Oral Fungal Microbiota: To Thrush and Beyond

Abstract

The oral microbiota is complex, multikingdom, interactive, and involves extensive biofilm formation. While dominated by bacteria, Candida is a frequent member of this microbiota; however, several other potentially pathogenic fungi (among around 100 identified species) appear to reside in some individuals, including Cryptococcus, Aspergillus, and Fusarium. Oral candidiasis may manifest as a variety of disease entities in normal hosts and in the immunocompromised. These include pseudomembranous candidiasis (thrush), hyperplastic or atrophic (denture) candidiasis, linear gingival erythema, median rhomboid glossitis, and angular cheilitis. The purpose of this review is to describe the oral fungal microbiota (ie, oral mycobiota), common mouth diseases caused by its members, predisposing factors and treatment, and the potential for causing disseminated disease like their bacterial counterparts.

Keywords: Candida; Cryptococcus; candidiasis; fungi; mouth disease; mycobiome; mycoses; oral.

Figure 1

Infant pseudomembranous candidiasis (thrush).

Figure 2

Hyperplastic (white) oral candidiasis on the labia, adjacent buccal mucosa and tongue. (Photograph from Williams D, Lewis M. Pathogenesis and treatment of oral candidosis. J Oral Microbiol. 2011;3(1):5771, republished with permission from David Williams and Michael Lewis per Creative Commons license.)

Figure 3

Acute atrophic (erythematous) candidiasis on the palate of an adult. (Photograph from Williams D, Lewis M. Pathogenesis and treatment of oral candidosis. J Oral Microbiol. 2011;3(1):5771, republished with permission from David Williams and Michael Lewis per Creative Commons license.)

Figure 4

Angular cheilitis.