What is denture stomatitis?

Denture stomatitis

What a pain! Is your stomatitis denture induced?

Let’s be frank; wearing a denture is not the same as having natural teeth. Wearing a denture comes with associated challenges including stomatitis or a sore and inflamed mouth. However, pause for a moment and think of the alternative: a gappy smile – if you’re game to smile at all; gumming your food instead of chewing; unfair judgement from others based on your appearance; compromised opportunities, including employment. Viewed from this perspective, it’s a no brainer. The challenges denture wearers face, pale in comparison to not having teeth at all. It is therefore comforting to know your sore and inflamed mouth can be fixed. Knowing what the cause is can expedite the healing process.

But first, what is stomatitis?

Stomatitis is an umbrella term for an inflamed and sore mouth. Stomatitis can affect any oral surface like your palate, tongue, inner cheeks, lips or gums.i This condition can seriously impact upon your quality of life in terms of your appearance, ability to sleep, eat and talk, and crucially, by causing you pain and distress. There are different types of stomatitis related to differing causes.

Types of denture stomatitis

We discuss three types of denture stomatitis: the first type can be the result of viral infections like Herpes virus or cold sores. The second is canker sores or aphthous ulcers, affecting the inner mouth, tongue or inner lip, which can result from a compromised immune system. Lastly, mechanical injury or irritation to your sensitive oral tissues can also cause stomatitis.

According to the literature, denture wearers frequently suffer at some point from denture stomatitis which presents as inflammation of the mouth’s mucosal areas covered by the denture.ii Epidemiological studies show denture stomatitis is more prevalent among the elderly and women.iii

Causes of stomatitis: dentures and you

Among the most common causes of denture stomatitis are those related to:

  • Poor oral and denture hygieneiv
  • Irritation or mechanical injury of the mucosa, like the denture rubbing on gums because of ill-fit, or continually wearing dentures over the 24-hour period, for example.v
  • Medications like chemotherapy, antibiotics, steroids et cetera.vi

Who is more prone to denture stomatitis?

  • Denture wearers with underlying health issues
  • Cancer patients
  • Denture wearers who use alcohol excessively
  • Smokers
  • Denture wearers with poor nutrition
  • Denture wearers with poor hygiene practices
  • Denture wearers on medications
  • Women and older denture wearers – 65 years and above vii

How to treat stomatitis: denture related

Oral hygiene

Given the direct relationship between dental hygiene and stomatitis, practising your best oral hygiene is essential. See here for denture cleaning procedure. This means not only taking good care of your denture but also your mouth and any remaining teeth you may have. Soaking your denture overnight and brushing carefully to remove any food particles. Brushing your teeth, tongue, and gums while your dentures are soaking. Old dentures may have impaired surface integrity which can allow microbial bacteria and fungi like candida to colonise the tiny cracks and fissures. Antifungal treatments and maintaining good oral hygiene can eradicate the problem and relieve the suffering from stomatitis.viii

Irritation or mechanical injuries

Old or ill-fitting dentures can damage sensitive oral and gum tissues creating sore spots and inflammation, potentially leading to infection. Having your dentures checked and maintained annually by a dental prosthetist can restore fit and remove plaque therefore avoiding unnecessary mouth trauma. ix

Medications

Denture wearers on medications for other health conditions are more prone to denture stomatitis. Some common medications cause dry mouth or a reduction in saliva production. Less saliva can mean discomfort when chewing, speaking and swallowing. It can also make the sufferer more prone to oral infection, since saliva regulates oral bacterial build up.x Reduced saliva production may make the denture wearer more susceptible to mechanical injury like rubbing and sore spots. There are sprays available specifically for a dry mouth.

If you are a cancer patient undergoing treatment like radiation or chemotherapy, it is not unusual to suffer with ulcers or inflammation of the mouth exposing you to poor nutrition, and an increased risk of infection.

Thrush or candida, a yeast-like fungal condition, can be an issue for denture wearers with compromised immune systems, or those taking medications like prednisone or antibiotics which disturb the natural balance of the body’s micro-organisms. Diabetics or those with high sugar diets may also be at increased risk of contracting candida.

New developments for stomatitis: dentures and you

Some inroads are being made to reduce the occurrence of denture yeast and bacterial colonisation by developing new, adherent biofilm-resistant denture materials to be used in conjunction with good denture hygiene practices.xi

Conclusion

If you suffer with stomatitis - denture wearers’ misery - then it’s important to discover the cause so you can address the issue before it seriously impacts your life. If the cause is hygiene related, with a little research you can probably manage the problem at home. If it’s a mechanical issue, like an ill-fitting or loose denture, then a visit to your dental prosthetist will resolve the issue so you can get back to the business of enjoying your life. If medications or other health issues are the problem, a chat with your prescribing health professional may help. Dental prosthetists are encountering stomatitis on a regular basis and can assist you to find the solution to your sore mouth whatever its cause.

i https://www.webmd.com/oral-health/guide/stomatitis-causes-treatment#1 ii Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011 Jun;20(4):251-60. doi: 10.1111/j.1532-849X.2011.00698.x. Epub 2011 Apr 4. PMID: 21463383. iii Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011 Jun;20(4):251-60. doi: 10.1111/j.1532-849X.2011.00698.x. Epub 2011 Apr 4. PMID: 21463383. iv Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol. 1981 Apr;10(2):65-80. doi: 10.1111/j.1600-0714.1981.tb01251.x. PMID: 6792333. v Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol. 1981 Apr;10(2):65-80. doi: 10.1111/j.1600-0714.1981.tb01251.x. PMID: 6792333. vi O'Brien CP. Management of stomatitis. Can Fam Physician. 2009 Sep;55(9):891-2. PMID: 19752255; PMCID: PMC2743583. vii https://my.clevelandclinic.org/health/diseases/21702-denture-stomatitis viii Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011 Jun;20(4):251-60. doi: 10.1111/j.1532-849X.2011.00698.x. Epub 2011 Apr 4. PMID: 21463383. ix Budtz-Jørgensen E. Oral mucosal lesions associated with the wearing of removable dentures. J Oral Pathol. 1981 Apr;10(2):65-80. doi: 10.1111/j.1600-0714.1981.tb01251.x. PMID: 6792333. x https://www.med.umich.edu/1libr/Dentistry/DryMouth&Dentures.pdf xi Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011 Jun;20(4):251-60. doi: 10.1111/j.1532-849X.2011.00698.x. Epub 2011 Apr 4. PMID: 21463383.



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