Factors Influencing the Occurrence of Prosthetic Stomatitis in Patients with Complete Denture

Colonization of Surfaces

Due to the very close contact with the oral mucosa, relatively rough surface, and limited saliva circulation, denture surfaces are almost ideal places for plaque accumulation. The adhered plaque is then a good base for bacterial and yeast colonization and contributes to the development of prosthetic stomatitis.

Chronic Soft Tissue Disease

Prosthetic stomatitis is a chronic inflammatory disease of the soft tissues. A large number of factors can influence its development. The most significant of these are the age of the denture, denture hygiene, wearing the denture at night, smoking, and the presence of (Candida) yeast or other microorganisms in the oral cavity. Studies show that the most affected group of patients are residents of nursing homes or clients of other institutional care. In addition to the factors mentioned above, these patients also have reduced immunity, the presence of other chronic diseases, and regular medication use.

Danger of Asymptomatic Form

The disease is very often asymptomatic, and patients can suffer from it for many years before it is diagnosed. The clinical picture usually includes painless edematous and hyperemic areas in both the upper and lower jaw, which can later develop into more serious inflammatory papillary hyperplasia. Hyperplastic changes in the mucosa can then cause malignant cell alterations and tumor development.

Research on Risk Factors

A team of Serbian doctors conducted research to investigate the risk factors of prosthetic stomatitis. Sixty patients with complete upper and lower dentures participated, all of whom were residents of a nursing home. Senile and uncooperative patients were not included in the study. Participants answered several simple questions − about their age, gender, age of dentures, cleaning methods, whether they smoke, and if they remove the denture at night. Subsequently, a clinical examination of the oral cavity, assessment of plaque amount, and statistical analysis were performed.

Study Findings

Of the 60 participants, 34 were men and 26 women aged 69 to 92. The sample was further divided into individuals aged up to and including 79 years and those aged 80 and above. Based on hygienic habits, participants were then divided into 3 groups:

1. Patients who clean their oral cavity only with a toothbrush.
2. Patients who clean their oral cavity with a toothbrush and toothpaste.
3. Patients who also use a special cleaning agent for dentures.

Prosthetic stomatitis was detected in 46.7% of study participants in the upper jaw and 26.7% in the lower jaw. Higher incidence was observed in patients with older dentures (> 10 years), poor hygienic habits (77.8% of those cleaning dentures only with a toothbrush showed signs of prosthetic stomatitis), and seniors who wear their dentures overnight.

Conclusion

The cited study confirmed that adequate denture hygiene has a significant impact on preventing prosthetic stomatitis. The denture should be removed from the oral cavity at night.

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Source: Puškar T., Potran M. Factors influencing the occurrence of denture stomatitis in complete dentures wearers. Healthmed 2012; 6 (8): 2828−2833.