Denture Stomatitis

Updated: Dec 06, 2020
  • Author: James J Sciubba, DMD, PhD; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Practice Essentials

Denture stomatitis is a common oral mucosal lesion (see the image below). The dominant etiologic factor appears to be fungal infection; Candida species have been identified in most patients. Mechanical plaque control and appropriate denture-wearing habits are the most important measures in preventing and treating the disease.

A variably intense erythema distributed over the p A variably intense erythema distributed over the part of the mucosa covered by the denture base is diagnostic of denture stomatitis.

Signs and symptoms

Although symptoms are uncommon, the presence of erythema and edema in the part of the palatal mucosa covered by the denture base is a diagnostic finding. Intense erythema is the most common finding.

See Presentation for more detail.


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.

See Workup for more detail.


The most important measures in preventing and treating denture stomatitis are mechanical plaque control and appropriate denture-wearing habits. In addition, denture sanitization is an important element of treatment.

Initiate antifungal therapy if fungal organisms are identified or if the condition fails to resolve. Topical therapy is the first-line treatment.

See Treatment for more detail.



In the United States and Western Europe, denture stomatitis is a common oral mucosal lesion. Prevalence rates of 2.5-18.3% in adults aged 35-44 years or 65-74 years are reported, with a predominance in the latter age group. [1, 2] Although patient age and denture quality alone do not predispose individuals this mucosal condition, the odds of developing stomatitis, denture-related hyperplasia, and angular cheilitis are increased almost 3-fold in denture wearers. [3] Studies indicate that correlations may exist with the amount of tissue coverage by a maxillary denture, vitamin A levels, smoking of cigarettes, and not removing dentures. [4]



Mucosal factors have been implicated in the etiology of this condition, as have behavioral and manner-of-use factors in patients who wear complete dentures. In these patients, the nighttime wear of the prosthetic appliance is the most significant factor. [5, 6]

Although the dominant etiologic factor now appears to be fungal infection, other factors must be considered; these include the prosthetic device itself and also local and systemic factors in patients who are aging and edentulous. The extent of inflammation has been correlated with the presence of yeast colonizing the denture surface. [7] Trauma has been shown to have a role in the production of basement membrane alterations involving expression of type IV collagen and laminin (alpha 1), thus indicating a possible relationship between these elements and denture stomatitis. [8] Regarding the prosthesis-related factor, an allergy in the form of contact mucositis is suggested. This reaction may be related to the presence of resin monomers, hydroquinone peroxide, dimethyl-p-toluidine, or methacrylate in the denture. Furthermore, contact sensitivities such as this one are more common with cold or autocured resins than with heat-cured denture-base materials.

Candida species have been identified in most patients [9, 10] or in all patients, [11] with Candida albicans being the predominant species isolated in addition to many other candidal species. [12] Whether the organism is merely commensal in this situation remains an issue because of the frequency of such organisms in the general population; the role of this organism as the sole etiologic factor in denture stomatitis is unclear; however, the presence of candidal organisms within the overall biofilm lends credence to its role in the development and maintenance of denture stomatitis. [13] The etiology is best considered multifactorial, with the prosthesis considered the prime etiologic factor. The character of biofilm communities of denture wearers, however, has been shown to be distinctive when compared with healthy non–denture-wearing individuals. [14]

Related Medscape Reference articles include Noncandidal Fungal Infections of the Mouth and Mucosal Candidiasis.



United States data

The exact prevalence of denture stomatitis is unknown, but it appears to be 2.5-18.3% among adults. The disease is common in elderly persons, especially those living in nursing home facilities. Findings from several studies suggest that denture stomatitis develops in as many as 35-50% of persons who wear complete dentures. [15, 16]

International data

Denture stomatitis is a common oral mucosal lesion in Western Europe, Thailand, and Turkey. [17, 18]

Race-, sex-, and age-related demographics

No racial predilection is recognized.

Sex-related frequencies differ among studies; therefore, no clear sex predilection is apparent.

The disease is more common in elderly persons than in young persons because elderly persons are more likely to wear dentures and because their level of oral and denture hygiene is reduced. In addition, age-related chronic disease (eg, type 2 diabetes mellitus), iatrogenic drugs, and age-associated immunocompromise contribute to this risk level.



In most patients, the elimination of mechanical and traumatic factors, the consistent use of oral hygiene measures, and the administration of local antimycotic therapy usually enable the inflammatory lesions to heal rapidly.

Recurrences are common when exacerbating factors are reintroduced.


When denture stomatitis is untreated and chronic, inflammatory papillary epithelial hyperplasia (IPEH) may develop. IPEH has never been reported to undergo malignant transformation.


Patient Education

The need for an educational component in a preventive oral health care program in geriatric institutions is unmet. [19]  Dental professionals who work with geriatric patients should address this need by implementing a preventive oral health care program. Such programs should include not only patient examinations and preventive care but also education for allied health care professionals and members of the patient's family.

Patients should be taught how to properly wear and sanitize their dentures and about how to perform good oral hygiene (see Deterrence/Prevention).