Management of Chronic Atrophic Candidiasis (Denture Stomatitis)-A Narrative Review

Int J Environ Res Public Health. 2023 Feb 9;20(4):3029. doi: 10.3390/ijerph20043029.

Abstract

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.

Keywords: Candida albicans; antifungal drugs; denture stomatitis; oral candidiasis; phytomedicine; sore mouth.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antifungal Agents
  • Candida albicans
  • Candidiasis, Oral* / complications
  • Dentists
  • Dentures / adverse effects
  • Female
  • Humans
  • Professional Role
  • Stomatitis*
  • Stomatitis, Denture* / epidemiology
  • Stomatitis, Denture* / etiology
  • Stomatitis, Denture* / pathology

Substances

  • Antifungal Agents

Grants and funding

Open access funding was provided by the Qatar National Library. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.