Sanja Petrović

Candida spp. in the oral cavity – insight into new roles in oral diseases and potential antimicrobial resistance

Candida spp. is normal inhabitant of the oral cavity. This fungus has been „well-studied“ and some traditional facts are: 1) it causes oral candidiasis, which occurs in cases of immunological disbalance; 2) Candida albicans is most commonly isolated, while non-albicans species are limited to immunocompromised subjects; 3) they are mainly isolated from the tongue, buccal mucosa or palatal mucosa of denture wearers; 4) as they are normal inhabitants of oral cavity, some amount of Candida is normally present (mucosal colonisation).
Recent studies have identified Candida spp. (both albicans and non-albicans species) in gingival/periodontal pockets of immunocompromised as well as immunocompetent subjects. As they reside in complex subgingival biofilm, these areas are considered reservoirs of potentially resistant Candida spp. into systemic circulation. At the same time, emerging evidence about fungal endocarditis, and some hypotheses about their origin from oral cavity are also rising. Additionally, Candida spp. is implicated in periodontal and peri-implant diseases, raising concerns about the role of antibiotics in their treatment. Recently, acrylic dentures are also recognized as Candida spp. reservoirs, potentially leading to aspiration pneumonia and systemic infections. New evidence also points to a potential role of Candida spp. (especially C.albicans) in the development of other oral diseases such as early childhood caries and even oral carcinoma.
This lecture will explore some novel findings on Candida spp. colonization and its involvement in oral diseases not traditionally linked to fungal infections. We will also discuss the oral cavity as a potential reservoir for resistant Candida spp. strains and offer therapeutic recommendations when colonization and infection are difficult to distinguish.

Sanja Petrovic is a Teaching Assistant at the Department of Microbiology and Immunology, School of Dental Medicine, University of Belgrade, Serbia. She earned her dental degree from the same institution in 2009 and completed her PhD in Medical Science – Dentistry in 2016. Over 10 years at the Department of Periodontology and Oral Medicine, she was involved in clinical and research activities in various areas, including periodontology, oral and periodontal medicine, and oral microbiology, with a particular focus on oral candidiasis.
Since 2011, Dr. Petrovic has contributed to multiple research projects funded by organisations such as the Ministry of Education, Science and Technology of the Republic of Serbia, the Innovation Fund of Serbia, the Bilateral DAAD project, and the Eklund Foundation, Sweden. She has authored over 50 publications, including 18 articles in scientific journals, and presented her work at numerous scientific conferences. Dr. Petrovic is a member of the Serbian Society of Periodontology and the European Federation of Periodontology (EFP).