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Mouth Diseases

What can cause all these conditions in mouth?

02/28/2009

Question:

After dental implants and new dentures, my mouth now stays dry, bitter taste, milky spit and food has no taste other than the blah or bitter taste. the area the dentures (horseshoe cut on top) is very red and the roof is white, looks like i have the denture in when it is removed because of the red and white roof. My dentists can`t figure out what is wrong and I have spent $24,000.00 out of pocket for this bad taste and etc. any suggestions. thanks

Answer:

There are a number of things that may be causing your unpleasant clinical presentation. Altered taste can be the result of medication, vitamin deficiencies (Zinc), infection, trauma, dental material hypersensitivity (Lichenoid-type reaction), and xerostomia (many etiologies associated with this disorder), just to list a few.

Based upon your description of the palatal tissue disturbance I would seriously consider in my differential diagnosis Candida sp. yeast infection. Denture base acrylic acts as a scaffolding for the attachment of this infectious agent, and it is very likely that you are reacting to the over-growth of Candida. Yeast infections have been related to dysgeuisa or altered perception of taste (bitter, metallic, salty). The "milky spit" may in actuality be a combination of sloughed or desquamitive tissue and milky yeast (Candida albicans; the most common species, Candida albicans actually translates to white or chalk-like, similar to the color of Roman robes or capes). The descriptive name probably was their attempt to describe the pseudomembranous form of the dimorphic yeast (2 forms or stages dependent upon physical conditions it exists in).

I would have your dentist examine you for the possibility of yeast infection. Culturing may be difficult as would mucosal smears for definitive diagnosis as we all carry yeast at one time or another. Thus you may require treatment with an antifungal agent to rule out yeast infection.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University