eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Denture Stomatitis: Differential Diagnoses & Workup

Author: James J Sciubba, DMD, PhD, Retired Professor and Director of Dental and Oral Medicine, Johns Hopkins University School of Medicine; Consulting Staff, Milton J Dance Head and Neck Center; Private Practice, Oral and Maxillofacial Pathology, Oral Medicine, Baltimore, MD
Contributor Information and Disclosures

Updated: Feb 18, 2009

Differential Diagnoses

Cancers of the Oral Mucosa
Contact Stomatitis
Oral Manifestations of Autoimmune Blistering Diseases
Oral Manifestations of Systemic Diseases

Workup

Laboratory Studies

  • A smear of the fungal material from the mucosa can be prepared and studied by using a potassium hydroxide (KOH) preparation or periodic acid-Schiff staining in the laboratory.
  • Other methods of identifying fungal organisms involve the use of imprint cultures.20

Histologic Findings

  • Inflammatory papillary epithelial hyperplasia (IPEH) is not associated with cytologic signs of dysplasia.
  • Epithelial dysplasia has not been observed in specimens of denture stomatitis.

Staging

  • The level of denture stomatitis can be classified as follows21 :
    • Type I - Pinpoint hyperemia or localized simple inflammation
    • Type II - Diffuse erythema confined to the mucosa in contact with the denture base (see Media file 1)
    • Type III - Granular surface or inflammatory papillary hyperplasia of the palate (see Media file 2)
  • Type III denture stomatitis involves the epithelial response to chronic inflammatory stimulation secondary to yeast colonization and, possibly, low-grade local trauma resulting from an ill-fitting denture.

More on Denture Stomatitis

Overview: Denture Stomatitis
Differential Diagnoses & Workup: Denture Stomatitis
Treatment & Medication: Denture Stomatitis
Follow-up: Denture Stomatitis
Multimedia: Denture Stomatitis
References
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References

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  2. Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the third national health and nutrition examination survey, 1988-1994. J Amer Dent Assoc. 2004;135:1279-1286. [Medline].

  3. MacEntee MI, Glick N, Stolar E. Age, gender, dentures and oral mucosal disorders. Oral Dis. Mar 1998;4(1):32-6. [Medline].

  4. Shulman JD, Rivera-Hidalgo F, Beach MM. Risk factors associated with denture stomatitis in the United States. J Oral Pathol Med. 2005;34:340-346. [Medline].

  5. Fenlon MR, Sherriff M, Walter JD. Factors associated with the presence of denture related stomatitis in complete denture wearers: a preliminary investigation. Eur J Prosthodont Restor Dent. Dec 1998;6(4):145-7. [Medline].

  6. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jan 2003;95(1):51-9. [Medline].

  7. Le Bars P, Piloquet P, Daniel A, Giumelli B. Immunohistochemical localization of type IV collagen and laminin (alpha1) in denture stomatitis. J Oral Pathol Med. Feb 2001;30(2):98-103. [Medline].

  8. Schou L, Wight C, Cumming C. Oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly in Lothian, Scotland. Community Dent Oral Epidemiol. Apr 1987;15(2):85-9. [Medline].

  9. Budtz-Jorgensen E, Stenderup A, Grabowski M. An epidemiologic study of yeasts in elderly denture wearers. Community Dent Oral Epidemiol. May 1975;3(3):115-9. [Medline].

  10. Cardash HS, Helft M, Shani A, Marshak B. Prevalence of Candida albicans in denture wearers in an Israeli geriatric hospital. Gerodontology. Winter 1989;8(4):101-7. [Medline].

  11. Marcos-Arias C, Vicente JL, Sahand IH, et al. Isolation of Candida dubliniensis in denture stomatitis. Arch Oral Biol. Feb 2009;54(2):127-31. [Medline].

  12. Ramage G, Tomsett K, Wickes BL, Lopez-Ribot JL, Redding SW. Denture stomatitis: a role for Candida biofilms. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jul 2004;98(1):53-9. [Medline].

  13. Campos MS, Marchini L, Bernardes LA, Paulino LC, Nobrega FG. Biofilm microbial communities of denture stomatitis. Oral Microbiol Immunol. Oct 2008;23(5):419-24. [Medline].

  14. Cumming CG, Wight C, Blackwell CL, Wray D. Denture stomatitis in the elderly. Oral Microbiol Immunol. Apr 1990;5(2):82-5. [Medline].

  15. Frenkel H, Harvey I, Newcombe RG. Oral health care among nursing home residents in Avon. Gerodontology. Jul 2000;17(1):33-8. [Medline].

  16. Jainkittivong A, Aneksuk V, Langlais RP. Oral mucosal conditions in elderly dental patients. Oral Dis. Jul 2002;8(4):218-23. [Medline].

  17. Kulak-Ozkan Y, Kazazoglu E, Arikan A. Oral hygiene habits, denture cleanliness, presence of yeasts and stomatitis in elderly people. J Oral Rehabil. Mar 2002;29(3):300-4. [Medline].

  18. Nikawa H, Jin C, Makihira S, Egusa H, Hamada T, Kumagai H. Biofilm formation of Candida albicans on the surfaces of deteriorated soft denture lining materials caused by denture cleansers in vitro. J Oral Rehabil. Mar 2003;30(3):243-50. [Medline].

  19. Dorocka-Bobkowska B, Budtz-Jorgensen E, Wloch S. Non-insulin-dependent diabetes mellitus as a risk factor for denture stomatitis. J Oral Pathol Med. Sep 1996;25(8):411-5. [Medline].

  20. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J. Nov 20 1979;147(10):267-72. [Medline].

  21. Newton AV. Denture sore mouth as possible etiology. Brit Dental J. 1962;112:357-60.

  22. Vitkov L, Weitgasser R, Lugstein A, Noack MJ, Fuchs K, Krautgartner WD. Glycaemic disorders in denture stomatitis. J Oral Pathol Med. Oct 1999;28(9):406-9. [Medline].

  23. Wilson J. The aetiology, diagnosis and management of denture stomatitis. Br Dent J. Oct 24 1998;185(8):380-4. [Medline].

  24. Matear DW. Demonstrating the need for oral health education in geriatric institutions. Probe. Mar-Apr 1999;33(2):66-71. [Medline].

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Further Reading

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Keywords

denture stomatitis, denture sore mouth, oral mucosal lesions, dentures, oral candidal infection, denture-related lesions, denture-related hyperplasia, angular cheilitis, contact mucositis, dentures, Candida

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Contributor Information and Disclosures

Author

James J Sciubba, DMD, PhD, Retired Professor and Director of Dental and Oral Medicine, Johns Hopkins University School of Medicine; Consulting Staff, Milton J Dance Head and Neck Center; Private Practice, Oral and Maxillofacial Pathology, Oral Medicine, Baltimore, MD
James J Sciubba, DMD, PhD is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Dental Association, and International Association for Dental Research
Disclosure: Nothing to disclose.

Medical Editor

Peter Fritsch, MD, Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria
Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Drore Eisen, MD, DDS, Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati
Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
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