Treatment of Oral Candidiasis When Tooth Decay Is a Concern, or Complicated by Diabetes, Steroid Use, or an Immunocompromised State

Not all oral candidiasis presentations are the same. When dental caries is a concern, or when the patient has diabetes, is on corticosteroids, or is immunocompromised, certain commonly used topical treatments may not be appropriate — and a specific alternative approach is indicated.

This protocol applies to oral candidiasis in patients where any of the following are present:

Tooth decay / Dental caries Diabetes Corticosteroid use Immunocompromised state

Treatment Approach

In these cases, an oral antifungal from the triazole class has been found to be effective. The complete first-line regimen — including agent selection and all relevant clinical considerations — is available in the full protocol.

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References

DOI: 10.1136/pmj.78.922.455

Both nystatin oral rinses and clotrimazole troches have a high sucrose content and if tooth decay is a concern or the oral candidiasis is complicated by diabetes, steroid use or an immunocompromised state, triazoles which include fluconazole or itraconazole once per day has been found to be effective in these cases.

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