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Epulis fissuratum is an overgrowth of tissue around the flange of a denture that does not fit correctly. The tissue is usually firm with a pinkish appearance, and it has a distinctive fissure where the edge of the flange sits. Denture-wearers can develop this condition if they don’t attend regular appointments to check the fit of their dentures and receive periodic adjustments to make sure their oral health is maintained. Women appear more likely to experience epulis fissuratum than men, although the reasons behind this are not clear.
When dentures don’t fit properly, they can rub against the cheek and gums, causing irritation over time. Patients may notice problems like pain and soreness, trouble eating, and a feeling of general discomfort. This inflammation can eventually trigger excessive cell growth, and in some cases the new tissue also ulcerates, becoming red, raw, and tender to the touch. The epulis fissuratum may be identified on a routine dental examination or when a patient goes to the dentist to complain of oral pain.
People using dentures may not be aware that the shape of the mouth can change over time, and the material in the dentures can also compress. They need periodic checkups to confirm that the dentures fit right and are safe to use. It may be necessary to reline dentures with new material, remodel them, or replace them with an entirely new model. When patients receive dentures for the first time, they should ask for information about maintaining them, including recommendations on the timing of checkups for fit and comfort.
The immediate treatment for epulis fissuratum is oral surgery to remove the excessive tissue. It is advisable to send a sample to a pathologist for evaluation, because while epulis fissuratum is benign, overgrowth can also be a sign of malignancy. A dentist may want to be safe rather than sorry with a check for oral cancer, especially if a patient has a history of risk factors like smoking. Once the patient’s mouth has had a chance to heal, a specialist can refit dentures to the mouth and make recommendations for a maintenance schedule to prevent the recurrence of epulis fissuratum and keep the patient comfortable.
In cases where epulis fissuratum is actually a malignant condition masquerading as denture-induced irritation, the patient may need additional surgery, chemotherapy, or radiation. This can prevent recurrence of the unwanted growth and also protects the surrounding teeth and jaw from any remaining cancer cells. Regular checkups are typically recommended to make sure any signs of the cancer’s return are caught early so the patient can be treated rapidly.