Lesions of the oral mucosa associated with the wearing of removable dentures may represent acute or chronic reactions to microbial denture plaque, a reaction to constituents of the denture base material, or a mechanical denture injury. These lesions constitute a heterogeneous group with regard to pathogenesis (Budtz‐Jorgensen 1981). They include stomatitis caused by dentures, angular cheilitis, traumatic ulcers, denture irritation hyperplasia, flabby ridges, and oral carcinomas (Budtz‐Jorgensen 1981).

Stomatitis caused by dentures is also termed as denture‐induced stomatitis, denture stomatitis and denture‐related stomatitis in the literature. It is the term used in the literature to indicate an inflammatory state of the denture bearing mucosa (Lombardi 1993). It is a pathology that is characterized by chronic erythema and oedema of part or all of the palatal mucosa under maxillary dentures (Cross 1998). It is the most common alteration on the palate of denture wearers (Pires 2002) and it affects particularly elderly people (Lombardi 1993). It was first graded by Newton according to the severity of its clinical appearance in: localized erythematous (or type I), diffuse erythematous (type II) and hyperplastic granular (type III) (Newton 1962).

Denture stomatitis is considered a multifactorial disease precipitated by several predisposing and aetiological factors (Lombardi 1993). Candida albicans is the most common of the isolates amongst denture stomatitis patients (Pires 2002). Until recently, however there has been controversy concerning the aetiology of the disease. Although some earlier investigators linked denture stomatitis with trauma or bacterial infection, others had isolated candida albicans from the mouths of patients with this condition (Radford 1999; Webb 1998a). It has been recently shown that the presence of candida albicans in denture stomatitis is probably related to an extensive degree of inflammation (Barbeau 2003) and that denture stomatitis is usually associated with the detection of candida species while other factors such as denture hygiene habits (Lombardi 1993; Pires 2002), and trauma (Webb 1998a) are important to the development of the disease. There is also some recent evidence indicating that nocturnal wear of dentures and smoking are other significant risk indicators to denture stomatitis (Barbeau 2003). Certain systemic conditions such as diabetes (Guggenheimer 2000) and/or defects in the immune system may also predispose the host to candida‐associated denture stomatitis (Webb 1998a).

There are several reports about the prevalence of denture stomatitis in the dental literature. Recent findings from a Chilean prevalence study indicate that denture stomatitis is the most common lesion amongst Chileans aged 65 years and over, affecting 22.3% of the individuals evaluated in a random sample of Santiago (capital of Chile) inhabitants (Espinoza 2003). In another study where aged individuals were evaluated, a prevalence of 18.3% of denture stomatitis was reported in a representative sample of Germans aged from 65 to 74 years (Reichart 2000). In Finland, the most common oral mucosa lesion affecting denture wearers is also denture stomatitis, with a reported prevalence of 25% (Nevalainen 1997). A Swedish study carried out in the Koster islands showed an image somewhat different, with a prevalence of denture stomatitis of 59.2% (Eliasson 1992). Denture stomatitis is also reported as the most frequent mucosa lesion in institutionalised elderly. A Brazilian report shows a prevalence of 20.0% of denture stomatitis in an institution located in Piracicaba, São Paulo (Jorge Júnior 1991).

There have been several traditional reviews concerning the treatment of denture stomatitis in the literature (Lombardi 1993). Their conclusions vary and cover findings about different treatment regimens, several of which have not been systematically investigated. While some advocate the use of antifungals (Jeganathan 1992; Webb 1998b) such as nystatin and amphotericin B for the treatment of denture stomatitis and consider it effective, at least initially (Webb 1998b), others believe that the use of antimycotic drugs seems unnecessary (Arendorf 1987). Unfortunately, therapeutic failure, when using antifungal agents (Webb 1998b) or when the local or systemic predisposing factors are not corrected (Budtz‐Jorgensen 1990), is not uncommon (Ellepola 2000). It is also not uncommon that the disease recurs if the appropriate therapy is stopped (Webb 1998b). Some alternatives to antifungal agents have also been described in the literature. The use of disinfecting agents, such as sodium hypochlorite (Webb 1998b) and chlorhexidine (Budtz‐Jorgensen 1990), aimed to eliminate denture plaque (Arendorf 1987; Jeganathan 1992) and to control colonization of the fitting denture surface by candida (Budtz‐Jorgensen 1990) and also some new alternatives, such as the use of microwave irradiation that, at a specified setting and exposure time, are bactericidal and fungicidal (Webb 1998b). Correction of denture faults (Arendorf 1987; Jeganathan 1992) and discontinuous denture wearing (Jeganathan 1992) are also considered important for the treatment of denture stomatitis.

Since it has not been established in the literature which is the best intervention to treat denture stomatitis we will perform a systematic review aimed to compare all randomized controlled trials where antimicrobial agents, denture replacement, correction of denture faults and other types of treatment as well as combinations of different types of treatments were used to treat denture stomatitis.