Denture Adhesives: Do They Work? Do You Need Them?

    Watch enough television and you could be convinced that everyone with dentures should be using an adhesive. Talk to some dentists and you might be convinced that no one should use an adhesive. The reality lies somewhere between the extremes. "Denture adhesives do have a role in the use of complete dentures," says Gerald S. Weintraub, D.D.S., chair of the department of general restorative dentistry at the University of Pennsylvania School of Dental Medicine. "Many dentists think it is a negative statement on their ability to create well-fitting dentures if patients have to use adhesives, but that's not so."

    Even if a denture is well-fitting, Dr. Weintraub says, many patients may have problems adapting to maintaining the denture in their mouths and keeping it stable. Also, the bone that supports the denture, called the residual ridge, starts to resorb after the teeth are lost. The loss of this bone, and the shrinkage of the tissues covering the bone, make dentures more likely to move during use.   "A denture could fit well, but that doesn't mean it's retentive," he says. "It could still move. Patients with a well-fitting denture may also need an adhesive, particularly if the ridge [bone] has undergone significant shrinkage prior to the construction of the denture." However, Weintraub says, adhesives should not be used to compensate for poorly fitting dentures, which should be relined or rebased by your dentist.How do you know whether you need an adhesive or an adjustment? Patients who need dentures in the future should talk to their dentist about adhesives at the first visit. If you already have dentures, visit your dentist regularly — every six months — and if you notice changes in the comfort of your denture, set up an appointment as soon as possible. You may think you need an adhesive when you actually need an adjustment, such as a refitting of the denture.On the other hand, "If you're already wearing dentures you don't use an adhesive, that doesn't mean you would not benefit from it," Dr. Weintraub says. "I've seen patients whose dentures are not retentive, but the patients have adapted and know how to keep them in place. Adhesives would make things easier for these patients."There is also a psychological component to the use of adhesive. Some people, especially first-time denture-wearers, are worried their dentures might slip or fall out in public. Proper use of adhesives will alleviate this concern."Adhesives can be used as a training aid for a patient who's never worn a denture before. They know it will stay in place," Dr. Weintraub says. "This makes learning to use dentures an easier and less frustrating experience."And that's fine, Dr. Weintraub says, as long as the adhesives are used properly and the denture and tissues are kept clean.He recommends powdered adhesives, rather than pastes. "The powder is easier to clean off the denture and the tissue," Dr. Weintraub says. "The paste is more difficult to clean and it can interfere with the bite because it is placed in the denture in a thicker layer. If I feel the paste is necessary, I will teach a patient how to apply it so it doesn't affect the bite."To use the powdered adhesive, first clean and rinse your denture, and then "like a salt shaker — shake a thin layer of powder onto the denture, moisten it, and then place the denture," Dr. Weintraub says.How long the adhesive lasts depends on various factors. Adhesives usually are effective for a longer period of time in upper dentures. There are more opportunities for food and fluids to loosen a lower denture, which may be an indication to use the paste form for the lower denture."When the denture is removed, thoroughly clean it and then place it in water with an effervescent cleansing product," Dr. Weintraub says. "There are also special toothbrushes that are very soft and have two sides to help clean both sides of the dentures." Also, massage your tissues with a soft brush or gauze pads to keep them clean and healthy.The bottom line: Practice good oral hygiene and visit your dentist regularly whether you use adhesives or not."Too many people believe that once they have dentures, they no longer require the services of a dentist and that is not true," Dr. Weintraub says. "Seeing your dentist regularly allows him or her to observe changes in the denture or the supporting tissues and correct the situation."