dental disorders
Dental Appliances
Denture problems
Occasionally, the mucosa beneath a denture becomes inflamed (denture sore mouth, inflammatory papillary hyperplasia). Contributing factors to this often painless condition include candidal infections, poor denture fit, poor hygiene, excessive movement of the denture, and, most frequently, wearing a denture 24 hours a day. The mucosa appears red and velvety. Candidal overgrowth may be indicated by adherent cottonlike patches or, more commonly, erosive lesions on the mucosa. The presence ofCandidacan be confirmed by the microscopic appearance of typical branching hyphae. There is still uncertainty in the possible role ofCandidaas a cause of inflammatory papillary hyperplasia. A new well-made denture almost always improves the situation. Other treatments consist of improving oral and denture hygiene, refitting the existing denture, removing the denture for extended periods, and using antifungal therapy (nystatinrinses for the mouth and overnightnystatinsoaks for the denture). Soaking the denture in a commercial cleanser is sometimes helpful. Other options for candidal overgrowth include applyingnystatinsuspension to the tissue surface of the denture and placing sublingualclotrimazoletroches 10 mg 5 times a day. IfCandidainfection does not resolve with local oral measures,fluconazole100 mg (2 tablets initially and 1 tablet each day thereafter until resolved) can be given. If inflammation persists, biopsy is indicated, and systemic conditions should be ruled out. 