Candida‐associated denture stomatitis. Aetiology and management: A review. Part 3. Treatment of oral candidosis

Abstract

Treatment of oral candidosis with topical antifungal agents such as nystatin and amphotericin B is effective initially. However, medication can produce side effects in some patients and when therapy is stopped the condition can recur. Alternative treatment involving the use of antiseptics and disinfecting agents has been shown to play an important role in the control of dental plaque. The use of sodium hypochlorite as an overnight denture soak has been shown to eliminate denture plaque and recent investigations have demonstrated that microwave irradiation of dentures at a specified setting and exposure time is bactericidal and candidacidal.Key words: Candida albicans, antifungals, denture stomatitis, chlorhexidine, sodium hypochlorite, microwave i r r a d i a t i o n .

Effects of hemin, CO2, and pH on the branching of Candida albicans filamentous forms

“…Any disturbance in the formation of the hypha may result in the failure of invasive growth and reduced virulence [48,49]. Very importantly, yeast cells and true hyphae are always observed during C. albicans infections, such as oral candidiasis [50] or invasive candidiasis in the spleen, kidney, and liver [51,52]. While true hyphae play an important role in invasiveness [6,53], pseudohyphae are less virulent in hematogenously disseminated candidiasis [54] and their functions in infections are still understudied [53].…”

“…It is important to note that hemin is released by oxidized ferric (Fe 3+ ) hemoglobin in the human body [60], and hemin has been demonstrated to initiate the Y → H morphological transition of C. albicans in vitro [13,14], which is likely to facilitate the superficial invasion of the oral mucosa by C. albicans in vivo [50,61,62]. On the other hand, highly branched mycelium can be the prerequisite of an effective nutrient assimilation and may also moderate the invasiveness of C. albicans [45] in the oral cavity as well.…”

<i>In vivo</i> study of antifungal effects of low-molecular-weight chitosan against <i>Candida albicans </i>

“…Treatment of denture stomatitis includes cleaning the dentures, avoiding overnight use of dentures, relining or replacement of prosthesis, and use of topical or systemic antifungal medications. The use of all methods of treatment is more effective than just one (7,10).…”

“…Polyene agents such as nystatin and amphotericin are remedial treatments for primary oral candidosis (1,9,11). Nystatin binds to ergosterol within the cell membrane of Candida and creates pores in the fungal cell membrane, resulting in leakage of fungal cell contents and potassium ions, which results in cell death (7,12,13). Polyenes are not absorbed from the gastrointestinal tract, and drug-induced resistance is extremely rare (9,12).…”

“…Bacteria, mechanical microtrauma, and poor denture hygiene are predisposing factors for this disease (2,6). The medical treatment of Candida infection depends on the severity and location of the lesion as well as patient's immune status (6)(7)(8)(9). Treatment of denture stomatitis includes cleaning the dentures, avoiding overnight use of dentures, relining or replacement of prosthesis, and use of topical or systemic antifungal medications.…”