Denture-related stomatitis (also called the mouth of denture's denture , denture stomatitis , chronic atrophy candidiasis , Candida-stirred denture triggers stomatitis , and denture-associated erythematous stomatitis ) is a common condition in which mild inflammation and redness of the mucous membrane of the mouth occur under a denture. Approximately 90% of the cases, Candida are the species involved, which is usually a harmless component of the oral microbiota in many people. Denture-related stomatitis is the most common form of oral candidiasis (fungal infection of the mouth). This is more common in older people, and in those who wear complete upper dentures (dentures replacing all the upper teeth, worn by someone without a natural tooth in the upper jaw). Stomatitis associated with artificial teeth is more likely to develop when artificial teeth are left in the mouth, rather than removing them during sleep, and when the denture is not cleaned regularly.
Video Denture-related stomatitis
Classification
Newton's classification divides stomatitis associated with denture into three types based on severity. Type one can represent the initial phase of the condition, while type two is the most common and the type three is rare.
- Type 1 - Appropriate local inflammation or hyperemia
- Type 2 - More diffuse erythema (redness) involving part or all of the mucosa covered by denture
- Type 3 - Inflammatory nodular/papillary hyperplasia usually on the central hard palate and alveolar ridge
Maps Denture-related stomatitis
Signs and symptoms
Although the alternative name for this condition, "mouth denture", is usually painless and asymptomatic. The emergence of the involved mucosa is erythematous (red) and edematous (swollen), sometimes with petechial hemorrhage (pin-point of bleeding). This usually occurs under the top artificial teeth. Sometimes angular cheilitis can co-exist, which is inflammation in the corners of the mouth, also often associated with Candida albicans. Stomatitis rarely develops under lower dentures. The affected mucosa is often defined sharply, in the form of a denture that covers it.
Cause
The main risk factor for the progression of this condition is to use complete denture over, especially when not removed during sleep and regularly cleaned. Older dentures are more likely to be involved. Other factors include xerostomia (dry mouth), diabetes or high carbohydrate diet. Human immunodeficiency virus (HIV) can rarely be an underlying factor.
Wearing dental equipment such as dentures transforms oral microbiota. Microbial plaque consisting of bacteria and/or yeast is formed on the surface of a suitable denture (surface attached to the ceiling) and to a closed mucosa. Over time, these plaques may be colonized by Candida species. The local environment beneath the denture is more acidic and less exposed with saliva cleansing action, which supports high activity of Candida enzyme and can cause inflammation in the mucosa. C. albicans is the most commonly isolated organism, but occasionally bacteria are involved.
There is controversy over whether this condition is an actual infection by C. albicans or just a reaction to various micro-organisms under dentures. It has been reported that frequent denture surfaces exhibit a positive culture for Candida but the biospies of the mucosa rarely show hyphae attacking the epithelium. Similarly, the microbiological swabs of the involved mucosa show much less colonization than the surface of the denture. This leads some to conclude that the decisive feature of an actual infection does not exist in denture-related stomatitis.
Poorly false teeth can cause pressure on the mucosa and mechanical irritation may create a similar clinical appearance, but this is rare. Orthodontic instruments may not produce the same results. However, mucosal trauma is thought to improve the ability of
In addition to infection and mechanical trauma, mucosal inflammatory reactions under denture can also result from irritation or allergies (allergic contact stomatitis) caused by the material in the denture itself (acrylic, cobalt, chromium), or in response to the substance in the denture adhesive. Incomplete preservation of acrylic resin (prosthetic material) may also be a factor involved.
Diagnosis
Diagnosis is usually made on the basis of clinical appearance, and swabs can be taken from the surface of the denture. Investigations to rule out the possibility of diabetes may be indicated. A tissue biopsy is usually not indicated, but if taken indicates histologic evidence of proliferative or degenerative responses and reduces keratinization and epithelial atrophy.
Treatment
The most important aspect of treatment is improving denture hygiene, ie removing dentures at night, cleaning and disinfecting, and storing them overnight in an antiseptic solution. This is important because denture is usually infected with C. albicans which will cause reinfection if not removed. Substances used include solutions of alkaline peroxide, alkaline hypochlorite (eg hypochlorite, which can cause corrosion of metal components from dental appliances), acids (eg benzoic acid), lytic yeast enzymes and proteolytic enzymes (eg protease alcalase). Another aspect of treatment involves resolution of mucosal infections, which are used for topical antifungal drugs (eg nystatin, amphotericin, miconazole, fluconazole or itraconazole). Often antimicrobial mouthwash such as chlorhexidine is prescribed simultaneously. Underlying disease possible (diabetes, HIV) should be treated if possible.
Prognosis
Stomatitis associated with denture is usually a harmless condition with no long-term consequences. It usually heals with simple actions such as improved denture hygiene or topical antifungal drugs. In individuals with severe immune system disorders (eg those with HIV), infection can pose a more serious threat.
Epidemiology
Stomatitis associated with denture is common throughout the world. Usually the affected person is middle age or elderly, with women being exposed slightly more often than men. Prevalence of up to 70% has been reported in elderly in elderly care homes. It is by far the most common type of oral candidiasis.
References
Source of the article : Wikipedia
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