25 May 2017
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Dental Fungal Infections – Short Notes

Dental Fungal Infections – Short Notes

 

Oral Candidosis (Thrush)

  • ‘a disease of the diseased’
  • Has a high incidence in HIV patients.

Clinical Features

  • Thrush forms soft, friable and creamy coloured plaques on the mucosa.
  • They can easily be wiped off to expose an erythematous mucosa.
  • Predisposing factors include Denture wearing, smoking, Antibiotic treatment, xerostomia and Immunodeficiency.
  •  A stained smear shows large masses of tangled hyphae, detached epithelial cells and leucocytes.

Management

  • If the cause is from use of a steroid inhaler – advise rinsing after using the inhaler
  • Control of any topical antibiotic treatment can cause thrush to resolve; if this is not possible then:
  • A course of NYSTATIN or AMPHOTERICIN lozenges.
  • Failure to respond to these topical antifungals suggests immune deficiency.

Angular Stomatitis

  • Caused by leakage of candida infected saliva at the angles of the mouth.
  • Can be seen in denture wearers.

Clinical Features

  • Mild inflammation at the angles of the mouth.
  • In patients with denture induced stomatitis inflammation frequently extends along folds of the facial skin extending from the angles of the mouth.
  • These are caused by closed bite and sagging of the facial tissues with age.

Management

  • Treatment of intra oral candidosis alone causes angular stomatitis to resolve.
  • If there is a co-infection with Staph aureus then local application of fuscidic acid cream may be required.
  • A swab is required in some cases to establish the causative organism.

Denture-induced stomatitis

Key features and management

  • Risk factors include a well fitting denture, poor denture hygiene, and keeping the denture in the mouth overnight.
  • Enclosed mucosa is cut off from protective action of saliva.
  • Redness of the mucosa that is sharply restricted to the area covered by the denture.
  • Smear shows gram positive hyphae
  • Management is by antifungal treatment.

 

Article by Simranjeet Kaur – Liverpool Dental Student