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Pathology · single question

A complete-denture wearer presents with erythematous denture stomatitis (chronic atrophic candidiasis) of the palate. What is the best initial management?

  1. Start with a systemic antifungal regardless of severity
  2. Start with a topical antifungal (e.g., nystatin or miconazole) and reserve systemic antifungals for cases where topical therapy fails or the patient is medically compromised
  3. Topical antifungal only, and the patient may continue wearing the denture day and night as usual
  4. No treatment is necessary; it will self-resolve
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Correct answer: B. Start with a topical antifungal (e.g., nystatin or miconazole) and reserve systemic antifungals for cases where topical therapy fails or the patient is medically compromised

Topical antifungals are first-line. Systemic therapy (fluconazole, itraconazole) is reserved for refractory cases or immunocompromised/diabetic patients. Equally important — and often tested — is denture hygiene: the denture itself harbors Candida, so it must be cleaned, disinfected (soaked in an antifungal/antiseptic solution), and left OUT at night to break the reinfection cycle.

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