Candida albicans is the most commonly detected fungal species in the oral cavity of healthy as well as medically compromised individuals, according to an article by Siqueira and Sen. The incidence of C albicans in the oral cavity has been reported to be 30% to 45% in healthy adults and 95% in HIV infected patients. The primary oral location of the fungus is the dorsum of the tongue. Other sites that may be colonized secondarily include the micosa and supragingivae, dentin, root, subgingivae, and periodontal pockets. C albicans is a versatile pathogen and is able to adapt to a range of physiologic extremes, such as pH. This fungus produces hydrolytic enzymes that may be involved in periradicular tissue damage, as well as in degradation of dentin collagen. C albicans can form biofilms on different surfaces, which could make it more pathogenic than species that are less able to form biofilms. In the field of endodontics, fungi such as C albicans have occasionally been found in primary root canal infections, but seem to be more common in the root canals of obturated teeth with failed treatment. Reports indicate that Candida species are resistant to some medications commonly used in endodontics, such as calcium hydroxide. It appears that medicaments such as chlorhexidine digulconate, calcium hydroxide combined with CPMC or chlorhexidine, and EDTA have the potential to be used as effective intracanal medications for endodontic patients with suspected fungal infection.
(Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, Vol. 97, No. 5, 2004)