DENTURE ADHESIVE
COMPARED TO
PERMA SOFT
Don't put your Dentures in a Glass
WEAR THEM!
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Denture Adhesive is messy and you can end up swallowing most of it before the end of the day. It does hold for awhile, but in a few hours it starts to dissolve and then it starts to ooze out from under your Dentures into your saliva and down your throat.

Now you have the
hassle of changing your Adhesive while trying to get the old out and applying  new again.

PERMA SOFT RELINE is ONLY applied ONCE for a Soft but Firm comfortable and reliable fit that FEELS GREAT on your Gums. PERMA SOFT lasts up to 2 years with just ONE APPLICATION (See our customer testimonials) with no daily, messy adhesive. PERMA SOFT can be added right over top of the old reliner when it begins to wear out. Furthermore, NO EATING denture adhesive ALL DAY LONG.

Now you can make a comparison between Denture Adhesive and Perma Soft.

To learn more about Dentures and our
Professional Dental Products and Kits please click on links above.

Powders and paste can be very useful in maintaining stability of dentures, but they only works for short periods of time.
Having to wear
adhesive means you either have no gum structure or your dentures need to be relined or you need new dentures. Adhesive can't cure this so a reline would be the first step of ending adhesive use.  Again denture adhesive is only a temporary fix so why not reline your dentures easily and inexpensively until you can see your dentist with Perma Soft and rid yourself of misery.

Adhesives powders, paste and cushions can get expensive after a few months using it over and over again. Some denture wearers can't use paste or powders because it makes them gag, but all denture wearers and all adhesives are not alike. So which type of adhesive should you use? Good question. The best way to answer that is not to use adhesive at all and reline your dentures with Perma Soft or have your dentures relined by a dentist.

Denture adhesive can't be good for you if used month after month year after year.  So don't use denture adhesive if you can get by without it.

More information on Dentures and Professional
Denture Products on ABOVE links.

WARNING: Although Perma Soft lasts up to 2 years, FDA advises that this product should be considered a temporary solution until a dentist can be seen. Keep regular dental appointments for proper fitting dentures.

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Use of Denture Adhesives

Complete denture treatment needs to be customized for each patient's particular needs.  Successful treatment combines exemplary technique, effective patient rapport and education, and familiarity with all possible management options in order to provide the highest degree of patient satisfaction.  Commercially available denture adhesives are products that have the capacity to enhance treatment outcome.  This reality is compellingly underescored by two facts:  (1) consumer surveys reveal that approximately 33% of denture patients purchase and use one or more denture adhesive products in a given year; and (2) denture adhesive sales in the U.S. exceeded $200 million in 1994 (12% more than for denture cleaners, and nearly twice the spending on dental floss).  Dentists need to know about denture adhesives for two reasons:  (1) to be able to educate all denture patients about the advantages, disadvantages, and uses of the product, because adhesives are a widely-used dental material and patients rightfully expect their dentists to be accurately informed about over-the-counter oral care products; and (2) to identify those patients for whom such a product is advisable and/or necessary for a satisfactory denture wearing experience7.

In the following, "denture adhesive" is used to refer to a commercially available, non-toxic, soluble material (powder, cream, or liquid) that is applied to the tissue surface of the denture in order to enhance denture retention, stability, and performance.  It does not refer to insoluble patient-directed efforts at improving denture fit and comfort such as home reliner kits, home repair kits, paper or cloth pads, or other self-applied "cushions"--many of which have been anecdotally linked with incidents of serious soft tissue damage, alterations in occlusal relations and vertical dimension of occlusion, and exacerbated alveolar bone destruction.  Included in this second category are thin wafers of water-soluble material that are adherent to both basal tissue and denture base, and which lack the ability to flow and therefore do not have the capacity to direct uneven and point pressures against the bearing tissues.

Components and Mechanism(s) of Action

Denture adhesives augment the same retentive mechanisms already operating when a denture is worn.  They enhance retention through optimizing interfacial forces by:  1) increasing the adhesive and cohesive properties and viscosity of the medium lying between the denture and its basal seat; and 2) eliminating voids between the denture base and its basal seat.  Adhesives (or, more accurately, the hydrated material that is formed when an adhesive comes into contact with saliva or water) are agents that stick readily to both the tissue surface of the denture and to the mucosal surface of the basal seat.  Furthermore, since hydrated adhesives are more cohesive than saliva, physical forces intrinsic to the interposed adhesive medium resist the pull more successfully than would similar forces within saliva.  The material increases the viscosity of the saliva with which it mixes, and the hydrated material swells in the presence of saliva/water and flows under pressure.  Voids between the denture base and bearing tissues are therefore obliterated.

Denture adhesive materials in use prior to the early 1960's were based on vegetable gums--such as karaya, tragacanth, xanthan, and acacia--that display modest, non-ionic adhesion to both denture and mucosa, and possessed very little cohesive strength.  Gum-based adhesives (still commercially available) are highly water soluble, particularly in hot liquids such as coffee, tea, and soups, and therefore wash out readily from beneath dentures.  Allergic reactions have been reported to karaya (and to the paraben preservative that the vegetable derivatives require), and formulations with karaya impart a marked odor reminiscent of acetic acid.  Overall, the adhesive performance of the vegetable gum-based materials is short-lived and relatively unsatisfactory.

Synthetic materials presently dominate the denture adhesive market.  The most popular and successful products consist of mixtures of the salts of short-acting (carboxymethylcellulose or "CMC") and long-acting (poly[vinyl methyl ether maleate], or "gantrez") polymers.  In the presence of water, CMC hydrates and displays quick-onset ionic adherence to both dentures and mucous epithelium.  The original fluid increases its viscosity and CMC increases in volume, thereby eliminating voids between prosthesis and basal seat.  These two actions markedly enhance the interfacial forces acting on the denture.  Polyvinylpyrrolidone ("povidone") is another, less-commonly used agent that behaves like CMC.  Over a more protracted time course than necessary for the onset of hydration of CMC, gantrez salts hydrate and increase adherence and viscosity.  The "long-acting" (i.e, less soluble) gantrez salts also display molecular cross-linking, resulting in a measurable increase in cohesive behavior.  This effect is significantly more pronounced and longer lived in calcium-zinc gantrez formulations than in calcium-sodium gantrez.  Eventually all the polymers become fully solubilized and washed out by saliva; this elimination is hastened by the presence of hot liquid.

Other components of denture adhesive products impart particular physical attributes to the formulations.  Petrolatum, mineral oil, and polyethylene oxide are included in creams to bind the materials and to make their placement easier.  Silicone dioxide and calcium stearate are used in powders to minimize clumping.  Menthol and peppermint oils are used for flavoring, red dye for color, and sodium borate and methyl- or poly-paraben as preservatives.

Indications and Contraindications

Scientific evidence favoring the support of routine and safe use of adhesives is lacking.  Yet clinical experience indicates that prudent use of adhesives to enhance the retentive qualities of well made complete dentures is sound clinical judgment.  Denture adhesives are indicated when well made complete dentures do not satisfy a patient's perceived retention and stability expectations.  Irrespective of the underlying reasons(s) for a patient's reported dissatisfaction--psychological, occupational, morphological, functional, etc.--the dentist must recognize that a patient's judgment of the treatment outcome is what defines prosthodontic success.  Such maladaptive patients are clearly candidates for an implant supported prosthesis.  But health, financial, or other considerations can preclude this, and then a well organized protocol of functional "do's and don't's" may be the best palliative measure the professional can offer.  Specific patient populations who can benefit from this strategy include patients with salivary dysfunction or neurological disorders, and those who have undergone resective surgical or traumatic modifications of the oral cavity.

Patients who suffer from xerostomia due to medication side effects, a history of head and neck irradiation, systemic disease or disease of the salivary glands, have great difficulty managing complete dentures due to impaired retention and an increased tendency for ulceration of the bearing tissues.  The use of denture adhesive can compensate for the retention that is lacking in the absence of healthy saliva, and can mitigate the onset of oral ulcerations that result from frequent dislodgments.  Xerostomic patients must be educated, however, that the adhesive-bearing denture will need to be deliberately moistened (e.g., with water from the tap) before it is seated in the otherwise dry mouth, in order to initiate the actions of the material.

Several neurological diseases can complicate the use of complete dentures, but adhesive may help to overcome the impediments imposed.  Cerebrovascular accident (stroke) may render part of the oral cavity insensitive to tactile sensation, or partially or wholly paralyze oral musculature.  Adhesives can assist in helping these patients accommodate to new dentures or to prostheses that were fabricated prior to the stroke but that the patient is now unable to manage due to lost sensory feedback and neuromuscular control.  Orofacial dyskinesia is a prominent side effect of phenothiazine-class tranquilizers (e.g., fluphenazine, trifluoperazine, thioridazine or thiothixine), other neuroleptics (e.g., haloperidol), and even gastrointestinal medications (e.g., prochlorperazine, metoclopramide).  This movement disorder, sometimes termed "tardive dyskinesia" because it is often a late-onset side effect of dopamine-blocking drugs, is characterized by exaggerated, uncontrollable muscular actions of the tongue, cheeks, lips and mandible.  In such situations, denture retention, stability, and function may be a virtual impossibility without adjunctive retention, such as that made possible with denture adhesive.

Patients who have undergone resective surgery for removal of oral neoplasia, or those who have lost intraoral structures and integrity due to trauma, may have significant difficulty in functioning with a tissue-borne prosthesis unless denture adhesive is employed, even if rotational undercuts have been surgically created to resist displacement of the prosthesis.

It must be emphasized that a denture adhesive is not indicated for the retention of improperly fabricated or poorly fitting prostheses.

Patient Education

It is mandatory that dentists educate denture patients about denture adhesives--their use, abuse, advantages, disadvantages, and available choices.  The major information resource for a patient should be the dentist and not magazine and television advertisements, or the testimonials of relatives and acquaintances.

The choice between cream and powder is largely subjective, but certain facts may underscore a patient's selection.  Powder formulations, as a rule, do not confer the same degree of "hold", nor do their effects last as long, in comparison to comparable cream formulations.  However powders can be used in smaller quantities, are generally easier to clean out of dentures and off tissues, and are not perceived as "messy" by patients.  Furthermore, the initial "hold" for powders is achieved sooner than it is with cream formulations.

Obtaining the greatest advantage from the use of an adhesive product is dependent on its proper usage.  For powder and cream products, the least amount of material that is effective should be used.  This is approximately 0.5 to 1.5 g per denture unit (more for larger alveolar ridges, less for smaller ones).  For powders, the clean prosthesis should be moistened and then a thin, even coating of the adhesive sprayed onto the tissue surface of the denture.  The excess is shaken off, and the prosthesis inserted and seated firmly.  If the patient suffers from inadequate or absent saliva, the sprayed denture should be moistened lightly with water before being inserted.  For creams, two approaches are possible.  Most manufacturers recommend placement of thin beads of the adhesive in the depth of the dried denture in the incisor and molar regions, and, in the maxillary unit, an antero-posterior bead along the mid-palate.  However, more even distribution of the material can be achieved if small spots of cream are placed at 5 mm intervals throughout the fitting surface of the dried denture.  Regardless of the pattern selected, the denture is then inserted and seated firmly.  As with powders, use of denture adhesive cream by the xerostomia patient requires that the adhesive material be moistened with water prior to inserting the denture.

Patients must be instructed that daily removal of adhesive product from the tissue surfaces of the denture is an essential requirement for the use of the material.  Removal is facilitated by letting the prosthesis soak in water or soaking solution overnight, during which the product will be fully solubilized and can then be readily rinsed off.  If soaking is not possible before new adhesive material needs to be placed, removal is facilitated by running hot water over the tissue surface of the denture while scrubbing with a suitable, hard-bristle denture brush.  Adhesive that is adherent to the alveolar ridges and palate is best removed by rinsing with warm or hot water, and then firmly wiping the area with gauze or a washcloth saturated with hot water.

Finally, patients need to be educated about the limitations of denture adhesive.  Discomfort will not be resolved by placing a "cushioning layer" of adhesive under the denture.  In fact, pain or soreness signals a need for professional management.  Gradual increase in the quantity of adhesive required for acceptable fit of the denture is also a clear signal to seek professional care.  In all cases, denture patients need to be recalled annually for oral mucosal evaluation and prosthesis assessment, but they also need to be educated about the warning signs that should alert them to seek professional attention between the check-ups.