Varied presentation of candidiasis in the Oral Cavity: Understanding Pathogenesis, Diagnosis, and treatment strategies

Candida albicans is a fungus responsible for causing oral candidiasis, an infection that occurs when this fungus accumulates on the oral mucosa. According to the World Health Organization (WHO), about 3.5 billion people worldwide, or approximately 50% of the global population, suffer from some form of oral disease. Candida is a common microorganism in the mouth, but it can sometimes overgrow and cause symptoms. Oral thrush, a type of oral candidiasis, appears as creamy white lesions on the inner cheeks or tongue and can spread to the throat, tonsils, gums, or roof of the mouth. Oral candidiasis is an opportunistic infection that affects immunocompromised individuals of all ages, from newborns to the elderly. There are three types of candidiasis: erythematous candidiasis, hyperplastic candidiasis, and pseudomembranous candidiasis. Pseudomembranous candidiasis, often found in neonates and chronically ill individuals, presents as soft, white plaques on the tongue and buccal mucosa, resembling a thin, milky texture. Chronic hyperplastic candidiasis, also known as candidal leukoplakia, features firm, white plaques on the lips, tongue, and buccal mucosa that can persist for years. These plaques may be either homogeneous or nodular. This chronic form often affects HIV patients, typically appearing on the palate and the dorsum of the tongue, and rarely on the buccal mucosa. To prevent oral candidiasis, maintaining stringent oral hygiene practices and reducing dietary sugar intake are essential measures. Treatment strategies involve the administration of antifungal agents, including azoles, polyenes, and echinocandins, as well as the application of topical antifungal ointments. For immunocompromised individuals, routine dental examinations and the prompt management of any oral lesions are imperative to mitigate the risk of recurrent infections.