title: Denture induced stomatitis, patient and denture related factors
Creators: name: Calvert, Gareth David
Publisher: name: University of Glasgow
Year: 2018
Subjects: subject: Denture stomatitis.

description: Purpose: Denture hygiene habits are highly variable amongst denture wearers, and can be frequently non-existent. Approximately 20% of the UK population wear some form of denture prosthesis. Almost half of these individuals show signs of denture induced stomatitis. There is currently a lack of evidence of how certain denture hygiene habits influence denture plaque composition, and whether this directly contributes towards oral inflammation and associated morbidity. Moreover, Candida albicans is primarily attributed as the causative agent due to its biofilm forming ability, thought to be influenced by the denture material, and in turn their effectiveness of decontamination.
Aims: To assess denture hygiene habits and risk factors with respect to host and microbial factors on the clinical presence of denture induced stomatitis. Also, to conduct in vitro analyses of biofilm formation of clinical denture isolates on various denture substrates and the antimicrobial activity of common denture cleansers. 
Materials and methods: Data regarding participant demographics and denture hygiene habits were collected using a standardised questionnaire. Denture plaque samples were analysed from participants wearing either a complete or partial denture, and Candida spp. enumerated. Data on the bacterial microbiome composition of each participant was analysed in respect to denture hygiene habits. C. albicans isolated from dentures of healthy and diseased individuals was quantified using real-time polymerase chain reaction and biofilm biomass assessed using crystal violet. Biofilm development on the denture substratum polymethylmethacrylate, Molloplast B and Ufi-gel was determined. Early and mature biofilms were treated with popular over the counter denture hygiene products and assessed using metabolic and biomass stains.

Results: Clinical data suggests the presence of denture induced stomatitis was positively associated with a history of smoking, denture design, poor denture hygiene, and retention of dentures whilst sleeping. Although C. albicans was detected in greater quantities in diseased individuals, it was not significantly associated with denture induced stomatitis. Microbiome analysis indicated that poor denture hygiene did not reveal any significant changes in microbiome composition in comparison to satisfactory oral hygiene. Neither did frequency of denture cleaning or sleeping whilst wearing a denture in situ reveal significant changes in the denture plaque composition. Denture substrata were shown to influence biofilm biomass, with polymethylmethacrylate providing the most suitable environment for C. albicans to reside. Of all the denture hygiene products tested, Milton had the most effective antimicrobial activity on early biofilms, reducing biofilm biomass and viability the greatest.
Conclusions: This study has shown that denture hygiene practices appear to have minimal direct influence on the composition of the denture microbiome and clinical presence of denture induced stomatitis, reinforcing the idea that denture induced stomatitis is a multifactorial disease, influenced by host, microbial and environmental factors.