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Denture StomatitisBy: Tiffany MontesWhat is Denture Stomatitis?Denture stomatitis is a candidiasis (fungal infection) that occurs only beneath a denture. It can be asymptomatic or symptomatic causing a burning sensation, discomfort and bad taste. Candida albicans

candidaconquered.wordpress.comDiploid fungusKingdom: Fungi

Class:SaccharomycetesGenius:Candida8 different types of CandidaCandida albicansCandida glabraraCandida tropicalisCandida guilliermondii

Candida cruserCandida parapsilosisCandida stelatoideaCandida kefyr

Question timeWhat is another name for denture stomatitis?

Chronic atrophic candidiasisPapillary hyperplasiaPalatal papillomatosisAll of the aboveCorrect Answer isD) All of the aboveContributing factors:denture wearersCandida albicansPoor oral hygiene Lack of knowledge: removing @ nightSmokingIll fitting denturesDecreased salivary flowVitamin A deficiency Newtons Classification ofDenture stomatitisType 1= localized inflammationType 2= diffuse erythema (redness) without hyperplasiaType 3= Inflammation, erythema and involves papillary hyperplasiaCASE STUDYWilliam aka SalWilliam62 year old Caucasian male Currently under the care of a physicianPreviously hospitalized: Hernia 1996 ; broken neck 1995Last visit 3months ago for a cleaning? (1 yr) Coming to CCC since 2008Medical History Yes answersArthritisCold SoresDrug addictionHepatitisHigh blood pressurePersistent cough

Psychiatric disordersRecreational drug useSTDsTobacco useOther-smoking herbsEO/IO Significant findings2 5x5mm bilateral scars above eyebrows (from halo brace)Red, irritated tissue on upper ridge bilaterallyMultiple red papules on hard palate (12x6mm)= Denture stomatitisSlightly fissured and coated tongueXerostomiaDental HistoryWilliam has a (FUD) full upper denture. -Fits poorly, chewed by dog

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Dental FindingsGen. 6-7mm pocketsGen BOPGen. 4-5 mm recessionLoc. class II mobility Loc. class 1 furcationsGen. Horizontal bone lossCase Class VAAP IIB

QUESTION TIME:If Williams probing depth was 7mm and his recession was 5mm, his total CAL (clinical attachment level) would be?A) 12mmB) 10mmC) 2mmCORRECT ANSWER ISA) 12mm*Can anyone tell me the Clinical attachment loss??Social HistoryPrevious Meth/Cocaine addiction; quit in 1985Tobacco use previouslyPatient wears an ankle monitorOn probation so cant smoke marijuanaCurrently smoking herbs from co-op (Mullen, Mugwart, Catnip, White sage, Yerba Santa, Damiana)Has a dog that he speaks of at every visit

Chief ComplaintWilliam just wants his teeth cleaned and to prevent loosing more teeth. Would like to find a place to fix his dentures.Mentioned getting rid of gaps in his teeth and whitening them. Oral Hygiene StatusAppointment 1= 1.66Appointment 2= 1.66

Overall Fair according to the OHI-S. Only scored from lower teeth.

*Reviewed denture brushing on each appointment. Gum go betweens for diastemas.Oral Hygiene Status Cont.Oral hygiene with dentures= non existentNo removal of denturesNo cleaning of denturesBroken denturesBrushed remaining teeth well. Just struggled with interproximal areas.ConcernsDenture stomatitis

Carrington College California DH ClinicConcernsDenture stomatitis

Carrington College California DH ClinicQUESTION TIME:According to Newtons Classification of denture stomatitis, William is a Type?A) Type 1B) Type 2C) Type 3D) He does not have denture stomatitisCORRECT ANSWER ISC) Type 3 due to involvement of papillary hyperplasia Possible causes:Smoking with dentures inLeaving dentures in to sleepNot cleaning denturesIll fitting denturesSuggested ModificationsRemoving dentures while smoking/quittingDaily denture brushing/cleaningRemoving dentures to sleepDenture reline or new denturesTreatment Plan1st appointment: 7 PAs, local anesthesia, SRP LR sextant, tobacco/herb cessation, Medical referral for denture stomatitis.

2nd appointment: Tobacco/herb cessation, local anesthesia, SRP mand. anterior sextant and LL sextant, dental referral. Recommend 3mon recare appointment.THE 8 HUMAN NEEDSProtection from health risksFreedom from fear and stressFreedom from painWholesome facial imageSkin & mucous membrane integrity of the head and neckBiologically sound and functional dentitionConceptualization and problem solvingResponsibility for oral health.Williams Unmet needs (7)Protection from health risksFreedom from fear and stressWholesome facial imageSkin and mucous membrane integrity of the head and neckBiologically sound and functional dentitionConceptualization and problem solvingResponsibility for oral healthIn ConclusionDenture stomatitis was not being cared for and grew from 12x6mm to 20x10mm Patient didnt seem concernedI would have liked to recommend some of the research findings, but was unsure about liability to the clinic and myself.Additional denture care and tobacco cessation could be beneficial.

ReferencesHadi, S. D.-V. (2008, June 26). Influence of candida infection on denture stomatitis. Retrieved June 1, 2011, from Ebscohost: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vidKulak-Ozkan, E. (2002). Oral hygiene habits, denture cleanliness, presence of yeast and stomatitis in elderly people. Journal of Oral Rehabilitation , 300-304.Neppelenbroek, K. P. (2008). Effectiveness of microwave disinfection of complete dentures on the treatment of Candida-related denture stomatitis. Journal of Oral Rehabilitation , 836-846.Rosenberg, J. D. (2010, Feb 22). Periodontitis. Retrieved June 1, 2011, from PubMed: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002054/Shulman, J. R.-H. (2005). Risk factors associated with denture stomatitis in the United States. J Oral Pathol Med , 340-346.Yuntzu-Yen Chen, A. B., & Zirwas, M. J. (2007). Denture Stomatitis . SKINmed , 92-94.Yuntzu-Yen Chen, A. (2007, March). Denture Stomatitis. Retrieved May 30, 2011, from Ebsco:http://web.ebscohost.com/ehost/detail?sid