The Role of Antifungal Agents in Treating Denture Stomatitis

Abstract

Dentures made from acrylic resin based polymeric systems were popular because of their ease of moulding, excellent esthetic appearance and suitable mechanical characteristics in most clinical conditions. However, these denture bases are easily colonized by oral microorganisms which can induce a chronic inflammatory response in the oral mucosa, described as denture stomatitis. The primary etiological factor for denture stomatitis is associated with the growth of Candida species on the fitting surface of the denture where there is less flow of saliva resulting in anaerobic conditions and decrease in pH. Other factors such as poor denture hygiene, continuous denture wearing, ill-fitting dentures, the amount of tissue covered by dentures, wearing denture at night, smoking, carbohydrate-rich diet and allergy to denture base material may also lead to denture stomatitis. The treatment for Candidiasis includes denture replacement, adoption of prophylactic measures by the patient and prescription of antifungal drugs. For elderly and institutionalized patients this treatment is further complicated because of factors such as loss of memory, difficulty in proper cleaning of the denture and following a strict routine of topical application of an antifungal agent. These limitations have encouraged the development of other methods of drug delivery, such as incorporation of antifungal agents into denture base materials. The rationale for the development of such material is to ensure delivery of antifungal agents at the site of action within minimum possible concentration. This paper discusses the types of antifungal agents incorporated into the denture base materials in order to prevent denture stomatitis.