Hands On

Dentures as a source of pathogens

Background

With the prospect of having 22% of the global population age 60 or older in the next few decades, all health care providers must ensure that they understand the upcoming challenges in terms of systemic and oral health that are seen in people this age. Poor oral health has been linked to systemic health even in younger persons, but with age comes a decline in oral health, which will manifest in some systemic diseases. Dentures are commonly worn by older persons and are known to support the

Methods

One hundred thirty patients (mean age 70.4 years) were considered. Thirty-seven percent had denture stomatitis (DS) and 68% wore complete maxillary dentures, with 32% having a partial maxillary denture with at least 1 natural tooth remaining. Ultrasound was employed to remove denture plaque biofilm from the surface, with DNA then extracted and evaluated by quantitative polymerase chain reaction (qPCR). The number of colony-forming equivalents (CFEs) was estimated using standard curves.

Results

Eighty-four patients (64.6%) carried the potential respiratory pathogens Staphylococcus aureus, S pneumoniae, Pseudomonas aeruginosa, Hemophilus influenzae B, Streptococcus pyogenes, and Moraxella catarrhalis. The most common organism was S aureus, found in 67 isolates, all of which were methicillin-resistant S aureus (MRSA). The dentures of 58 patients were colonized by a single pathogen, those of 24 had two pathogens, and in 2 cases three pathogens were present.

Analysis of the CFE counts

Discussion

The nine key bacterial pathogens evaluated from these denture patients are widely implicated in respiratory infections. Nearly 65% of the patients’ dentures were positive for one or more of these pathogens. Thus dentures can serve as a reservoir for respiratory pathogens and increase the risk of the patient developing aspiration pneumonia.