Title:Oral Candidiasis and Novel Therapeutic Strategies: Antifungals, Phytotherapy,
Probiotics, and Photodynamic Therapy
Volume: 20
Issue: 5
Author(s): Maria Contaldo*, Dario Di Stasio, Antonio Romano, Fausto Fiori, Fedora Della Vella, Cosimo Rupe, Carlo Lajolo, Massimo Petruzzi, Rosario Serpico and Alberta Lucchese
Affiliation:
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli,
Naples, Italy
Keywords:
Oral candidiasis, denture stomatitis, photodynamic therapy, phytotherapy, antifungals, probiotics, mycobiome, microbiota.
Abstract: Oral candidiasis is an opportunistic infection of the oral mucosa sustained by fungi of the
genus Candida. Various Candida species, with a predominance of C. albicans, normally a saprophyte of
the oral cavity, may become virulent and infect the oral mucosa with variegated clinical presentation, in
case of imbalance of the oral microbiota, the presence of local predisposing factors and systemic conditions
that weaken the immune system. Conventionally, oral candidiasis eradication is done with the help
of antifungal drugs. However, the growing phenomena of drug resistance and the increase in infections
sustained by non-albicans species being less responsive to common antifungals have orientied researches
towards the experimentation of alternative therapies. The present review considered the most promising
alternative therapeutic proposals. The use of plant derivatives with phytotherapy is a promising
option, such as probiotics, to rebalance the oral microbiota in case of dysbiosis. Finally, antimicrobial
photodynamic therapy (aPDT), with highly selective fungicidal activity and free of side effects, is also
being studied as a powerful alternative to drug administration. All these therapies are alternatives or
supportive to the conventional treatment of recurrent and non-drug-responsive forms of oral candidiasis.
However, further studies are needed to define the most active compounds, the efficacy of the therapies
compared with the conventional ones, and the planning of regulated and standardized protocols.