|Denture Sore Mouth
Denture sore mouth is also known as sore mouth
under plates, chronic denture palatitis, stomatitis
prosthetica, denture-related candidiasis, denture-
induced stomatitis and denture stomatitis.
Nowadays, “denture stomatitis” stands for a mild chronic
erythematous candidiasis, usually seen after middle age
as erythema (redness) limited to the area beneath an
upper denture with the presence of the denture as the only
common aetiological factor to these situations. It is not
caused by allergy to the denture material.
Denture stomatitis is a common condition: findings from
several studies suggest that it can affect as many as 35 -
50% of persons who wear complete dentures.
The prevalence of denture stomatitis among those wearing
partial dentures is markedly lower than among complete
denture wearers, whose rank goes from 10 - 70%
depending on the population studied.
No racial or sex predilection exists, although some authors
have described a higher prevalence among women.
|Photos of Denture Stomatitis
| Predisposing Factors for Oral Candidosis include:
1. Systemic factors
- Physiological (Advanced age)
- Endocrine dysfunctions
- Nutritional deficiencies
- Broad spectrum antibiotics
2. Local factors
- Anti-microbials and topical / inhaled corticosteroids
- Carbohydrate rich diet
- Tobacco and alcohol consumption
- Deficient oral hygiene
- Wearing dentures (especially through the night)
- Good oral hygiene is mandatory. The mouth must be kept as clean as
possible and a thorough rinse after meals should be performed.
- Local factors which promote growth of yeasts, such as smoking or wearing
the dentures throughout the night, must be discouraged.
- Dentures should be removed for as long as possible and definitely overnight.
Dentures should be brushed in warm, soapy water and soaked overnight in an
antiseptic solution such as bleach (10 drops of household bleach in a denture
cup), chlorhexidine (not when the denture has metal components) or in any
solution suitable for sterilizing baby´s feeding bottles. Benzoic acid containing
products should be avoided as they induce changes in the composition of
- Denture fitting and occlusal balance should be checked to avoid trauma. A
new denture should be made, if necessary. Tissue conditioning agents are
porous materials easier to colonize than acrylic, so they are not recommended
for these patients. If there is no other choice, an anti-fungal agent, like
nystatin, miconazole or ketoconazole may be incorporated to the agent.
Dentures must be adequately polished and glazed as pores increase denture
contamination by oral micro-organisms
- Newton`s type I and II denture stomatitis have been successfully treated
with low energy lasers to reduce inflammation of the supporting mucosa.
Inflammatory papillary hyperplasia usually needs to be surgically removed (by
scalpel, cryosurgery, electro-surgery or with a laser beam) before the denture
is placed, although mild cases may respond to anti-fungal treatment.
- Anti-fungal medications are recommended when yeasts have been isolated, or
when lesions do not resolve with hygiene instructions.
First choice treatment is the topical application of nystatin or miconazole.
Resistance to nystatin is rare; the drug is administered as an oral suspension, with
an unpleasant taste and can induce gastro-intestinal problems and hypersensitivity.
Miconazole is available as a gel, varnish, lacquer and chewing gum. It also
provokes gastro-intestinal alterations and hypersensitivity, but it tastes better.
Miconazole enhances warfarin effect.
Systemic anti-fungal drugs (i.e. fluconazole, itraconazole or ketoconazole) are
almost exclusively reserved for patients with systemic factors that condition the
development and persistence of candidosis, such as immuno-suppression or
|Last Updated 9th February 2012
|What are the Signs & Symptoms of Denture Stomatitis?
Denture stomatitis lesions may show different clinical patterns and are more
frequently found in the upper jaw, especially on the palate (roof of the mouth). The
absence of denture stomatitis in the lower jaw is probably due to the washing
action of saliva.
Despite the fact that denture stomatitis is frequently asymptomatic, patients may
complain of halitosis, slight bleeding and swelling in the involved area or a burning
sensation, xerostomia, or taste alterations (dysgeusia). These symptoms occur,
with variable intensity, in 20 - 70% of patients with denture stomatitis. In these
situations, the patient usually does not relate the use of a denture to the
Different classifications have been proposed, but the reference classification for
denture stomatitis is the one suggested by Newton in 1962, based exclusively on
- Newton´s type I: pin-point hyperæmic lesions (localized simple inflammation)
- Newton´s type II: diffuse erythema confined to the mucosa contacting the
denture (generalized simple inflammation)
- Newton´s type III: granular surface (inflamatory papillary hyperplasia)