Candidosis

Question 1

How do candida and bacteria differ in size?

Answer 1

Candida approx. 25-100x bigger than bacteria

Question 2

What is a mycofilm?

Answer 2

physical scaffold of fungi for bacteria to colonise
- creates a protective environment for bacteria

Question 3

What are some risk factors for development of candidiasis?

Answer 3

• immunocompromised patients
• immunosuppressive drugs
• advanced HIV infection
• intra-abdominal surgery
• central venous catheter
• parenteral nutrition
• broad spectrum antibiotics
• dialysis
• diabetes

Question 4

Candidal disease can be caused by a spectrum of infections, list some dentally relevant ones:

Answer 4

• periodontitis
• dental implants
• denture stomatitis

Question 5

what type of oral candidosis is thrush?

Answer 5

pseudomembranous

Question 6

what type of oral candidosis is denture related?

Answer 6

erythematous

Question 7

what type of oral candidosis is HIV related?

Answer 7

erythematous

Question 8

what type of oral candidosis is candidal leukoplakia?

Answer 8

hyperplastic

Question 9

What can be used to treat angular chelitis?

Answer 9

topical miconazole

Question 10

What are the different Newtons classifications of denture induced stomatitis?

Answer 10

Newtons type I = localised inflammation
Newtons type II = diffuse inflammation
Newtons type III = granular inflammation

Question 11

what are the signs and symptoms of denture induced stomatitis?

Answer 11

• inflamed mucosa
• burning sensation
• discomfort
• bad taste

Question 12

what type of candida species is NOT sensitive to miconazole and metroconazole?

Answer 12

candida glabrata!

Question 13

what are hydrolytic enzymes?

Answer 13

the candida biofilm produces enzymes that catalyse the hydrolysis of a substrate through the addition of water

Question 14

what are examples of hydrolytic enzymes?

Answer 14

• phospholipase
• haemolysin
• proteinase

Question 15

What can candida in the mouth drive…

Answer 15

head and neck cancer

Question 16

What are the different methods for diagnosis of oral candidosis?

Answer 16

• smear
• oral rinse*** (most common)
• swab*** (most common)
• foam pad
• biopsy

Question 17

How do ‘Azoles’ antifungals work?

Answer 17

They work indirectly on the ergosterol diasynthesis pathway, preventing ergosterol being synthesised
- fungistatic

Question 18

How do ‘polyenes’ antifungals work? eg. Nystatin

Answer 18

they work directly on the ergosterol by binding to it and cause pores, which leads to leakage of cytoplasmic contents leading to cell death
- fungicidal

Question 19

If an immunocompromised patient presents with a candida infection, what should you do?

Answer 19

• systemic antifungal (eg fluconazole)
  +
• topical antifungal (nystatin/miconazole) AND chlorhexidine rinse

Question 20

If a patient presents with candida that is not immunocompromised and has poor OH, what is the treatment?

Answer 20

• improve OH
• chlorhexidine rinse

Question 21

If a patient presents with candida that is not immunocompromised and good OH, what is the treatment?

Answer 21

Any topical or systemic antifungal

Question 22

If a patient presents with candida that is not immunocompromised and a dry mouth, what is the treatment?

Answer 22

• topical antifungal
  AVOID systemic antifungal