What 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 ID: 760091
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Slide1
Denture Stomatitis
By: Tiffany Montes
Slide2What 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.
Slide3Candida albicans
candidaconquered.wordpress.com
Diploid
fungusKingdom: Fungi
Class:
Saccharomycetes
Genius:
Candida
Slide48 different types of Candida
Candida albicansCandida glabraraCandida tropicalisCandida guilliermondii
Candida
cruser
Candida
parapsilosis
Candida
stelatoidea
Candida
kefyr
Slide5Question time
What is another name for
denture stomatitis?
Chronic atrophic candidiasis
Papillary hyperplasia
Palatal papillomatosis
All of the above
Slide6Correct Answer is…
D) All of the above
Slide7Contributing factors:
denture wearers
Candida albicans
Poor oral hygiene
Lack of knowledge: removing @ night
Smoking
Ill fitting dentures
Decreased salivary flow
Vitamin A deficiency
Slide8Newton’s Classification ofDenture stomatitis
Type 1
= localized inflammation
Type 2
= diffuse erythema (redness) without hyperplasia
Type 3
= Inflammation, erythema and involves papillary hyperplasia
Slide9CASE STUDY
William aka Sal
Slide10William
62 year old Caucasian male
Currently under the care of a physician
Previously hospitalized: Hernia 1996 ; broken neck 1995
Last visit 3months ago for a cleaning? (1 yr) Coming to CCC since 2008
Slide11Medical History “Yes” answers
ArthritisCold SoresDrug addictionHepatitisHigh blood pressurePersistent cough
Psychiatric disorders
Recreational drug use
STD’s
Tobacco use
Other-smoking herbs
Slide12EO/IO Significant findings
2 5x5mm bilateral scars above eyebrows (from halo brace)
Red, irritated tissue on upper ridge bilaterally
Multiple red papules on hard palate (12x6mm)= Denture stomatitis
Slightly fissured and coated tongue
Xerostomia
Slide13Dental History
William has a (FUD) full upper denture. -Fits poorly, chewed by dog
uniquedental.co.nz
Slide14Dental Findings
Gen. 6-7mm pockets
Gen BOP
Gen. 4-5 mm recession
Loc. class II mobility
Loc. class 1 furcations
Gen. Horizontal bone loss
Case Class V AAP IIB
Slide15QUESTION TIME:
If Williams probing depth was 7mm and his recession was 5mm, his total CAL (clinical attachment
level
) would be?
A) 12mm
B) 10mm
C) 2mm
Slide16CORRECT ANSWER IS…
A) 12mm
*Can anyone tell me the Clinical attachment loss??
Slide17Social History
Previous Meth/Cocaine addiction; quit in 1985
Tobacco use previously
Patient wears an ankle monitor
On probation so can’t smoke marijuana
Currently smoking herbs from co-op (Mullen, Mugwart, Catnip, White sage, Yerba Santa,
Damiana
)
Has a dog that he speaks of at every visit
Slide18Chief Complaint
William 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.
Slide19Oral Hygiene Status
Appointment 1= 1.66
Appointment 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.
Slide20Oral Hygiene Status Cont.
Oral hygiene with dentures= non existent
No removal of dentures
No cleaning of dentures
Broken dentures
Brushed remaining teeth well. Just struggled with interproximal areas.
Slide21Concerns
Denture stomatitis
Carrington College California DH Clinic
Slide22Concerns
Denture stomatitis
Carrington College California DH Clinic
Slide23QUESTION TIME:
According to Newton’s Classification of denture stomatitis, William is a Type…?
A) Type 1
B) Type 2
C) Type 3
D) He does not have denture stomatitis
Slide24CORRECT ANSWER IS…
C) Type 3 due to involvement of
papillary hyperplasia
Slide25Possible causes:
Smoking with dentures in
Leaving dentures in to sleep
Not cleaning dentures
Ill fitting dentures
Slide26Suggested Modifications
Removing dentures while smoking/quitting
Daily denture brushing/cleaning
Removing dentures to sleep
Denture reline or new dentures
Slide27Treatment Plan
1
st
appointment: 7 PA’s, local anesthesia, SRP LR sextant, tobacco/herb cessation, Medical referral for denture stomatitis.
2
nd
appointment: Tobacco/herb cessation, local anesthesia, SRP mand. anterior sextant and LL sextant, dental referral. Recommend 3mon recare appointment.
Slide28THE 8 HUMAN NEEDS
Protection from health risksFreedom from fear and stressFreedom from painWholesome facial image
Skin & mucous membrane integrity of the head and neck
Biologically sound and functional dentition
Conceptualization and problem solving
Responsibility for oral health.
Slide29Williams Unmet needs (7)
Protection from health risks
Freedom from fear and stress
Wholesome facial image
Skin and mucous membrane integrity of the head and neck
Biologically sound and functional dentition
Conceptualization and problem solving
Responsibility for oral health
Slide30In Conclusion…
Denture stomatitis was not being cared for and grew from 12x6mm to 20x10mm
Patient didn’t seem concerned
I 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.
Slide31References
Hadžić
, 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?vid
Kulak-
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