COMPARATIVE EFFICACY OF COMBINED VS. SINGLE- METHOD DENTURE CLEANING PROTOCOLS FOR HALITOSIS AND BIOFILM REDUCTION. A RANDOMIZED CONTROL TRIAL IN COMPLETE DENTURE-WEARING POPULATION OF INDIA

One among the common complications faced by complete denture wearing population is halitosis and biofilm associated complications. Even though the recommendation of mechanical or chemical means of cleaning denture is quite a common practice, the combined/integrated or individual efficacy of these methods in reducing the microbial load and halitosis especially in complete denture wearing population remains underexplored. This randomized control trial aimed to compare the efficacy of mechanical, chemical and the combination of both mechanical and chemical methods of denture cleaning in reducing halitosis and microbial load among complete denture wearers.Seventy-five participants using complete dentures (PMMA) with the age of 60-75 were randomly allotted to one of the 3 groups; mechanical brushing (group 1) using denture brush and toothpaste, chemical intervention of soaking denture overnight with sodium perborate tablet (group 2) and the combined protocol employing both the mechanical and chemical methods (group 3). Halitosis levels were interpreted using halimeter, detecting levels of VSCs (volatile sulphur compounds) and the microbial load (CFU) was assessed by a digital colony counter upon culturing the samples taken as swabs from denture surface at baseline and post four weeks. The collected data were analyzed using one- way ANOVA for mean difference comparison, Tukey post-hoc test to identify the level of significance among the groups and paired t-tests for comparison within groups at baseline and post intervention (α=.05). The combined protocol (group 3) showed the highest level of reduction of VSCs and microbial load (CFU) at 35% and 39% respectively by outperforming chemical method (group 2) with 22% (VSC) and 25% (CFU) reduction. The mechanical group (group 1) revealed the least reduction levels with 11% (VSC) and 6% (CFU) despite showing significance difference (P=.03). A combined approach of integrating both chemical and mechanical cleaning methods with affordable and locally available products can have a significant impact on the denture hygiene by reducing the microbial load that is responsible for production of VSCs which in turn reflects in controlling the halitosis levels in complete denture wearers in Indian population.