Denture stomatitis is a common oral condition affecting many individuals who wear dentures. It involves inflammation of the mucous membranes directly beneath a denture, often manifesting as redness or irritation. Up to 67% of denture wearers globally may experience this condition.
Understanding Denture Stomatitis
Denture stomatitis often appears as redness and swelling of the oral mucosa, particularly under the upper denture. Small red bumps or pinpoint bleeding spots, known as petechial hemorrhages, may also be observed. The inflamed area typically matches the shape of the denture, indicating where the appliance makes contact with the tissue.
Individuals might experience symptoms such as a burning sensation, soreness, or discomfort. Other signs can include bad breath, altered taste, or difficulty swallowing. However, a significant portion of affected individuals, sometimes as many as 30%, may not experience any noticeable symptoms.
Common Causes
The most frequent cause of denture stomatitis is an overgrowth of Candida fungus, a type of yeast naturally present in the mouth. While small amounts of Candida albicans are harmless components of the oral microbiota, an imbalance can lead to its proliferation and infection. This fungal overgrowth is often facilitated by several contributing factors.
Poor denture hygiene is a significant factor, as it allows for the accumulation of plaque, bacteria, and yeast on the denture surfaces. Wearing dentures continuously, especially overnight, creates a warm, moist environment that promotes fungal growth by depriving the oral tissues of air and saliva. Ill-fitting dentures also contribute to the problem by creating pressure points, causing trauma to the mucosa, and trapping moisture. Additionally, certain systemic conditions like diabetes, a weakened immune system, dry mouth, or the use of broad-spectrum antibiotics can increase susceptibility to fungal infections.
Effective Treatment Approaches
Treating denture stomatitis often involves a multi-pronged approach, with antifungal medications frequently being the first line of defense. These can be prescribed as topical treatments like nystatin or miconazole in lozenge or gel form, applied directly to the affected areas or the denture surface. In more persistent cases, systemic antifungal medications such as fluconazole, taken as tablets, may be necessary. Most individuals feel better within two weeks of starting treatment, though the timeline can vary depending on severity.
Improving denture hygiene is a crucial component of treatment, as it directly addresses a primary cause of the condition. This includes proper cleaning techniques and using specialized denture cleaning products.
Professional dental care plays a significant role in management. Dentists can perform adjustments, relining, or replacement of ill-fitting dentures to alleviate pressure and improve comfort. Professional cleaning of the dentures can further remove microbial biofilms. In severe instances, minor oral surgery or laser therapy may be considered if antifungal medications are insufficient.
Preventing Future Occurrences
Preventing denture stomatitis requires consistent daily care routines for both the dentures and the mouth. Dentures should be thoroughly cleaned daily using a soft-bristled brush and a non-abrasive denture cleanser or mild soap. Soaking dentures overnight in a denture-specific cleaning solution helps to eliminate bacteria and yeast, but hot water should be avoided as it can warp the denture material. Rinsing dentures after meals also helps remove food particles and reduces microbial growth.
It is highly recommended to remove dentures for several hours, particularly overnight, to allow the gum tissues to rest and breathe. This practice reduces continuous pressure on the gums, improves blood circulation, and limits the warm, moist environment where fungi thrive. Regular dental check-ups are important for prevention. During these visits, a dental professional can examine oral tissues for early signs of inflammation, assess denture fit, and provide guidance on optimal denture care. Avoiding smoking and vaping, along with maintaining a balanced diet, can further contribute to oral health and reduce the risk of recurrence.