1. First line of treatment 
    1. Educate the pt 
    2. Discontinue wearing dentures 
    3. Gels 
  2. Denture stomatitis 4m***
    1. TYPE 1
      1. Localized type
      2. Same as sore mouth 
      3. Cause 
        1. Trauma 
        2. Localized infection 
      4. Pinpoint redness or hyperemia 
    2. TYPE 2
      1. Erythematous type
      2. Generalised diffuse appearance
      3. Type 2 and 3 are always associated with plaque accumulation
    3. Type 3 
      1. Also called Granular denture stomatitis 
      2. Involves hard palate and alveolar ridges
      3.  
    4. Candida associated denture stomatitis
      1. MC seen in diabetic pts 
      2. Mycelia present in the smear
      3. Presence of angular cheilitis 
      4. Higher risk for diabteic pt 
    5. Inflammatory papillary hyperplasia 
      1. Advanced stomatitis 
      2. This is a cancerous growth 
      3. Benign lesion = nodular 
      4. Not more than 2 mm in size 
      5. Location = hard palate 
  3. SORE SPOT 4m***
    1. It means small ulcers
    2. They usually develop within 1 to 2 days after placement of new dentures. 
    3. They are small, painful lesions covered with a grey necrotic membrane and surrounded by an inflammatory halo with firm, elevated borders. 
    4. Etiology 
      1. Due to unbalanced occlusion 
      2. Due to overextension of flanges like in frenum region
      3. Due to bony spicule impingement
      4. Immunocompromised drugs
    5. Fleeting painful sores = Short term sore spot  
    6. Treatment 
      1. In normal patients, these ulcers heal within a few days after correcting the dentures. 
      2. If no treatment is administered, it may progress to denture irritation hyperplasia. 
  4. EPULIS FISSURATUM 2m**
    1. Also known as denture irritation hyperplasia 
    2. Because of unstable denture = lot of load and trauma on denture bearing areas
    3. It is a hyperplastic reaction of the mucosa occurring along the borders of the denture. 
    4. Symptoms 
      1. flaps of hyperplastic connective tissue. 
      2. Deep ulcerations, fissuring and inflammation may occur at the depth of the sulcus. 
    5. The lesions usually subside after surgical excision of the tissues and correction of the dentures.
    6. Recurrence is rare. 
    7. These lesions may produce severe lymphadenopathy mimicking a neoplasm. 
  5. BURNING MOUTH SYNDROME 4m***
    1. Difficult to identify the main cause
    2. As there is No visible changes in oral mucosa
    3. Pain starts in the morning and aggravates during the day.
    4. Burning sensation is usually accompanied with dry mouth and persistent altered taste sensation.
    5. Local factors 
      1. Mechanical irritation caused by ill-fitting dentures.
      2. Constant excessive friction on the mucosa.
      3. Candidal infections and allergic reactions can
        produce symptoms similar to BMS.
      4. Myofascial pain.
    6. Systemic factors
      1. Vitamin and iron deficiency
      2. Xerostomia
      3. Menopause
      4. Diabetes
      5. Medication.
    7. Psychogenic Factors
  6. Treatment
    1. Generally BMS patients are more psychologically affected. 
    2. They consider that their psychiatric disorders are due to poor dentures. 
    3. These patients may need counselling to understand the irrelevance of the dentures with regard to their mental health and also to eliminate their fears. 
    4. The patient’s symptoms are given first priority.
    5. Soft Tissue conditioners 
    6. Remake new denture or relining/rebasing the denture