What Is Denture Stomatitis & How Is It Treated?

What Is Denture Stomatitis & How Is It Treated?

29th March 2021

Denture stomatitis (DS) or thrush is a localized infection in the mouth caused by yeast or fungus. It is caused by a high concentration of microbes called candida. The infection is non-communicable and affects palatal and gingival mucosa. DS is also commonly called ‘denture sore mouth’ and ‘prosthetic stomatitis.’

The primary trigger for denture stomatitis is a combination of wearing dentures and poor oral hygiene, which creates a conducive biofilm for candida growth.

What causes dental stomatitis?

DS is a common dental condition among denture-wearers. The base of the dentures, which is directly in contact with the gums and palate, attracts a buildup of plaque and biofilm. Numerous types of bacteria and other microorganisms multiply rapidly on such surfaces. Most dental studies show that DS is a result of Candida Albicans interacting with other mouth bacteria

External factors like denture material, eating habits, brushing patterns, etc., can also increase microbe buildup and subsequent inflammation. The top triggers for mild to moderate DS are:

Incorrect denture placement – this includes undue pressure on gums, abrasive parts etc.
Irregular and incorrect cleaning of dentures
Consumption of sugary foods and improper dental hygiene
Material and age of the dentures
Allergic reactions and immune response to the microbial buildup
Dentures blocking saliva from reaching certain parts of the mouth
Smoking
Underlying conditions like diabetes and immunodeficiency
Consuming certain antibiotics over a long period can also increase the incidence of DS

Who can get dental stomatitis?

DS is typically observed in denture and prosthetic users. It is also found to have a high incidence rate in patients with enamel caps and braces. It is a common condition for older adults. Men are twice as likely to suffer from DS than women.

People who regularly use inhalers or oral medicine apparatus like feeders can also develop symptoms of denture stomatitis. Irregular brushing and disinfection of removable dentures is the biggest trigger for unhealthy bacterial growth and eventual degradation of inner-mouth surfaces.

Some cohort studies indicate that at least 50% of denture wearers report some form of DS over a few years of using removable dental prosthetics.

How can you detect it – symptoms of dental stomatitis

Before you worry about developing denture stomatitis, remember that it is a typically mild condition that can be controlled medically and by adopting appropriate habits. It is temporary and not an alarming cause of concern.

However, early detection is ideal for early treatment. DS can manifest in more severe forms like tongue sores, bleeding gums, chronic numbness, or halitosis. So, watch out for these symptoms of DS:

Soreness in the area of the mouth that touches the dentures
Swelling of gums and abnormal redness
Redness and swelling on the corners of the lips
Bad breath
Ill-fitting dentures or prosthetic
Dryness and change in the texture of the palate
An abnormal decrease in saliva production
Burning sensation in the mouth
Dysgeusia – change in taste
Patients will experience multiple symptoms simultaneously in severe cases. However, most mild cases are accompanied by one or two symptoms of DS. Some cases also have non-specific symptoms, which increases the risk of non-detection and resultant lack of timely treatment. Dental professionals measure inflammation on the Newton inflammation scale to determine the severity of the condition.

DS-related inflammation can impact the quality of life and cause general discomfort over 1-2 weeks. It does not affect morbidity or mortality, although it can cause other negative conditions if left unchecked.

Dentists recommend that denture wearers stay vigilant for any signs of redness and swelling and carry out regular checkups to detect candida buildups.

Treatment for dental stomatitis

All forms of treatment for dental stomatitis are a mixture of medical intervention and good oral hygiene practices. The first treatment for this is a new better-fitting denture, implant denture, or all on 4 dentures. Some recommended denture-wearing habits include:

Caring for your dentures:
Sanitize your dentures using the recommended mouthwash products. Brush them regularly to get rid of tartar and plaque deposits. Don’t wear them overnight because this increases the chances of microbial growth.
Avoid wearing your dentures as much as possible if you notice inflammation. The pressure on your inflamed gums from the dentures will exacerbate discomfort and could spread the infection to other parts of the mouth.
Use a soft-bristle brush to clean your dentures. Hard bristles could damage the prosthetic material creating tiny abrasions on the surface. Remember, the greater the surface area on the dentures, the higher the possibility of infections. So, avoid scratching them unnecessarily.
Dentures with metal parts could require special cleaning solutions and sanitizing etiquette. Consult your dental hygienist for the best sanitisers and kinds of toothpaste to protect your dentures from developing a yeast infection.
Best DIY chemical cleaning options
Sanitising dentures regularly is crucial for preventing DS. We suggest using these chemical cleaning solutions along with mechanical cleaning for the optimum results. You can leave dentures in any of these solutions overnight:

Solution 1: 10 parts water and 1 part weak bleach (like sodium hypochlorite or sodium perborate). You can also switch out bleach for a weak acid.
Solution 2: Soak your dentures in biological enzymes like proteases and mutanases for 6-8 hours once a week.

Medical treatment options
In extreme cases of DS, dentists recommend opting for deep ultrasonic cleaning to obliterate any traces of infections. You can also apply topical antifungal applications and gels on the denture surface. Some commonly used formulas are ketoconazole and hexetidine.

You should avoid taking oral antifungal tablets during the infection to prevent harmful side effects and undue worsening of the inflammation.

You should work with your dentists to take every precaution that DS does not devolve into Inflammatory papillary epithelial hyperplasia (IPEH). This causes lesions and tearing in the mouth’s epithelial tissue. It needs to be surgically treated before re-fixing the dentures.

If you remember nothing else, remember this…

Denture stomatitis is a low-risk condition that can easily be mitigated through good oral hygiene. Take ideal care while cleaning and sanitizing your dentures to minimize the risk of microbial infestations. Consult your dentist at the earliest if you notice any unexplained inflammation and soreness.