Denture plaque — past and recent concerns

Objective: This paper critically reviews the history of denture plaque and identifies some concerns with the presence of Candida in the mouth. Data sources: This review covers literature sources related to Candida albicans and its relationship to denture plaque. Study selection: The articles selected for this review are from refereed journals and describe C. albicans and its relationship to oral, gastrointestinal and pleuropulmonary infections. The relationship to caries, root caries and periodontal disease is also covered. Conclusions: Denture plaque containing Candida could cause not only oral candidiasis, like oral thrush or denture-induced stomatitis, but also caries, root caries and periodontitis of abutment teeth. However, there is only limited experimental evidence or information available on the cariogenicity of Candida. The continuous swallowing or aspiration of micro-organisms from denture plaque exposes patients, particularly the immunocompromised host or medicated elderly, to the risks of unexpected infections. The term, ‘denture plaque’ has been used throughout the review. However, the term ‘plaque on denture’ should be used because the microbial flora and its pathogenicity of denture plaque resembles those of plaque formed on the tooth surface, so called dental plaque. In addition, the term ‘denture related stomatitis’ would be preferable to ‘denture induced stomatitis’, since the inflammation of (palatal) mucosa is not induced by the denture, but by wearing the denture or by plaque on the denture.