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      Medium-chain fatty acids as an alternative treatment for denture stomatitis in older people

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          Abstract

          Objective

          To determine the effect of medium-chain fatty acids (MCFA) on the severity of denture stomatitis (DS) and the counts of Candida spp. in older people (OP) wearing removable prostheses (RP).

          Materials and methods

          This randomized, controlled and triple-blind study included forty-three OP presenting DS. The control group was treated with 0.12% chlorhexidine (CHX) and the experimental group with MCFA, 2 × /day for 15 days. Intraoral examination and counts of Candida spp. were performed at 0, 7, and 15 days. The differences between both groups in the decrease of the severity of DS and the viability of Candida spp. were determined clinically and microbiologically, respectively.

          Results

          OP carriers of RP treated with MCFA presented remission of the clinical signs of DS, but the Candida spp. counts only decreased significantly in the CHX-treated group at 7 days of treatment (p < 0.05). Besides, MCFA was shown to reduce the clinical signs of DS after the first week of application, while CHX after the second week.

          Conclusions

          The MCFA is effective in reducing the clinical signs of DS associated with oral candidiasis in subjects with RP. Both treatments showed a significant decrease in severity, for MCFA after the first week and for CHX two weeks after starting the corresponding treatment.

          Clinical relevance

          The MCFA is an effective, harmless, and accessible treatment alternative against DS, since it manages to reduce the severity of the lesion in the milder cases of DS in the oral mucosa of OP carriers of RP.

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          Most cited references31

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          Epidemiology and etiology of denture stomatitis.

          Zvi Loewy, Kerry Gendreau (2011)
          Denture stomatitis, a common disorder affecting denture wearers, is characterized as inflammation and erythema of the oral mucosal areas covered by the denture. Despite its commonality, the etiology of denture stomatitis is not completely understood. A search of the literature was conducted in the PubMed electronic database (through November 2009) to identify relevant articles for inclusion in a review updating information on the epidemiology and etiology of denture stomatitis and the potential role of denture materials in this disorder. Epidemiological studies report prevalence of denture stomatitis among denture wearers to range from 15% to over 70%. Studies have been conducted among various population samples, and this appears to influence prevalence rates. In general, where reported, incidence of denture stomatitis is higher among elderly denture users and among women. Etiological factors include poor denture hygiene, continual and nighttime wearing of removable dentures, accumulation of denture plaque, and bacterial and yeast contamination of denture surface. In addition, poor-fitting dentures can increase mucosal trauma. All of these factors appear to increase the ability of Candida albicans to colonize both the denture and oral mucosal surfaces, where it acts as an opportunistic pathogen. Antifungal treatment can eradicate C. albicans contamination and relieve stomatitis symptoms, but unless dentures are decontaminated and their cleanliness maintained, stomatitis will recur when antifungal therapy is discontinued. New developments related to denture materials are focusing on means to reduce development of adherent biofilms. These may have value in reducing bacterial and yeast colonization, and could lead to reductions in denture stomatitis with appropriate denture hygiene. © 2011 by The American College of Prosthodontists.
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            Short- and medium-chain fatty acids exhibit antimicrobial activity for oral microorganisms.

            Chifu B. Huang, Yelena Alimova, Taylor Myers … (2011)
            This study assessed the antibacterial activity of short-, medium-, and long-chain fatty acids against various oral microorganisms. The short-chain fatty acids [formic acid (C1), acetic acid (C2), propionic acid (C3), butyric acid (C4), isobutyric acid (C4), isovaleric acid (C5), hexanoic acid (C6)], medium-chain fatty acids [octanoic acid (C8), capric acid (C10), lauric acid (12)], and long-chain fatty acids [myristic acid (C14), palmitic acid (C16)], were investigated for antimicrobial activity against Streptococcus mutans, Streptococcus gordonii, Streptococcus sanguis, Candida albicans, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Porphyromonas gingivalis. The data demonstrated that the fatty acids exhibited patterns of inhibition against oral bacteria with some specificity that appeared related more to the bacterial species that the general structural characteristics of the microorganism. As a group the fatty acids were much less effective against C. albicans than the oral bacteria, with effectiveness limited to hexanoic, octanoic, and lauric acids. Formic acid, capric, and lauric acids were broadly inhibitory for the bacteria. Interestingly, fatty acids that are produced at metabolic end-products by a number of these bacteria, were specifically inactive against the producing species, whilst substantially inhibiting the growth of other oral microorganisms. The results indicate that the antimicrobial activity of short-chain fatty acids (SCFAs), medium-chain fatty acids (MCFAs), long-chain fatty acids (LCFAs) could influence the microbial ecology in the oral cavity via at least 2 potential pathways. First, the agents delivered exogenously as therapeutic adjuncts could be packaged to enhance a microbial-regulatory environment in the subgingival sulcus. Second, it would be the intrinsic nature of these fatty acid inhibitors in contributing to the characteristics of the microbial biofilms, their evolution, and emergence of species within the biofilms. Further studies on these functions are required to better understand the nature of these potential microbial interactions in the biofilms. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Prevalence of oral mucosal lesions in elderly people in Santiago, Chile.

              J. Gamonal, R Rojas, W. Aranda … (2003)
              Oral prevalence studies are important to know the state of health and the needs of treatment. Our aim was to determine the prevalence of oral mucosal lesions and associated factors among aging Chileans. A random sample by age, gender, and socioeconomic status was obtained, comprising 889 individuals older than 65 years. Individuals were interviewed and examined in Santiago, the capital of Chile, according to the World Health Organization guidelines. The prevalence of one or more oral mucosal lesions in the sample was 53%. Logistic regression model revealed that denture use increased the probability of one or more oral mucosal lesions by threefold, while age, gender, smoking, medication use, xerostomia, and social or cultural factors had no effect. The most common lesion was denture stomatitis (22.3%), followed by irritative hyperplasia (9.4%), oral mucosal varicosities (9%), solitary pigmented lesions (4%), traumatic ulcer (3.5%), angular cheilitis (2.9%), multiple pigmented lesions (2.8%), hemangioma (2.3%), lichen planus (2.1%), leukoplakia (1.7%), recurrent aphthous stomatitis (1.4%), nicotine stomatitis (1.3%), median rhomboid glossitis (0.9%), actinic cheilitis (0.9%), pyogenic granuloma (0.7%), oral squamous papiloma (0.6%), and mucocele (0.2%). One case of oral cancer was observed. Different factors increased the probability of specific oral mucosal pathologies. We can conclude that oral mucosal lesions are common in elderly people in Santiago, suggesting the necessity for improved standards of prevention, and diagnostic and opportune treatment of these lesions.
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                Author and article information

                Contributors
                Carla P. Lozano:
                ORCID: http://orcid.org/0000-0002-1294-3677
                clozano@odontologia.uchile.cl
                Journal
                Journal ID (nlm-ta): Clin Oral Investig
                Journal ID (iso-abbrev): Clin Oral Investig
                Title: Clinical Oral Investigations
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 1432-6981
                ISSN (Electronic): 1436-3771
                Publication date (Electronic): 29 May 2023
                Pages: 1-8
                Affiliations
                [1 ]GRID grid.443909.3, ISNI 0000 0004 0385 4466, Institute for Research in Dental Sciences, Faculty of Dentistry, , University of Chile, ; Olivos 943, Independencia, Santiago, Chile
                [2 ]GRID grid.443909.3, ISNI 0000 0004 0385 4466, Department of Health Sciences Education, Faculty of Medicine, , University of Chile, ; Profesor Alberto Zañartu 1060, Independencia, Santiago, Chile
                [3 ]Inter university Center on Healthy Aging (CIES), Santiago, Chile
                [4 ]GRID grid.443909.3, ISNI 0000 0004 0385 4466, Department of Paediatric Dentistry and Dentofacial Orthopaedics, Faculty of Dentistry, , University of Chile, ; Olivos 943, Independencia, Santiago, Chile
                Author information
                http://orcid.org/0000-0002-1294-3677
                Article
                Publisher ID: 4987
                DOI: 10.1007/s00784-023-04987-3
                PMC ID: 10225286
                PubMed ID: 37247088
                SO-VID: 7dda6e82-038b-4df5-b7f6-1ff00fed0dc4
                Copyright © © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 27 January 2023
                Date accepted : 28 March 2023
                Funding
                Funded by: Chilean National Research and Development Agency (ANID), the Chilean Government
                Award ID: FONIS SA19I0025
                Award ID: FONIS SA19I0025
                Award ID: FONIS SA19I0025
                Award ID: FONIS SA19I0025
                Award Recipient :
                Categories
                Subject: Research

                ScienceOpen disciplines: Dentistry
                Keywords: denture stomatitis,older people,medium-chain fatty acids,chlorhexidine
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: denture stomatitis, older people, medium-chain fatty acids, chlorhexidine

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