tactile sensibility or that caused paralyzed oral musculature. Adhesives may be used in such patients if the denture is fairly new, or made prior to the accident, and still fits well, yet cannot be retained by the patient due to the loss of tactile sensibility or nueromuscular control.
Patients who have undergone resective surgery due to pathology, trauma or accident. These patients may have lost intraoral tissues or structures that will cause difficulty to retain a prosthesis without the help of a denture adhesive.
The cases in which the use of denture adhesives is contraindicated include:
Patients who have very loose dentures. The adhesive should not compensate for prosthesis that does not fit adequately in the oral environment. Continuous use of ill-fitting dentures may cause oral infections, irritations, ulcers and bone loss. When the patient has increased the amount and frequency of adhesive used, this may be a sign that the denture needs adjustment or replacement.
Patients whose dentures fit well and are adequately retained without the use of adhesives. Most patients have oral musculature with ability to adapt and maintain and well-made, well-fitting prosthesis. Dental professionals should advise these patients not to rely on adhesives.
Denture adhesives should not be prescribed by the professional to compensate for a poorly fabricated or poorly fitting prosthesis. Retention is first and foremost achieved through proper denture design
Denture adhesives, particularly cushions, should not be used to alleviate discomforts, pain or soreness felt by the patient. In such circumstances, patients should be advised to have a check-up in order to adjust the denture or fabricate a new denture as needed.
Zinc-containing Denture Adhesives
The newest concern regarding the use of denture adhesives is reports of adverse systemic effects due to prolonged and excessive zinc ingestion. Zinc toxicity occurs when there is an increase in the levels of serum zinc, resulting in a decrease of serum copper. This may cause bone marrow depression and sensory and motor neuropathies with degeneration of the spinal cord. Studies have however reported that zinc toxicity will not happen when there is occasional or moderate use of zinc-containing denture adhesives, making use generally safe. Patients must just be warned of over using or excessive using of zinc-containing adhesives for prolonged periods of time. If caution is still warranted, the use of zinc-free adhesives can be prescribed.
With proper case selection and patient education, the use of adhesives may greatly contribute to the success of a denture case. Dental education professionals and patients must however understand that adhesives should not compensate for any lack of retention due to ill-fitting or poorly-made dentures. Patients should also return at least annually for assessment and detection of changes to the prosthesis and oral cavity tissues, in order to maintain optimum ongoing results.
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