Dental OSCE (Objective Structured Clinical Examination) Practice Exam

If a patient on long-term tetracycline therapy presents with a burning tongue and a smear shows yeast and fungi, what is the appropriate treatment?

1. Amoxicillin

2. Clotrimazole

3. Nystatin

4. Fluconazole

The correct answer is: Clotrimazole

The appropriate treatment in this scenario is Clotrimazole. This antifungal medication is effective against oral candidiasis, often referred to as a yeast infection. Patients on long-term tetracycline therapy may experience dysbiosis in their oral flora, leading to an overgrowth of Candida species and resulting in symptoms such as a burning tongue. Clotrimazole is particularly beneficial because it can be applied topically in the oral cavity, making it a convenient option for addressing localized infections. When addressing fungal infections in the mouth, it is crucial to target the specific pathogen, and Clotrimazole's mechanism of action disrupts the fungal cell membrane, effectively resolving the symptoms. While other antifungal options exist, Clotrimazole is often preferred for acute cases of oral candidiasis due to its specific formulation for oral use, its efficacy, and its relatively low risk of systemic side effects. In contrast, options such as Nystatin and Fluconazole are also effective, but the immediate choice of Clotrimazole is more directly suitable based on the setting described.