Although it is often associated with infectious agents such as Candida species or Staphylococcus aureus, dentistry plays a central role in both its etiology and long-term management.
In many patients, angular cheilitis is a visible sign of underlying occlusal, prosthetic, or functional problems.
🦷 The Role of Dentistry in Angular Cheilitis
From a dental standpoint, angular cheilitis is frequently the result of mechanical and anatomical alterations that promote saliva accumulation at the labial commissures.
Persistent moisture weakens the epithelial barrier, making it susceptible to microbial colonization and chronic inflammation.
🔍 Main Dental Causes
1. Loss of Vertical Dimension
Reduction of the vertical dimension of occlusion—commonly due to tooth loss, severe attrition, or poorly designed prostheses—causes overclosure of the mouth.
This leads to skin folding at the commissures and constant saliva pooling, creating ideal conditions for angular cheilitis.
2. Poorly Adapted Dental Prostheses
Ill-fitting complete or partial dentures can alter lip support and facial height.
Instability, worn occlusal surfaces, or incorrect flange design often result in microtrauma and chronic moisture retention at the mouth corners.
3. Partial or Total Edentulism
The absence of posterior teeth compromises occlusal stability and facial support.
Without proper rehabilitation, patients experience functional collapse that directly contributes to commissural lesions.
4. Occlusal Disorders
Deep bite, collapsed bite, or altered maxillomandibular relationships can change muscular dynamics and facial posture, increasing the risk of angular cheilitis—especially in older adults.
5. Old or Worn Dentures
Long-term denture use without periodic evaluation leads to progressive bone resorption and loss of vertical dimension.
This makes angular cheilitis a common finding in geriatric dental patients.
6. Inadequate Oral and Prosthetic Hygiene
Poor hygiene allows fungal and bacterial overgrowth. When combined with constant salivary humidity, this significantly increases the risk of recurrent or chronic angular cheilitis.
🧠 Clinical Approach and Management
Effective management of angular cheilitis must go beyond topical therapy.
While antifungal or antibacterial agents may control acute symptoms, recurrence is likely if the dental cause is not addressed.
A comprehensive approach should include:
✔ Evaluation and restoration of vertical dimension
✔ Adjustment or replacement of dental prostheses
✔ Correction of occlusal discrepancies
✔ Reinforcement of oral and prosthetic hygiene protocols
🦷 Key Takeaway for Dental Professionals
Angular cheilitis should be viewed as a multifactorial condition with a strong dental component.
Recognizing and correcting the underlying odontogenic causes not only resolves the lesion but also improves oral function, facial aesthetics, and overall patient comfort.
