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Fast Facts: Perio Edition – Non-Dental Biofilm Induced Gingivitis – Fungal Origin

Fast Facts: Perio Edition Episode 42

[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello and welcome to Fast Facts: Perio Edition. On this week’s episode, we are continuing the conversation about non-dental biofilm induced gingivitis cases. Last week, we looked at patients who present with some type of an inflammatory condition in their oral cavity, but that inflammatory condition is associated with viruses, not necessarily due to dental biofilm. This week, there’s a fungus among us, we’re looking at patients that present with some type of an inflammatory condition due to fungal origin, and it is important to note that there are concentrations of fungus that can be observed in the oral cavity and these types of fungus can give rise to oral infection. Most specifically when we’re talking about fungal infections of the oral cavity, we’re looking at candidiasis, right? Candida Albicans, we know, is one of the most commonly, pathogenic of species in the oral cavity in that C. albicans really is the organism that we oftentimes see associated with opportunistic candidiasis infections. We can see candidiasis infections anywhere in the oral mucosa. And we, of course, know that one of the most common characteristics of a candidiasis infection is that it demonstrates itself as kind of a white creamy lesion that can wipe off to a red bleeding base. So that redness of the attached gingiva or that granular surface is typically what helps us gather a differential diagnosis.
We can see other relatively uncommon lesions associated with candidiasis infection. These would be, for example, elevated nodules in a white or a reddish observation. In order to effectively diagnose a patient, though, I want to be clear, this requires us to gather a culture, a smear or a biopsy of the infection itself, another infection that can be seen in the oral cavity associated with fungal origin is a histoplasmosis infection. Histoplasmosis is actually an interesting infection that’s acquired via the lungs via the respiratory tract due to inhalation of infected bat droppings. How random, right? But if a patient presents with histoplasmosis, they can also present with an inflammatory condition in their oral mucosa. Specifically, it demonstrates itself as kind of a red transient ulceration of the gingiva. And finally, we’re starting to evaluate a massive change from the 1999 workshop that was done around linear gingiva erythema. For those of us who learned the 1999 classification systems, we learned that linear gingiva erythema was previously termed HIV associated gingivitis. It was characterized by a two to three millimeter marginal band of intense redness in the free gingiva.
And we identified these patients as having linear gingiva erythema because although we would provide conventional periodontal therapy, some type of a debridement to de-plaque the area that the gingiva itself did not respond to this conventional self care perio therapy. And so this is where we would start to send patients to receive testing, come in and go into your physician and receive some testing. It’s possible that you may be HIV positive. Now, what we’re starting to find is that patients that present with linear gingiva erythema may have this associated with an HIV infection, but even more so, we’re starting to see a resolution of linear gingival erythema not only associated with being placed on an antiretroviral if an HIV diagnosis is found, but also placing the patient on an antifungal for high level therapy.
Thank you for tuning in this week as we looked at patients that can present with an inflammatory condition of their oral mucosa associated with fungal origin. Stay tuned next week as we look at Mucocutaneous disorders that can affect a non dental biofilm induced gingival case. Thank you for tuning in this week and have an awesome week.
This has been another episode of Fast Facts – Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts – Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We’ll see you next week for another Fast Fact!

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