WHEN clinical Candidiasis (also known as thrush) emerges, it can result from a variety of predisposing or associated factors. These factors include but are not limited to age extremes, malnourishment, metabolic disease (eg. diabetes), concurrent infection with other harmful germs, antibiotic treatment, HIV infection and radiotherapy. Candida can be found in newborns’ mouth and anal region at a rate of approximately 40 %, which correlates well with the vaginal carriage of the mother at the time of birth. However, the disease affects 4 to 10%. These infections appear as milky white curd-like plaques which are easily removed by digital rubbing and are generally evident three to seven days after birth.

Infections caused by Candida species of fungus comprise one of the most common oral disease conditions encountered in dentistry. In the majority of cases the disease may clinically present itself in several different forms. It is mainly observed as white, soft plaques overlying areas of redness on the mucosa (lining), which are removed easily, possibly showing pinpoint areas of ulceration sores. In infants, it is commonly referred to as thrush.

With the increasing age and a corresponding increase in the diversity of the germs that naturally inhabit the mouth, there appears a corresponding reduction in the incidence of the signs and symptoms of Candidosis. This may result from increasing environmental competition in the oral cavity and the child’s developing competence to fight off infections.

Women suffer from Candida infections four times as much as men because of hormonal factors, and are a greater incidence of iron deficiency in women. Notwithstanding, this disease is also a common sign of uncontrolled diabetes.
In the elderly, a major predisposing factor is the wearing of dentures. Chronic atrophic Candidosis (generally known as denture sore mouth) may result from poor denture hygiene and when the denture is worn on a 24-hour basis. The infection appears as redness with swelling of the gums, which is generally confined to the outline of the denture. The situation may be quite serious when the white patches of the Candidosis are presented in adults and cannot be scraped off easily. The condition can be a Candidal Leuplakia which is accepted as pre-cancerous. Frequently, dentists detect such a scenario to inveterate smokers of tobacco.

Several easily recognised clinical entities have been identified in which Candida is at least circumstantially involved. One of them is angular cheilitis that we Guyanese call “white corner”. The victim usually complains of dryness and a burning sensation at the corners of the mouth. Vitamin B deficiency often may play a role in initiating such lesions. Another case is median rhomboid glossitis. These big words simply describe the painless, smooth areas we sometimes accidentally discover on our tongue. The palate opposite the lesion may also be affected.

Treatment for Candidiasis must be done by one who can assimilate the significance of the prevailing condition as it relates to the patient as a whole. A competent professional must do diagnosis and treatment. Drugs available for therapy include fluconazole, clotrimazole and nystatin.