title: Reducing the incidence of denture stomatitis: are denture cleansers sufficient?
abstract: OBJECTIVE
  Candida albicans is the predominant oral yeast associated with denture stomatitis. With an increasing population of denture wearers, the incidence of denture stomatitis is increasing. Effective management of these patients will alleviate the morbidity associated with this disease. The aim of this study was to examine the capacity of four denture cleansers to efficiently decontaminate and sterilize surfaces covered by C. albicans biofilms.
  
  
  METHODS
  Sixteen C. albicans strains isolated from denture stomatitis patients and strain ATCC 90028 were grown as mature confluent biofilms on a 96-well format and immersed in Dentural, Medical Interporous, Steradent Active Plus, and Boots Smile denture cleansers according to the manufacturers' instructions or overnight. The metabolic activity and biomass of the biofilms were then quantified, and scanning electron microscopy (SEM) used to examine treated biofilms.
  
  
  RESULTS
  Dentural was the most effective denture cleanser, reducing the biomass by greater than 90% after 20 minutes. Steradent Active plus was significantly more effective following 10-minute immersion than overnight (p < 0.001). All cleansers reduced the metabolic activity by greater than 80% following overnight immersion; however, Boots Smile exhibited significantly reduced metabolic activity following only a 15-minute immersion (p < 0.001). SEM revealed residual C. albicans material following Dentural treatment.
  
  
  CONCLUSIONS
  This study showed that denture cleansers exhibit effective anti-C. albicans biofilm activity, both in terms of removal and disinfection; however, residual biofilm retention that could lead to regrowth and denture colonization was observed. Therefore, alternative mechanical disruptive methods are required to enhance biofilm removal.
authors.affiliation: Section of Infection and Immunity, Glasgow Dental School, Faculty of Medicine, University of Glasgow, UK.
authors.forename: Anto
authors.initials: A
authors.lastname: Jose
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Coco
authors.forename: Steven
authors.initials: S
authors.lastname: Milligan
authors.forename: Beth
authors.initials: B
authors.lastname: Young
authors.forename: David F
authors.initials: DF
authors.lastname: Lappin
authors.forename: Jeremy
authors.initials: J
authors.lastname: Bagg
authors.forename: Colin
authors.initials: C
authors.lastname: Murray
authors.forename: Gordon
authors.initials: G
authors.lastname: Ramage
mesh_terms: D018441:Biofilms / Q000187:drug effects; D002176:Candida albicans / Q000187:drug effects*; D002180:Candidiasis, Oral / Q000517:prevention & control; D016009:Chi-Square Distribution; D003666:Decontamination / Q000379:methods*; D003820:Denture Cleansers / Q000494:pharmacology*; D003824:Denture, Complete / Q000382:microbiology; D006801:Humans; D018709:Statistics, Nonparametric; D013282:Stomatitis, Denture / Q000517:prevention & control*
chemical_list: D003820:Denture Cleansers