Fungal infection in patients wearing dentures

The fungal infection of the oral cavity is caused by the proliferation of the fungus species Candida albicans, also known as oral thrush, which is present in the human body even under normal circumstances. There are factors, however, that cause this fungus to proliferate giving rise to complaints in different areas of the body such as the oral cavity. On many an occasion prosthetic materials and dentures provide excellent breeding ground to fungi.

What may trigger the formation of oral fungus?

The proliferation of Candida (aka candidiasis) may also be triggered by factors like smoking, inadequate oral hygiene, mechanical injury, medical treatment or a depleted immune system.

People on prolonged or high-dose antibiotic treatment, or wearing dentures, diabetics and patients using asthma inhalers are at increased risk. Dry mouth, pregnancy, having undergone an organ transplant and a stressed lifestyle contribute to an increased susceptibility to develop oral candidiasis, the disease usually presenting in infants during lactation.

How frequent is fungal infection in patients wearing dentures?

Unfortunately as many as 50 to 70 per cent of patients wearing dentures suffer from oral thrush. The proportion of women slightly outweighs that of men. More often not patients are even unaware of their fungal infection, they merely experience a slightly metallic taste in the mouth at best.

What are the symptoms associated with oral thrush?

The fungal infection of the oral cavity develops all of a sudden but tends to linger on with a long recovery time.The accompanying symptoms of fungal infection include cracks in the corner of the mouth, difficulties swallowing, bad breath and an unpleasant metallic taste in the mouth.In patients wearing dentures the mucosa covered by the denture and the tongue are red and sore. More often than not a sharp borderline can be observed between the areas covered and not covered by the denture.

How can oral thrush be prevented?

Oral thrush is best prevented by thoroughly cleaning the denture with a denture brush several times a day and disinfecting it on a regular basis. (For the avoidance of damage see that the denture is cleaned over a basinful of water to guard against breakage in case the denture dropped). In severe cases the fungi are so firmly established in the denture that only a replacement will help.

Denture brush and its use

If possible, refrain from the excessive use of mouth sprays and mouth rinse. Although these devices contribute to a fresh and clean feel of the oral cavity their excessive use may topple the normal chemical balance of the oral cavity, favouring thereby the proliferation of fungi.

By quitting smoking: as smoking not only promotes the fungal infection of the oral cavity but also increases susceptibility to oral cancer, it is advisable to let go of this harmful addiction as soon as possible.

By regularly monitored blood sugar levels: diabetics are five times more exposed to the risk of oral thrush, making regularly monitored and controlled blood sugar levels essential.

If possible, refrain from food containing excessive amounts of sugar and yeast as it may promote the proliferation of Candida, which is a common type of yeast.

Regular dental examinations are of crucial importance. By reporting for regular dental check-ups on a half-yearly basis you stand a good chance of timely detecting the infection which is a great deal easier to treat in the initial phase.

By having the occlusal height of the denture checked by the doctor and a reline performed every few years.

How can the infection be treated?

The diagnosis of oral thrush is established, and its treatment modality is prescribed, by a dental specialist.

Systemic treatment includes Nystatin pills or Diflucan suspension, whereas external treatment is best performed with rinses, topical applications (Nystatin solution), gels and creams. It is advisable to have the denture subjected to ultrasonic cleaning by a technician. Since there may be a number of other diseases conducive to the formation of oral thrush, other medical examinations and the replacement or discontinuation of previously taken medicines may also be in order to prevent the recrudescence of fungal infection.

If possible, wear the denture for as short a period as possible and never leave it inside overnight during the period the infection persists.