What is Denture Stomatitis and How Do You Treat It?

By David Hudnall, DMD

Denture stomatitis is a very common condition. So much so that it is not unusual for patients to have it without even realizing it. In fact, patients are often taken by surprise when a dental professional talks to them about having denture stomatitis during a routine oral exam.

Since many patients are completely asymptomatic, they fail to understand the importance of changing their denture hygiene routine even after diagnosis.

What Is Denture Stomatitis?

Denture stomatitis is characterized by inflamed, puffy, red tissue that follows the outline of a denture or other dental appliance that rests against the oral mucosa. Sometimes the swollen tissue is accompanied by pin-points of bleeding.

Fortunately, denture stomatitis is neither life-threatening nor a condition that can be passed on to others.

Is Denture Stomatitis a Fungal Infection?

Denture-induced stomatitis is the result of a yeast infection caused by the fungus Candida albicans, an opportunistic fungal pathogen found as part of the normal microflora in the human digestive tract.

This variety is one of approximately 200 different species of Candida. Candida albicans account for up to 75% of all Candida infections. It is the same fungus that also causes thrush.

Is Denture-Induced Stomatitis a Bacterial Infection?

Not exactly. It’s an overgrowth of yeast that thrives in the same environment along with many strains of bacteria. Dentures provide a warm, moist, dark reservoir that acts as a petri dish for the proliferation of both fungus and bacteria. Left unchecked, overgrowth of pathogenic bacteria in the mouth can lead to other oral conditions.

What Does Denture-Induced Stomatitis Look Like?

Here is an example of denture stomatitis caused by a partial denture. Notice the fiery-red outline of the partial on the patient’s palatal tissue.

Clinical denture-induced stomatitis photograph courtesy of PocketDentistry.com – a source for clinicians, students, and lecturers; copyright 2018; retrieved September 10, 2021.

How Common Is Denture Stomatitis?

Candida is present in everyone’s mouth, and it usually causes no problems. However, it’s the overpopulation of Candida in the mouth that actually causes the symptoms of denture stomatitis.

Epidemiological studies report the prevalence of denture stomatitis among denture wearers ranges anywhere from 15% to over 70%, depending upon the age of study participants. Elderly patients and nursing home patients tend to have a higher incidence of the condition.

Who Can Get Denture Stomatitis?

Anyone who wears dentures, partials, or orthodontic retainers where a portion of the oral tissue spends the majority of the time covered by the dental appliance can experience denture-induced stomatitis.

Patients with underlying health issues such as medication-induced dry mouth, diabetes, or immune suppression (i.e., cancer patients) have an increased susceptibility to opportunistic fungal overgrowth.

Causes of Denture Stomatitis

Before effectively treating denture stomatitis, we must first understand what causes it.

There are five main causes of denture-associated erythematous stomatitis that may compound or independently cause stomatitis.

Rough denture surface: Candida species seem to have a particular binding affinity to the rough acrylic denture surface.

Poorly fitting dentures: Dentures that don’t fit properly can cause trauma that damages the tissue, making it more prone to infection.

Poor denture hygiene: Not removing all of the bacteria and debris formed on denture surfaces will allow denture stomatitis to multiply.

Poor oral hygiene: Without daily brushing and flossing the normal fungus will multiply and get out of control.

Constant wear: Wearing dentures 24/7 dramatically increases the risk of contracting denture stomatitis.

Most at-risk individuals wear dentures daily and therefore must take steps to avoid these five common causes.

What Are the Symptoms of Denture Stomatitis?

Aside from the red outline of the dental appliance, nearly 30% of all patients with denture stomatitis experience no symptoms at all. Of the remaining patients, 20% to 70% of them may notice:

• Bad breath
• Slight bleeding and swelling in the area involved
• A burning sensation
• Dry mouth
• Altered taste sensations
• Pain or discomfort when swallowing
• Sore mouth or throat
• White or red patches on the tongue, gums, lips, inner cheeks or roof of mouth
• Sores or cracks in the corners of the mouth

How Is Denture Stomatitis Diagnosed?

Diagnosis is based on clinical appearance. The patient has denture stomatitis when the pattern of redness and swelling closely resembles the shape of the dental appliance in contact with the tissue. It occurs more frequently on the palate.

Further confirmation is usually not necessary. However, a definitive diagnosis may be obtained via microbiological swabs taken from the patient’s palate or the tissue side of the denture. Specimens will test positive for the presence of yeasts with Candida albicans being the most common yeast present.

How Is Denture Stomatitis Treated?

It’s important to know that regular dental check-ups are essential to monitor the condition and make any necessary adjustments to your treatment plan. That being said, there are several treatment options for managing denture stomatitis effectively:

Maintenance and Adjustment

Primary denture stomatitis treatment involves the removal of dentures while sleeping and thorough cleaning of the dental appliances using mechanical means to completely eliminate plaque and debris build-up. Your dentist can clean, polish, and glaze your dentures to prevent microorganisms from contaminating the appliance.

Keeping dentures out of the mouth for an extended period, especially overnight, allows the oral tissues to recover and prevents the moist environment that fungi thrive in.

Surgical Removal

Denture stomatitis may lead to the formation of small nodules on the roof of the mouth. These nodules can interfere with the proper fit of dentures, causing discomfort and functional issues. When this occurs, minor surgical procedures may be necessary to remove the nodules. This surgery helps to restore comfort and ensure that the dentures fit properly.

Anti-fungal Treatment

For long-standing cases of denture stomatitis, the dentist may prescribe topical antifungal medications to apply to the denture-fitting surface and the oral mucosa. Oral antifungals, such as nystatin or miconazole, can offer temporary relief of symptoms and reduce fungal count, providing an environment for the tissue to heal.

These medications are often administered as lozenges that dissolve in the mouth, releasing the medication directly where it is needed. In some cases, anti-fungal ointments may be prescribed to apply directly to the affected areas of the oral mucosa and the denture-fitting surfaces.

Laser Therapy

This treatment option uses focused light energy to reduce inflammation and promote healing in the affected areas. Laser therapy can be particularly useful in cases where traditional medication does not adequately control the symptoms of denture stomatitis.

Are There Early Signs of Denture-Related Stomatitis?

Usually, the first sign of denture stomatitis is tissue redness in the shape of the denture. Since most patients don’t look inside of their mouths that closely every day, it usually goes undetected until a dental professional mentions it or actual symptoms occur.

Prevention of Denture Stomatitis

The best way to prevent denture stomatitis is to make it a habit of removing your dentures before you go to sleep. Your oral mucosa needs to be exposed to the air and to saliva which helps wash away bacteria and reduces the number of normal fungi present in your mouth.

Your dentures are a breeding ground for microorganisms and must be cleaned daily. The best way to accomplish this is the following:

Use a Soft-Bristle Denture Brush: A brush with soft bristles is gentle on your dentures while effectively removing plaque and film.

Choose the Right Cleaning Products: Use liquid soap or a paste specifically designed for cleaning dentures. Avoid regular toothpaste as it can be too abrasive and damage the denture material.

Soaking Dentures: Relying on soaking dentures in a cleansing solution alone doesn’t generate the agitation necessary to break up and wash away all of the debris hiding in the nooks and crannies of acrylic dentures. However, you should still soak your dentures.

Mechanical Cleaning: Gently brush all surfaces of your dentures to mechanically remove plaque and film that can lead to stomatitis. Pay special attention to the areas that come into contact with your gums.

Denture Materials Can Make a Difference

At European Denture Center, we offer a wide array of denture styles, suitable for any preference and budget. Our Digital Dentures and Implant-supported Dentures are milled from the very highest-quality materials available.

This innovative milling process ensures that the dentures are less prone to voids and rough surfaces that can harbor odor-causing microorganisms which produce the symptoms of denture stomatitis. Our process allows these dentures to fit better and last longer than most traditionally processed dentures.

Here are the primary benefits of a high-quality material and process:

Improved Fit and Comfort: The digital design and milling process create dentures that conform more closely to the unique contours of your mouth. This results in a snug fit that enhances comfort and functionality, making it easier to speak, eat, and smile with confidence.

Durability: The materials used in our Digital Dentures and Implant-supported Dentures are known for their strength and resilience. This means your dentures are less likely to crack, chip, or wear down over time, providing you with a long-lasting solution.

Hygiene: One of the significant advantages of our advanced denture materials is their resistance to voids and rough surfaces. Traditional dentures can have tiny imperfections that trap food particles and bacteria, leading to bad odors and increasing the risk of denture stomatitis. Our high-quality dentures have smoother surfaces that are easier to clean and maintain, reducing the potential for odor-causing microorganisms to thrive.

European Denture Center Solutions

We understand the importance of both aesthetics and functionality in denture design. Our team is dedicated to providing solutions that enhance your quality of life. Explore our full line of dentures and find the perfect match for your needs. Whether you’re looking for the cutting-edge precision of Digital Dentures or the stability of Implant-supported Dentures, we have the solution for you.

See our full line of dentures and give us a call at 866-428-0505.