Candida albicans: An orthodontic point of view

Abstract

Introduction: Patients with long-term fixed and removable orthodontic treatment are susceptible toward an increase in oral microflora, especially Candida albicans, which can have repercussions by increasing the risk of periodontal lesions such as cariogenesis. Objective: To analyze the literature on the relationship between C. albicans and orthodontics and its epidemiology, diagnostic methods, pathogenicity and treatments. Methodology: A literature review was performed in databases with high impact such as PubMed, Scopus and Web of Science, including relevant articles from 2009 to 2022 using keywords such as: "Candida albicans", "oral candidiasis", "candidiasis", "orthodontic", "dental", "epidemiology", "diagnosis", "pathogenesis", and "treatment". Results: This fungal microorganism has a mortality rate of 40%, mainly in immunosuppressed patients. Fixed orthodontic appliances generate a significant increase for invasion by C. albicans. There are different diagnostic methods, including PCR examination, cytological smears, Gram stains, calcofluor white or fluorescent antibodies. In orthodontic patients it can be detected by clinical findings and by a decrease of HBD-3 and IL-1. Pathogenicity is directly related to host defenses, which control initial growth and inhibit subsequent tissue invasion. Treatment recommends good oral hygiene, such as manual brushing, use of chlorhexidine, ultrasonic cleaning, and the use of tablets over dentures for removable orthodontic appliances. Conclusion: Proper oral hygiene is needed during orthodontic treatment, as it is essential to reduce the presence of Candida albicans, decreasing the possibility of periodontal disease and cariogenic risk.