Oral Candidiasis

A Fictitious Report

Oral candidiasis is a condition where the fungus Candida albicans collects on the lining of the mouth (Mayo Clinic 2011). It is the most common fungal infection of the oral cavity (RDH 2011). Candida albicans can exist in one of two different ways: in a yeast (spore) form or a hyphal (filament) form (RDH 2011). An article published by RDH (2011), it states that the hyphal form is present and associated with the invasion of tissue, while the yeast form is not associated with infection and therefore not harmful.

There are four different types of oral candidiasis that are found in the oral cavity: hyperplastic, pseudomembranous, erythematous, and angular cheilitis (RDH 2011). Each one looks different in appearance and some patients may have just one form of thrush, while others may have a combination (RDH 2011).

Hyperplastic candidiasis is the least common type of candidiasis; it looks like a hard plaque and it cannot be removed by wiping or scraping. It is located most commonly on the anterior buccal mucosa and may also be on the lips and tongue. There are not any symptoms related to this form of candidiasis (RDH 2011).

Pseudomembranous candidiasis is quite common and it is often referred to as "oral thrush." It is the most widely recognized type of candidiasis (RDH 2011). It causes creamy white types of lesions on the tongue and the inner cheeks, which can be quite painful, bleeding a bit if they are scraped or irritated in some way (Mayo Clinic 2011). Oral thrush can spread to other areas of the mouth, including the roof of the mouth, the gums, tonsils, and the back of the throat (Mayo Clinic 2011). This form of candidiasis can be found in people of all ages and there isn't any sex predilection (RDH 2011); however, infants and chronically ill patients are the most susceptible to this type of candidiasis (RDH 2011). It is also seen in people who wear dentures, use inhaled corticosteroids, smoke, are undergoing chemotherapy, have diabetes, have HIV or other conditions that cause a weakened immune systems (Mayo Clinic 2011). Oral thrush isn't a major problem for people who have healthy and strong immune systems, but for those that don't, oral thrush can be hard to control and can often be quite severe (2011).

The symptoms related to pseudomembranous candidiasis -- oral thrush -- are often difficult to detect. The symptoms may also come on quite suddenly but then persist for a long period of time (Mayo 2011). Some of the symptoms are: 1) creamy, white lesions on the tongue, inner cheeks, roof of mouth, gums, and/or tonsils; 2) lesions have a "cottage-cheese" appearance; 3) bleeding if the lesions are scraped/rubbed; 4) cracking at the corners of the mouth; 5) dry or "cotton mouth"; and, 6) loss of taste (2011). (in some quite severe cases, oral thrush can spread down into the esophagus, which can make swallowing difficult) (2011).

Erythematous candidiasis (also known as atrophic candidiasis) is another common form of oral candidiasis (RDH 2011). It is typically seen in adults (as the name suggests) and in both sexes. It appears like a red patch, and the color of red differs from patient to patient. It can be bright red or faint red.

When erythematous candidiasis is found on the dorsal tongue, the lesion is related to loss of filiform papillae, which creates a bald spot on the tongue (RDH 2011). This type of candidiasis is commonly seen in people who wear dentures and it can be asymptomatic or quite painful, depending on the patient (2011). In the cases where there aren't any symptoms, the patch is usually found during an oral exam. It can oftentimes be overlooked because of the fact that the red patch appears quite faintly (2011).

Angular cheilitis (also called perleche) is another form of candidiasis. It can often be mistaken…