Fungal Infections

 Fungal infections are most often caused by the fungus Candida albicans. Similar to opportunistic bacteria, C. albicans is found in the mouth at low levels and does not normally cause problems.
   
  However, following antibiotic treatment or in individuals with impaired immune systems, C. Albicans can increase and cause an oral fungal infection called candidiasis, commonly referred to as thrush. Other factors that can promote the occurrence of candidiasis include:
      Use of dentures
    Poorly controlled diabetes
      Chronic dry mouth or other salivary impairments
    The use of inhaled steroids.
  C. Albicans undergo changes in activity when it changes from a commensal organism to a pathogenic agent. Candida first adheres to the epithelial lining of the oral cavity using hydrophobic and electrostatic interactions (Cotter & Kavanagh, 2000). These forces are sufficient to reduce saliva's normal ability to wash the mouth's fungal cells.

After initial adherence, agglutinin-like proteins and hyphal wall proteins are able to firmly adhere to the surface of the oral epithelial cells (Hoyer, 2001; Staab, Bradway, Fidel, & Sundstrom, 1999). After this occurs physical scraping of the lesions cannot dislodge the fungi. This binding process is required for Candida to transform into a virulent fungal infection.

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