Denture-Related Stomatitis Is Associated with Endothelial Dysfunction

Abstract

Oral inflammation, such as periodontitis, can lead to endothelial dysfunction, accelerated atherosclerosis, and vascular dysfunction. The relationship between vascular dysfunction and other common forms of oral infections such as denture-related stomatitis (DRS) is unknown. Similar risk factors predispose to both conditions including smoking, diabetes, age, and obesity. Accordingly, we aimed to investigate endothelial function and major vascular disease risk factors in 44 consecutive patients with dentures with clinical and microbiological features of DRS (n = 20) and without DRS (n = 24). While there was a tendency for higher occurrence of diabetes and smoking, groups did not differ significantly in respect to major vascular disease risk factors. Groups did not differ in main ambulatory blood pressure, total cholesterol, or even CRP. Importantly, flow mediated dilatation (FMD) was significantly lower in DRS than in non-DRS subjects, while nitroglycerin induced vasorelaxation (NMD) or intima-media thickness (IMT) was similar. Interestingly, while triglyceride levels were normal in both groups, they were higher in DRS subjects, although they did not correlate with either FMD or NMD. Conclusions. Denture related stomatitis is associated with endothelial dysfunction in elderly patients with dentures. This is in part related to the fact that diabetes and smoking increase risk of both DRS and cardiovascular disease.

Treatment of denture-related stomatitis improves endothelial function assessed by flow-mediated vascular dilation

“…Endothelium-dependent, flow-induced brachial artery dilatation steadily improved during the treatment and reached statistical significance 2 months after finishing the therapy, showing a significant improvement in vascular function, while the control, nitroglycerine-induced endothelium-independent vasodilatation remained unchanged. This observation is therapeutically important and extends our recent report that vascular function is impaired in DRS [22]. While the previously described link could have been attributed to confounding factors, such as diabetes, the results presented in this paper show that endothelial function in DRS is directly related to oral infection and removal of this pathology results in significant improvement of vascular health.…”

“…However, the group defined as “denture users” was very heterogeneous, and it remains unclear how many denture users suffered from DRS, as the study was based on a patient questionnaire, making it difficult to draw firm conclusions. More recently we have described the presence of vascular endothelial dysfunction in DRS patients, compared to the denture patients with healthy oral mucosa [22]. Since endothelial dysfunction is known to precede the development of hypertension and atherosclerosis [23] with its complications, such as heart attack and stroke, it is essential to clarify the influence of DRS on the endothelial function.…”

A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1,534 cases

“…Smokers are also strong "candidates," as smoking induces a variety of changes in the oral cavity. 13,24 The present study found that most individuals afflicted with oral candidiasis were nonsmokers with no systemic diseases and no comorbid oral lesions.…”

“…However, there is still a lack of large single-center retrospective studies conducted to evaluate oral candidiasis for identifying common risk factors for oral candidiasis and comparing with those identified in other studies. 10,11,12,13,14 Thus, the present 18-year retrospective survey was performed to capture the local epidemiology of oral candidiasis at a specialist center for oral diagnosis in Brazil (Pelotas, Rio Grande do Sul) for identifying risk factors for oral candidiasis and to characterize the demographic and clinical profiles of affected patients.…”

Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis

“…The DS has been recently associated with systemic implications (variations in blood pressure and endothelial dysfunction) that precede the development of serious cardiovascular disorders, such as atherosclerosis and hypertension, which are changes in general health with high mortality / morbidity rates [16][17][18]. However, the mechanisms that correlate oral inflammation and cardiovascular effects are not yet fully described, but one of the most important hypotheses is the pre-activation of the immune system [17].…”