1

Journal of Pakistan Association of Dermatologists 2011; 21 (3): 170-173.

Original Article
Oral mucosal lesions in complete denture
wearers
Asif Ali Shah, Tahir Jamil Ahmad*
Department of Prosthodontics, deMontmorency Coe!e of Dentistry ,"ahore.
#Department of Dermatoo!y, $atima %innah Medica Coe!e, "ahore
Abstract
Objective &o determine the fre'(ency of ora esions reated to !ender, a!e, the en!th of time of
dent(re (sa!e, the )aance of dent(re and ceanin! methods.
Patients and methods 10* patients +ho had od compete dent(res and came to Denta Department
to ha,e ne+ compete dent(res +ere re!istered in the st(dy. $re'(ency in reation to different
factors +as estimated. Ceanin! methods and fre'(ency +ere di,ided into 3 s()!ro(ps respecti,ey
as tooth )r(sh and tooth paste-soap, dent(re ceansin! ta)ets and sodi(m car)onate and 3 times a
day, e,ery day, e,ery 3 days and once a +ee.. Distri)(tions of ora esions in different areas +ere
noted. &he data o)tained +ere e,a(ated )y one-+ay /012/ ( test, st(dent t test. &he e,e of
statistica si!nificance +as set at p30.04.
Results 5n 10* patients 641 men and 44 +omen 7, 37-80 years of a!e +ith a mean a!e of *0.28
years, ora esions +ere present more as the a!e increases, the more esions +ere o)ser,ed 5n femae
patients and associated +ith (nsta)e dent(res. &he patients dispayed statisticay si!nificant
difference in presence of ora esions +ith the method of ceanin! and the +ay the patients (sed
their dent(res.
Conclusion &he compete dent(re +earers sho(d )e ed(cated a)o(t the importance of periodic
e9amination d(e to chan!es of s(pportin! tiss(es and eary detection of m(cosa esions to maintain
their ora and dent(re hy!iene in optim(m e,e.
Key words
Compete dent(re, ora m(cosa esions.
Introduction
M(cosa infammation in dent(re +earers occ(rs
in ,ario(s forms : oca, !enerai;ed,
papiomato(s. /c(te and chronic infammatory
conditions of the ora m(cosa can )e cassified
on the )asis of their respecti,e etioo!ica
factors.
1
&hese inc(de ne(rom(sc(ar tra(matic
in<(ries arisin! from dent(res +ith or +itho(t
)aanced occ(sion,
2
tra(matic in<(ries of ora
Address for correspondence
Dr. /sif /i =hah,
Prosthetics Department.
deMontmorency Coe!e of Dentistry
"ahore
> mai: asif?shah12@hotmai.com
m(cosa res(tin! from tra(matic occ(sion of
,ario(s .inds,
3
mere presence and action of the
dent(res as a forei!n )ody,
A
poor o9idation and
,entiation of ora m(cosa co,ered )y dent(res,
4
inade'(ate retention of the dent(res,
*
inade'(ate
m(cosa resistance ca(sed )y ,ario(s systemic
diseases,
7
endocrinoo!ic and ne(roo!ica
conditions,
8
acc(m(ation of infectio(s materia
on the (nders(rface of dent(re,
B
chemicoto9ic
in<(ries to the ora m(cosa ca(sed )y dent(re
)ase materia
10
and poor n(trition.
1
Micro)ia pa'(e and Candida albican ha,e aso
)een impicated in the de,eopment of
infammation.
2
/n!(ar cheiitis is o)ser,ed at
the corners of mo(th fre'(enty accompanyin! a
!enerai;ed or papiomato(s stomatitis. 5t may
res(t from systemic disorder, )(t more
commony it is associated +ith an (ncean and
(nsta)e dent(re.
3
&ra(matic hyperpasia in
dent(re +earers is ind(ced from chronic
irritation from the periphery of (nsta)e dent(re.
5t may de,eop into ep(is fiss(rat(m.
A
Dent(re stomatitis is cassified into three types,
0e+ton type1: Cyperaemia, +hich is associated
+ith tra(ma; 0e+ton type 2: Denerai;ed
erythema; and 0e+ton type 3: Papiary
hyperpasia ony reso,ed )y s(r!ery.
&he pre,aence of dent(re stomatitis ,aries from
24E-*4E dependin! on the pop(ation st(died.
4
5n edery patients, the increased incidence of
disa)iity foo+in! conditions s(ch as stro.e
may imit their a)iity to effecti,ey cean their
dent(res. Poor dent(re hy!iene, contin(o(s
dent(re +earin! and dr(! therapy 6especiay
anti)iotics and steroids7 may ead to an
increased fre'(ency of yeast infection. &he
etioo!ica factors in dent(re stomatitis are
dent(re tra(ma and poor ora hy!iene +ith a
s(perimposed C. albicans infection7. Dent(re
stomatitis is more common in patients +ho +ear
their dent(res day and ni!ht.
*,7
&he st(dy of ,ario(s sites of ora m(cosa, ora
esions in reation to its de!ree of toerance or
,(nera)iity to dent(res sho(d emphasi;e the
importance of in,esti!atin! caref(y the
compaint of the patient. >,ery effort sho(d )e
e9erted to determine the so(rce of the tro()e
)efore (nderta.in! correcti,e meas(res of the
prosthesis.
Patients and methods
>dent(o(s patients +earin! compete dent(res
reportin! to the Prosthodontic Department of
deMontmorency Coe!e of Dentistry, "ahore
or referred from Dermatoo!y Department,
$atima %innah Medica Coe!e-=ir Dan!a Fam
Cospita, "ahore, from %an(ary 2011 to %(ne
2011 +ere as.ed to participate in the st(dy. &he
dia!nosis +as )ased on history of the patient,
cinica o)ser,ation of morphoo!y,
character-)eha,ior of the esions 6painess,
nonheain! for fe+ +ee.s-months7. /
re!istered patients +ere s()<ected to detaied
cinica e9amination of the esions ta.in! into
acco(nt the n(m)er, site, si;e, morphoo!y and
type of esions.
/ main factors +ere estimated in s()!ro(ps.
Ceanin! methods and fre'(ency +ere di,ided
into 3 s()!ro(ps respecti,ey as tooth )r(sh and
tooth paste-soap, dent(re ceansin! ta)ets and
sodi(m car)onate and 3 times a day, e,ery day
and once a +ee..
&he data +ere e,a(ated )y one +ay /012/, (
test, st(dent t test. &he e,e of statistica
si!nificance +as set at p30.04.
Results
10* patients 641 men and 44 +omen7, a!e ran!e
of 37-80 years +ith a mean a!e of *0 years +ere
re!istered. 1ra esions in od dent(re +earers
+ere e9amined, it +as fo(nd that ora esions
+ere more in femaes than maes. 1ra esions
+ere aso more fre'(ent in od a!e patients than
yo(n! patients. Fe!ardin! the se,erity of
esions, 0e+ton type 1 +as more fre'(ent than
type 2 and 3. &he fre'(ency of different esions
mentioned in Tale 1. Most of the patients cean
their dent(res +ith tooth )r(sh. 1ny 1 E (se
dent(re ceanin! ta)ets as sho+n in Tale 2.
Tale 1 &he fre'(ency of ora esions +ith !ender.
Oral lesions N&% Male Female
0e+ton &ype1 30 10 20
0e+ton &ype2 18 8 10
0e+ton &ype 3 21 * 14
>p(is fiss(rat(m 7 2 4
2ira stomatitis 4 3 2
1ra esions +ith c(taneo(s in,o,ement 2 1 1
='(amo(s ce carcinoma 1 1 0
Tale 2 $re'(ency of ceanin! and ceanin! methods of dent(res.
roup N &% ! times dail" #$er" da" Once a %eek
Dro(p 1 6tooth )r(sh ony7 40 7 A0 3
Dro(p 2 6tooth)r(sh and paste7 A8 8 34 4
Dro(p 3 6dent(re ceanin! ta)ets7 2 0 1 1
!iscussion
&he fre'(ency of ora esions reated to !ender,
a!e, the dent(re ceanin! ha)its, ed(cation e,e
and economic stat(s has )een st(died in
different societies i.e %apan, &(r.ey and many
>(ropean societies. &he res(ts of this st(dy
match the res(ts of other st(dies.
1,2,3
Most of o(r
patients )eon!ed to the o+er socioeconomic
stat(s as this st(dy +as done in a p()ic hospita.
Most of the patients +ho +ere see.in! ne+ sets
of prosthesis, on e9amination sho+ed different
ora esions. &his s(!!ests that these patients
need a treatment )efore the ne+ compete
dent(res can )e made. &he patients +ho had
fa))y rid!e, fi)ro(s infammatory hyperpasia,
tra(matic (cers and dent(re stomatitis persisted
statisticay si!nificant on!er than the patients
+ho had heathy tiss(es.
&o )rin! a)o(t a practica chan!e in dent(re
ceanin! )eha,ior, the dentist m(st reinforce the
ne+ )eha,ior on re!(ar )asis. 5n >(ropean
societies, the (se of dent(re ceanin! ta)ets is
common )eca(se of media p()icity +hereas
this st(dy sho+s patients (s(ay cean their
dent(re mechanicay )y )r(shin! or +ith paste.
&he roe of C. albicans in dent(re stomatitis is
,ery contro,ersia. Candida spp. may )e present
as commensa or!anism in norma heathy
pop(ation. 5n dent(re stomatitis, tra(ma ca(ses
infammatory e9(date +hich enhances the
adherence of C. albicans to dent(re s(rface. 5n
patients +ith dent(re stomatitis, no C. albicans
penetrates the dent(re acryic )(t it is present in
hi!h concentration on dent(re s(rface, especiay
in poro(s and (nderc(t areas. /ntif(n!a a!ents
do not need to )e prescri)ed ro(tiney and if
(sed aone res(t in reapse and fai(re to reso,e
the condition. &hese dr(!s sho(d )e prescri)ed
ony +here dent(re stomatitis fais to reso,e
and f(n!a in,o,ement has )een confirmed.
Dent(re disinfection can )e achie,ed )y soa.in!
the dent(re o,erni!ht in 0.2E chorhe9idine, this
a!ent is effecti,e a!ainst C. albicans aso
aternati,ey a mid so(tion of hypochorite can
)e <(st as effecti,e pro,ided the dent(res do not
contain a resiient soft inin! or meta )ase pate.
&he dent(res are soa.ed o,erni!ht in a dent(re
dish of +ater containin! a fe+ drops of
ho(sehod )each. 5n the mornin! the patient
m(st thoro(!hy rinse the dent(res )efore
pacin! them in the mo(th.
"onclusion
&he compete dent(re +earers sho(d )e
ed(cated in the importance of periodic
e9amination d(e to chan!es of s(pportin!
tiss(es and eary detection of m(cosa esions to
maintain their ora and dent(re hy!iene in
optim(m e,e.
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