Conquer Denture Stomatitis Essential Guide!

*Candida-Associated Denture Stomatitis*

Denture stomatitis is a common oral condition caused by **Candida species**, primarily *Candida albicans*. It affects the palatal mucosa beneath dentures and is more common in elderly and immunocompromised individuals.

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*Clinical Features*
*Redness and Inflammation* of the palatal mucosa covered by the denture.
**Burning Sensation or Discomfort**, but often asymptomatic.
*Swelling* and possible tenderness in severe cases.
*White Patches (Candida Overgrowth)* in some cases.
*Poorly Fitting Dentures* may worsen symptoms.

#### *Newton’s Classification of Denture Stomatitis*
1. *Type I* – Localized inflammation or pinpoint hyperemia.
2. *Type II* – Generalized erythema of the palatal mucosa.
3. *Type III* – Granular or nodular appearance of the mucosa (inflammatory papillary hyperplasia).

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*Diagnosis*
**Clinical Examination**: Redness under the denture with or without symptoms.
**Candida Detection**:
Smear or swab from the affected mucosa for *KOH test* or Gram staining.
*Fungal Culture* (Sabouraud dextrose agar) to identify Candida species.
**Biopsy (Rare Cases)**: When hyperplasia or malignancy is suspected.

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*Treatment*
#### *1. Local Measures*
**Denture Hygiene**:
Remove dentures at night.
Clean dentures with **chlorhexidine or sodium hypochlorite (for acrylic dentures, not metal ones)**.
Soak dentures in *antifungal solutions* (nystatin or miconazole).
**Oral Hygiene Improvement**: Brushing gums and tongue to reduce fungal load.

#### *2. Antifungal Therapy*
**Topical Antifungals (First-line treatment)**:
*Nystatin (oral suspension, lozenges)* – 100,000 IU 4–5 times daily.
*Miconazole gel* – Applied to the affected area 4 times daily.
*Clotrimazole troches* – 10 mg dissolved in mouth 5 times daily.
**Systemic Antifungals (Severe or Recurrent Cases)**:
*Fluconazole* 50–100 mg once daily for 7–14 days.
*Itraconazole* or *Amphotericin B* in resistant cases.

#### *3. Addressing Underlying Causes*
Adjust **ill-fitting dentures**.
Manage systemic conditions like **diabetes and immunosuppression**.
Reduce **sugar intake and smoking**.

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*Prevention*
Maintain **good oral and denture hygiene**.
Regular *denture cleaning* and overnight removal.
Routine **dental check-ups**.

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