Management of Swollen Gums from Ill-Fitting Dentures
The dental team must eliminate the source of trauma by adjusting or refitting the ill-fitting dentures, and patients should defer wearing the dentures as much as possible until the gingival tissues heal. 1
Immediate Denture Management
- Remove the dentures immediately and discontinue wearing them until the inflamed gingival tissues have healed 1
- Have a dentist evaluate and correct the denture fit within 24-48 hours, as ill-fitting prostheses are a direct source of mechanical trauma that must be eliminated 1, 2
- If hospitalized or the dentures must be worn temporarily, soak them for 10 minutes in an antimicrobial solution (e.g., chlorhexidine 0.2%) before inserting them into the mouth 1
Oral Hygiene Protocol During Healing
- Clean the swollen gums gently with a soft toothbrush or swab after meals and before sleep to reduce bacterial load without causing additional trauma 1
- Rinse the mouth with an alcohol-free bland rinse (1 teaspoon salt, 1 teaspoon baking soda in 4 cups of water) at least four times daily for approximately 1 minute, then spit out 1
- This salt and sodium bicarbonate combination raises oral pH, prevents overgrowth of acidogenic bacteria, and promotes healing 1
- Avoid alcohol-containing mouthwashes, as they can further irritate inflamed tissues 1
Denture Hygiene Protocol
- Remove dentures before performing oral care 1
- Brush dentures thoroughly with toothpaste and rinse with water after each meal and at bedtime 1
- Remove dentures from the mouth for at least 8 hours per 24-hour period (typically overnight) and soak in the rinsing solution 1
- This nocturnal removal allows traumatized tissues to recover and reduces Candida biofilm development 3
Moisturization and Supportive Care
- Moisturize the oral cavity with water-based or non-petroleum-based lubricants such as plant- or animal-based fats (beeswax, cocoa butter, lanolin) 1
- Apply lubricant after each cleaning, at bedtime, and as needed throughout the day 1
- Drink ample fluids to keep the mouth moist and support tissue healing 1
- Avoid petroleum-based products (vaseline/white paraffin) for chronic use, as they promote mucosal dehydration and increase infection risk 1
Assess for Denture Stomatitis
- Examine the palatal mucosa and areas in contact with dentures for erythema, swelling, or edema, as denture stomatitis affects 17-75% of denture wearers and is often caused by Candida albicans biofilm 3
- If denture stomatitis is present, consider topical or systemic antifungal therapy in addition to the measures above 3, 4
- Poor denture hygiene, long-term denture wear, and ill-fitting dentures facilitate Candida biofilm development 3
Avoid Irritating Stimuli
- Instruct patients to avoid smoking, alcohol, citrus fruits, tomatoes, hot drinks, and spicy, hot, raw, or crusty foods during the healing period 1, 5
- These substances can exacerbate inflammation and delay tissue recovery 1
Critical Pitfall to Avoid
Do not allow the patient to continue wearing ill-fitting dentures while attempting symptomatic treatment alone—this perpetuates the mechanical trauma and prevents healing, potentially leading to chronic inflammation, denture irritation hyperplasia, or more severe complications 1, 6. The source of trauma must be eliminated first 1.
Follow-Up
- Reassess gingival tissues within 2 weeks to ensure adequate healing 2
- If swelling persists despite proper denture adjustment and hygiene measures, reevaluate for underlying conditions such as denture stomatitis, systemic disease, or other oral pathology 3, 4
- Once tissues have healed, the patient may resume wearing properly fitted dentures with continued adherence to denture hygiene protocols 1