Prosthodontics & Occlusion · single question
A patient has pain at the corner of the mouth. What is the most likely cause?
Show answer and explanation
Correct answer: A. Insufficient VDO — Candida infection (Angular Cheilitis)
Insufficient VDO (decreased vertical dimension of occlusion) leading to Candida-associated Angular Cheilitis (A). When the VDO is reduced (overclosed), the corners of the mouth droop downward, creating deep skin folds at the commissures. Saliva pools in these folds → maceration → Candida albicans infection → angular cheilitis (perleche).
• This is especially common in edentulous patients with old, worn dentures (loss of VDO over time) and in patients with reduced inter-arch space.
• Treatment: antifungal cream (nystatin, clotrimazole) at the commissures + correct the VDO by remaking/relining the dentures.
• Increased VDO (B): would cause TMJ strain, muscle pain, cracked teeth — not angular cheilitis.
• Angular cheilitis can also be caused by: nutritional deficiencies (B2, B3, B6, iron, zinc), HIV, Sjögren's.
• This is especially common in edentulous patients with old, worn dentures (loss of VDO over time) and in patients with reduced inter-arch space.
• Treatment: antifungal cream (nystatin, clotrimazole) at the commissures + correct the VDO by remaking/relining the dentures.
• Increased VDO (B): would cause TMJ strain, muscle pain, cracked teeth — not angular cheilitis.
• Angular cheilitis can also be caused by: nutritional deficiencies (B2, B3, B6, iron, zinc), HIV, Sjögren's.
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