What Is Denture Stomatitis & How Is It Treated?

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 the 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 denture 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 more common in men. Men are twice as likely to suffer from DS as 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 typically mild coon thacan be controlled by adopting appropriate habits, and is not an alarming cause for 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 quality of life and affect general health; 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 swelling and carry out regular checkups to prevent Candida buildup.

Treatment for Candida buildup is

All forms of treatment combine good oral hygiene practices. The first treatment for this is a new, better-fitting implant denture or all-on-4 dentures.

Some recommall-on-4all-on-4nture-wearing habits include:

• Caring for your dentures
• Sanitize your dentures using the recommended mouthwash products. Brush them regularly to remove tartar and 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. Pressure from the dentures can worsen the infection in many 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 sanitizers and kinds of tooth sanitizers to protect your dentures from developing a yeast infection.
• Best DIY chemical cleaning options
• Sanitizing dentures is crucial for preventing yeast infections; use 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 replace the bleach with an 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 eliminate any traces of infection. You can also apply antifungal applications and gels on the denture surface. Commonly used options include clotrimazole and ketoconazole.

You should avoid taking oral medication to prevent harmful side effects and further worsening of the inflammation.

You should work with your dentist to take every precaution to prevent it from developing into inflammatory papillary epithelial hyperplasia (IPEH). This causes lesions and tearing in the mouth’s epithelial tissue. It needs to be surgically treated.

If you remember nothing else, remember this…

Denture stomatitis is a low-risk condition that can easily be mitigated through good oral hygiene. Take proper care when cleaning and storing your dentures to minimize the risk of microbial infections. Consult your dentist as soon as possible if you notice inflammation or soreness.