Lotufo et al.,20 performed antimicrobial susceptibility tests in vitro for 105 strains of anaerobic bacteria isolated from patients with periodontitis. According to the results, the antimicrobial metronidazole was more action on the organism studied. None of the isolates showed resistance to metronidazole. Amoxicillin also showed good results, with approximately 94% of strains sensitive to this

drug. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. It is believed that the presence of C. albicans in subgingival sites is in the form of biofilms, Cyclopamine which could explain the resistance to antifungal therapy. Plants are good options for obtaining a wide variety of drugs.21 This alternative could benefit a large population that uses plants as a first treatment option.22 Plants have been used in medicine for a long time and are extensively

used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable Doramapimod nmr to various diseases.23 Therefore, these constitute an excellent alternative in the search for substances that can be used to develop new antifungal drugs.24 It is necessary to seek new antifungal agents that are fungicides, which cause disruption or destruction of biofilms, which are effective in isolates that express resistance using several molecular mechanisms and which are not toxic. In the present report, the literature on the presence of Candida spp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed. Based on their prevalence in healthy and asymptomatic populations, the isolation of Candida spp. from the oral cavity does not

necessarily imply an infection. 25 Many studies have shown that approximately half of the healthy adult population carries yeasts in the oral mucosa, however, the prevalence has been found to vary amongst different population groups. 25 and 26 Several different groups present levels of oral colonization by yeasts larger than the average population in general, with these groups being known at-risk populations. 27 Studies report a higher prevalence of Candida species pentoxifylline in patients with Down’s syndrome, in individuals with salivary gland hypofunction, decreased flow or salivary pH and diabetes mellitus. These conditions seem to alter the oral environment and promote colonization by these and other species of opportunistic pathogens. 28 The occurrence of these fungi has also been reported in HIV-positive patients, with rates of infection that are higher than in other at-risk populations. 29 The increasing proportion of these fungi suggests a deficient immune response associated with the progression of viral infection in HIV-infected individuals, which could be a predictive factor for the development of candidiasis.