Denture stomatitis with multiple intramucosal fistulae

A hitherto undescribed clinical and histologic entity occurring in the palate of 13 denture-wearing patients is described. Clinically it is characterized by the presence of small yellowish areas in the hard palate, which on pressure yield a whitish creamy material through multiple openings. The surrounding mucosa may exhibit various degrees of erythema. The histologic changes are characterized by the presence of intramucosal fistulae lined with unkeratinized squamous epithelium. The content of the fistulae, which corresponds to the creamy material expelled, consists of desquamated epithelial cells. These changes have mostly been noticed in elderly females, all wearing maxillary dentures for many years. This entity is considered a type of denture stomatitis characterized by intramucosal proliferation of epithelium, possibly because of long-standing chronic irritation from dentures. The origin of the intramucosal fistulae is unknown. The fistulae are believed to originate either from the ductus of the minor salivary glands or from the surface epithelium of the palate.