Denture stomatitis is a very common condition which typically affects the roof of the mouth. It’s so common that some studies say up to 70% of people in elderly care homes have the condition 1. It’s not directly related to age, however, as some children with orthodontic appliances can suffer also.
Let’s take a look at this problem and how you can treat it and prevent it’s recurrence should you get it.
What is it?
The most typical type of denture stomatitis is when certain microbes grow on the denture where it covers the roof of the mouth. This then causes a red area on that part of the mouth, although it’s usually painless. It does sometimes spread to the corner of the mouth, and where it does can be painful and irritating. Usually it’s not that serious, however, and in theory at least should be simple to treat.
Having an underlying immune system problem (such as diabetes or HIV infection) can increase the risk of denture related stomatitis. Indeed in some cases this may be a first sign of an immune problem, pointing to a need for further medical investigation.
Those with dry mouth are also at increased risk, due to a reduction in the levels of cleansing saliva.
How to get rid of it
Getting rid of denture stomatitis can be divided into three stages, the first two of which are just basic advice useful to anyone with a denture.
1. Take dentures out at night
Everyone should take their dentures out at night. There are a lot of reasons why this is important, including preventing increased wear, loss of bone, loss of teeth near partial dentures, etc.
Preventing stomatitis is part of this list as well. For some patients, just doing this results in the eradication of problem, often quite quickly.
For some, however, this isn’t quite enough. In this case, oddly enough, just straightforward correct care of their ‘false teeth’ is enough to get rid of it. Given the number of myths which have built up around this topic though, it’s important to look at it carefully…
2. Looking after dentures well
- When taken out at night they should be kept in simple plain water.
- Dentures should be cleaned twice a day as well, obviously, but with denture-cleaning paste and not toothpaste, as the latter contains stain-removing abrasive. This will make the prosthesis shiny and flat may affect the fit over time.
- Once or twice a week a cleaning solution (like Steradent) can be dissolved in water and the dentures soaked for a short time. They can’t be soaked overnight though as over time they will turn white.
- Complete dentures are therefore quite simple. Partial dentures, however, are more complicated. Toothpaste can’t be used as it’s too abrasive. Denture cleaning paste can’t be used on teeth because fluoride is essential for them. A gold-star student, therefore, would use denture cream/paste on dentures, and toothpaste when cleaning teeth as normal. Twice a day. Very few dentists explain this fully when patients receive new false teeth. A slightly cheaper way would be to use soap and water on the dentures instead, but a lot of rinsing with water is necessary otherwise they taste terrible. Carefully doing all this, however, will usually eliminate any stomatitis.
3. Get professional advice
Lastly, of course, if none of this works after a few weeks then it’s necessary to book in with a dentist for further denture stomatitis treatment. A dentist may recommend overnight cleaning with stronger antiseptics and antibiotic or antifungal creams for the roof of the mouth. You may even need antifungal tablets, similar to treatment for oral thrush.
For most people, though, the above steps are enough to put a stop to it.
Medical problems are often more complicated than they first seem, however, and so there are a few extra things which deserve a mention.
A lot of websites talk about ‘thrush’ when talking about denture stomatitis. This is not a true type of thrush, although the candida fungus involved may be the same. To make it more confusing some people even call that fungus ‘thrush’ as well as calling the disease the same. With denture induced stomatitis the fungus or bacteria grow on the denture, not in the soft tissue, and the treatment, therefore, is often different.
Because of the relationship between this condition and fungi, some of the treatments can involve antibiotic and antifungal drugs. Most dentists, however, will recommend a period of cleaning at home first before considering swabs for microbial sensitivity.
Steroid inhalers, iron deficiency, allergy to denture materials, diabetes, etc, are all occasionally mentioned as associated with denture stomatitis. These associations are rare, however when compared to denture hygiene as a cause, and so ask for the advice of a dentist first before looking into these factors.
Smoking is also associated with this condition, but although smoking is a disaster for health generally it is more connected with difficulty in treating this condition rather than causing it.
Lastly some people use bleach to clean off the bacteria or fungi from the denture. Bleach causes metal parts to turn black, depending on the alloy, so get help first before trying this.
Denture stomatitis is common, but not usually serious, and some basic sensible advice on looking after dentures is enough for most people to completely get rid of it.
1. Scully, Crispian (2008). Oral and maxillofacial medicine: the basis of diagnosis and treatment (2nd ed.). Edinburgh: Churchill Livingstone. pp. 201–203.