A denture is a removable replacement for missing teeth and surrounding tissues. While dentures restore function and appearance during the day, dental professionals advise they must be removed before going to sleep. This recommendation is based on biological and microbiological factors that affect long-term oral and systemic health. Understanding the consequences of continuous wear is important for maintaining well-being.
How Continuous Wear Harms Oral Tissues
Leaving dentures in place overnight subjects the soft tissues of the mouth, including the gums and palate, to continuous pressure. These tissues require a daily rest period, typically six to eight hours, to recover from the constant load of the appliance. Without this respite, blood flow to the underlying tissue is restricted, slowing the natural recovery process.
This ongoing pressure and lack of adequate blood circulation can lead to localized inflammation, redness, and painful sores. One common consequence is denture stomatitis, a fungal infection caused by an overgrowth of Candida albicans. This condition appears as redness and swelling, often without pain, on the tissue covered by the denture, particularly the upper palate. Failure to remove the denture at night significantly increases the risk of developing this infection.
Continuous pressure also accelerates the natural process of bone loss, known as resorption, in the jaw. The jawbone requires stimulation to maintain its density, a function normally provided by natural teeth. Wearing dentures constantly causes a progressive decrease in bone height and width.
This accelerated bone resorption changes the shape of the mouth over time, directly impacting the appliance’s fit. A denture that once fit securely will become loose, requiring more frequent relines or replacements. Allowing the tissues and bone to rest nightly helps mitigate this process, preserving supporting structures and the long-term stability of the denture.
The Connection to Biofilm and Systemic Infection Risk
The surface of a denture, especially the acrylic resin, provides an ideal environment for microorganisms to accumulate and form a tough, protective layer called biofilm. This biofilm is a complex community of bacteria and fungi, including the yeast Candida albicans, which adheres strongly to the denture material. The warm, moist conditions of the mouth encourage the rapid growth and maturation of this microbial layer.
This dense concentration of oral pathogens poses a risk that extends beyond localized mouth infections like denture stomatitis. The denture biofilm acts as a reservoir for opportunistic microorganisms, which can impact overall health. Studies have established an association between wearing dentures during sleep and an increased risk of developing aspiration pneumonia, particularly in older adults.
Aspiration pneumonia occurs when bacteria from the mouth or throat are accidentally inhaled into the lungs. Research indicates that individuals who sleep with their dentures in have an approximately 2.3-fold higher risk of contracting pneumonia compared to those who remove them at night. This risk is comparable to other serious factors like a history of stroke or cognitive impairment.
The denture surface can also harbor respiratory pathogens like Staphylococcus species, which can be inhaled, triggering a lower respiratory tract infection. Allowing the continuous build-up of this microbial load raises the potential for these pathogens to enter the respiratory system, placing a burden on the body’s immune defenses.
Nighttime Routines for Tissue Health and Denture Longevity
Removing dentures nightly is the first step toward promoting oral health, but it must be followed by a specific care routine. Immediately after removal, the appliance must be thoroughly cleaned to disrupt the tenacious biofilm accumulated throughout the day. This involves gently brushing all surfaces with a soft-bristled brush and a non-abrasive denture cleaning paste or mild soap.
It is important to avoid using regular toothpaste, as its abrasive nature can scratch the acrylic surface, creating microscopic grooves where bacteria and fungi can embed themselves. After cleaning, dentures should be stored by soaking them in water or a dedicated denture-soaking solution overnight. Soaking prevents the material from drying out, which can cause the appliance to warp and lose its fit.
While the dentures are soaking, the soft tissues of the mouth also require attention. Use a soft toothbrush or a damp cloth to gently clean the gums, tongue, and the roof of the mouth. This action removes residual adhesive, stimulates circulation, and reduces the bacterial and fungal load in the oral cavity.
Following this routine allows the underlying gums and bone to rest, aids in tissue recovery, and prevents the formation of an infectious biofilm. These actions protect the integrity and fit of the denture and the long-term health of the body.