Muzyka Brian C
Department of Oral Medicine, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, Box 140, New Orleans, LA 70119, USA.
Dent Clin North Am. 2005 Jan;49(1):49-65, viii. doi: 10.1016/j.cden.2004.07.007.
Candidiasis is the most common oral fungal infection diagnosed in humans. Candidiasis may result from immune system dysfunction or as a result of local or systemic medical treatment. Because oral candidiasis is generally a localized infection, topical treatment methods are the first line of therapy, especially for the pseudomembranous and erythematous variants. Patients with dental prostheses should also be advised to disinfect the prosthesis routinely during the candidal treatment period, because the prosthesis may serve as a source of reinfection. Additionally, patients should be advised that oral hygiene aids, such as toothbrushes and denture brushes, may also be contaminated and should be discarded or disinfected. A disinfecting solution of equal parts of hydrogen peroxide and water may be used. Likewise, 2% chlorhexidine gluconate solution may be used asa disinfecting solution for dental prostheses and oral hygiene aids. Occasionally the clinician encounters a more resistant form of oral candidiasis such as the hyperplastic variant or a variant that does not respond to topical therapy. Appropriate systemic therapy should be employed for the treatment of these infections. Additionally, a biopsy should be undertaken in individuals with the hyperplastic variant of Candida because there is some degree of risk for malignant transformation. Deep fungal infections should be managed in association with appropriate medical specialists to rule out other systemic involvement. The dental health care provider plays an important part in the diagnosis and management of fungal disease, and therefore clinicians should be aware of the presenting signs and symptoms or oral fungal disease.
念珠菌病是人类诊断出的最常见的口腔真菌感染。念珠菌病可能由免疫系统功能障碍引起，也可能是局部或全身药物治疗的结果。由于口腔念珠菌病通常是局部感染，局部治疗方法是一线治疗手段，尤其是对于假膜型和红斑型变体。佩戴假牙的患者在念珠菌治疗期间也应被建议定期对假牙进行消毒，因为假牙可能成为再次感染的源头。此外，应告知患者，牙刷和假牙刷等口腔卫生辅助用品也可能被污染，应丢弃或消毒。可以使用等量过氧化氢和水的消毒溶液。同样，2%葡萄糖酸氯己定溶液可作为假牙和口腔卫生辅助用品的消毒溶液。偶尔，临床医生会遇到更具抗药性的口腔念珠菌病形式，如增生型变体或对局部治疗无反应的变体。对于这些感染的治疗应采用适当的全身治疗。此外，对于念珠菌增生型变体患者应进行活检，因为存在一定程度的恶变风险。深部真菌感染应与适当的医学专家联合处理，以排除其他全身受累情况。牙科保健提供者在真菌病的诊断和管理中起着重要作用，因此临床医生应了解口腔真菌病的表现体征和症状。
