What’s new in the world of oral fungal infections?

This summary is based on the article published in the Dental Clinics of North America: Update on oral fungal infections (October 2013)

Key Messages

• Candidiasis is the most common oral fungal infection diagnosed in humans. Candidiasis may result from immune system dysfunction or as a result of local or systemic medical treatment. Because oral Candida is generally a localized infection, topical treatment methods are the first line of therapy, especially for the pseudomembranous and erythematous variants.
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  Patients with a dental prosthesis should also be advised to disinfect the prosthesis routinely during their Candida treatment period, as the prosthesis may serve as a source of fungal reinfection.
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  Patients should be advised that oral hygiene aids, such as toothbrushes and denture brushes, may also be contaminated and should be discarded or disinfected. A disinfection solution of sodium hypochlorite (1 part household bleach mixed with 10 parts water) may be used for non–metal-containing dental prosthesis and appliances, and oral hygiene aids.
• Occasionally the clinician will encounter a more resistant form of oral candidiasis, such as the hyperplastic variant or a variant that does not respond to topical therapy. Appropriate systemic therapy should be used for the treatment of these infections. In addition, a biopsy should be undertaken in individuals with the hyperplastic variant of Candida, as there is some degree of risk for malignant transformation.
• Deep fungal infections should be managed in association with appropriate medical specialists to rule out other systemic involvement.
• The dental health care provider plays an important part in the diagnosis and management of fungal disease, so clinicians should be aware of the presenting signs and symptoms of oral fungal disease.

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