CANDIDIASIS

• GUIDED BY - • PRESENTED BY -
• Dr. Shilpashree H.S. • Shivangi vadangar.
• Dr. Siddhana Gouda. • Roll No-74
• Dr. Pranay Patel. • 4th year B.D.S.
 CANDIDIASIS
• OTHER NAMES

• Candidosis
• Monailiasis
• Thrush
 INTRODUCTION
• Candidiasis is most common type of fungal
infection that occurs in the oral cavity.
• It mainly caused by yeast like fungus,candida
albicans.
• Candida albican is an
oppturnistic fungal
pathogen that is responsible
for candidiasis in human hosts.
• Commonlly affected areas are
• mouth,Skin,genital,throat.
 classification
Oral candidiasis
• ACUTE
• Acute psedomembranous candidiasis
• Acute atropic candidiasis
• CHRONIC
• Chronic atrophic candidasis
• Denture stomatitis
• Median rhomboid glossitis
• Angular cheilitis
• Id reaction
• Chronic hyperplastcic candidiasis
• CHRONIC MUCOCUTANEOUS CANDIDIASIS
• Familial chronic mucocutaneous candidiasis
• Localized chronic mucocutaneous candidiasis
• Diffuse chronic mucocutaneous candidiasis
• Candidasis endocrinopathy syndrome.
• EXTAORAL CANDIDIASIS
• Oral candidiasis associated with extraoral
lesion,orofacial & intertriginous sites
• (candidal vuluovaginitis, intertriginous
candidiasis)
• Gastraintestinal candidiasis
• Candida hypersensitivity syndrome
• SYSTEMIC CANDIDIASIS
• Mainly affectes the eye, kidney & skin.
 CLASSIFICATION
• PRIMARY ORAL CANDIDIASIS
• ACUTE FORM
• pseudomembranous
• erythematous
• CHRONIC FORM
• hyperplastic
• erythematous
• pseudomembranous
• CANDIDA –ASSOCIATED LESION
• Denture stomatitis
• Angular stomatitis
• Median rhomboid glossitis
• KERANTINIZED PRIMARY LESION SUPER-
INFECTED WITH CANDIDA
• Leukoplakia
• Lichen planus
• Lupus erythematous
• SECONDARY CANDIDIASIS
• ORAL MAINFESTATION OF SYSTEMIC
MUCOCUTANEOUS CANDIDIASIS
• Diseases such as thymic aplasia & candida
endocrinopathy syndrome.
 Predisposing factor
• Marked changes in oral microbial flora
1. Due to the use of antibiotics
2. excessive use of antibacterial mouth rinses,or
xerostomia
• Chronic local irritants
1. Denture & orthodontic appliances
• Administration of corticosteroid
• Poor oral hygiene
• Pregnancy
• Nutritional deficiency
 PATHOGENESIS
• It is the common inhabitant of the oral cavity,
gastrointestinal tract and vagina.
• When the favorable condition develops,the
organism transform into hyphe.
• Thus it appears that the mere presence of fungus
is not sufficent to produce the disease.these must
be actual penetration of the tissues.
• It was considered to be only an infection,affecting
individual who were debilited by another dise.
 ACUTE PSEDOMEMBRANOUS
CANDIDIASIS (THRUSH)
• It is the most common form of candidiasis.

• It is a superficial infection of the

outer layer of the epithelium.

• Thrush is seen in chronically

ill patient or in children and
in adults of all ages.
 Clinical Features
• Infants
• Receiving systemic corticosteroid therapy.
• Soft white aderent patches on the oral
mucosa.
• Generally painless.
• Removed with little difficulty.
 Clinical Features
• Adult
• Appear as soft ,white,slightly elevated plaque
like lesions.
• Most frequently occuring on
• buccal mucosa and tongue
• but also seen on the palate,
• gingiva & floor of the mouth.
• Prodromal symptom :
• Rapid onset of bad taste
• Burning sensation of mouth
& throat.
• Plaque resembles like
• Milk curd or cottage cheese.
• Consist of tangled masses of fungal hyphe
with desquamated epithelium, keratin,
necrotic debris & bacteria.
• Plaque can usually wiped away with gauze,
• That leaves either normal mucosa,or an
erythematous area which is painfull.
 Differential Diagnosis
• Food debris
• Habitual cheek biting
• Rarely genetically determined epithelial
abnormality such as:
• white sponge nevus.
 Acute Atrophic Candidiasis
• It is also known as Antibiotic Sore Mouth.
• Prolonged drug therapy
• Topical steroid
• Broad spectrum antibiotics
• Denture wearers
 Clinical Freatures
• Any site but mainly involves
• Tongue or area facing prosthesis
• Red or Erythematous
• Pain or Burning sensation
• Erythematous appearance occurs due to loss
of filiform papillae.
 Chronic Atrophic Candidiasis
• Chronic atrophic candidiasis includes :

• Denture Stomatitis. (Denture sore mouth)

• Angular chelitis.

• Median rhomboid glossitis.

 Denture stomatitis
• It is also known as Denture sore mouth.
• Clinical Features
• Women are affected more
frequently than man.
• It is the most common form
of the oral disease.
• Numerous palatal patchies.
• More diffuse erythema involving of the denture
covered mucosa.
• Development of tissue granulation or nodularity
commonly involving the central areas of the hard
palate & alveolar ridgrs.
 Angular Cheilitis
• It is also called as angular cheilosis,
cheilocandidiasis, perleche.
• Micro-organisms : particularly candida
albicans,but also staphylococci,streptocci.
• Clinical Features
• It occurs in young children as well as in adults.
• It characterized by feeling of dryness & a
burning sensation at the corners of the mouth.
• Epithelium at the commissure appears
wrinkled as time,wrinkling becomes more
pronouced to form one or more deep fissures
or cracks which appear ulcerated.
 Median Rhomboidal Glossitis
• Erythematous patches of atrophic papillae
located in the central area of dorsum of
tongue are considered a form of chronic
atrophic candidiasis.
• Lesion become more nodular
the Condition referred to
• hyperplastic median rhomboid
glossitis.
 Chronic Hyperplastic Candidiasis
• Candidal leukoplakia
• Slightly white to dense white with cracks & fissures
occasionally.
• Associated with iron & folate deficiency and
defective cell mediated immunity.
• Clinical Features
• Firm adherent white patches
• Predominantly in men.
• Middle age or above –
• heavy smokers.
• Site: cheek,lip & tongue.
• Firm & white leathery plaque.
• Persist without any pain for years.
• Diffrential diagnosis
• Hairy leukoplakia
• Lichen planus
 Chronic mucocutaneous candidiasis
• Usually result of defect in cell mediated
immunity or may be iron deficiency.
• It is characterized by chronic candidal
involvement of
• skin
• Nails
• Scalp
• Mucous membrane.
 Chronic Localised mucocutaneous
candidiasis
• There is wide spread in involvement &
granulomatous & horny masses on the face &
scalp with no genetic transmission.

• The mouth is the common primary site for the

typical white plaque & nail involvement is
usually present.
 Candidasis Endocrinopathy syndrome
• It is genitically transmitted condition
charaterized by candida infection of
• Skin,scalp,nails& mucous membrane.

• Clasically the oral cavity, in association with

either hypoadrenalism, hypoparathyroidism,
hypothyroidism ovarian insufficiency.
 Treatment of oral candidiasis
• A variety of Topical & systemically
administered medications.

• Antifungal agents are been beneficial in

treatment.
 Topical treatment
• Topical treatment preferred –
Less systemic absorption,
• Effectiveness depends entirely on patient
compliance
• clotrimazole
-antifungal as well as anti bacterial property
• -10mg tablets- soluble in water
5 times a day
1% genitian violet not ideal
causes staining
 Systemic treatment
• Nystatin
• It is polyene agent given
-250 mg tds – 2 weeks followed by 1 troche per
day for 3 weeks.
• ketaconazole
• 200 mg tab with food OD
• Long term use needed careful monitoring Because
of liverside effect.
• It requires acidic environment for absorption.
Thank you.