A patient with angular cheilitis and red swollen commissures wearing complete dentures — which of the following is LEAST likely to be a contributing factor?

Correct answer: B. Increased vertical dimension of occlusion (VDO)

• A. Decreased saliva pooling at commissures from decreased VDO is a classic mechanism for angular cheilitis.
• B. Correct. INCREASED VDO would cause the lips to be held more open/apart, reducing commissure folding — this would NOT typically contribute to angular cheilitis. It is the exception. Conversely, DECREASED VDO causes lip commissure folding and saliva pooling that promotes candidal infection.
• C. Ill-fitting dentures that have lost their vertical dimension are a common cause of angular cheilitis.
• D. Candida infection is a primary cause of angular cheilitis (perleche).