# Association between early Candida infection (oral thrush) and severe early childhood caries

> **NIH NIH K23** · TEMPLE UNIV OF THE COMMONWEALTH · 2024 · $167,940

## Abstract

PROJECT SUMMARY
The proposed K23 career development award in clinical and translational research will form a foundation for Dr.
Yuan Liu to become an independent clinician-scientist, with expertise on severe early childhood caries (S-ECC).
The K23 training objectives progress in a sequential fashion and will support her development of key expertise
in 3 areas: 1) developing advanced skills in designing and conducting clinical studies; 2) acquiring advanced
knowledge and methods in fungal biology and microbiome; 3) improving scientific communication, grant writing
skills and networking. The candidate will acquire experience in directing longitudinal study and essential training
by making the use of the extensive resources at the University of Pennsylvania and capitalizing on an
interdisciplinary mentoring committee with broad, complementary expertise in clinical research, epidemiology,
bioengineering, microbiome, and bioinformatics. S-ECC is a major public health problem characterized by
dysbiotic oral microbial burden leading to a persistent and virulent biofilm on the teeth of toddlers that causes
rampant tooth decay. This process not only destroys the dentition but can also have a negative impact on the
general health, such as complicated systemic infections, and the well-being of young children. Emerging clinical
evidence has spotlighted the potential role of Candida albicans in S-ECC. Furthermore, our retrospective study
using electronic health records (EHR) from six major children’s hospitals revealed that, oral thrush
(oropharyngeal candidiasis or OPC) detection in toddlers less than 12 months of age was strongly associated
with the development of dental caries soon after, particularly between 13 and 36 months. However, only cross-
sectional human studies have been performed thus far. Longitudinal studies are warranted to better assess the
causal association between OPC and S-ECC in toddlers. In parallel, further studies are needed to determine the
fungal role in caries and if Candida colonization in oral cavity could be a reliable clinical marker for risk of S-ECC.
To address this, the proposed research will be focused on conducting a 2-year prospective longitudinal study to
investigate the association between early OPC and the progression of S-ECC, and the impact of Candida
colonization on the functional plaque microbiome and biofilm virulence. Dr. Liu will investigate 3 specific aims:
(1) examine the association between early OPC and S-ECC development in a cohort of infants; (2) evaluate the
influence of OPC and Candida colonization on the plaque microbiome in infants; (3) study the role of Candida
on biofilm cariogenic properties. Results from this clinical and translational effort will further elucidate the causal
link between OPC and S-ECC, and enhance the understanding of fungal contributions to the etiopathogenesis
of S-ECC. Collectively, these results will provide future opportunities for mechanistic clinical studies and
developing...

## Key facts

- **NIH application ID:** 11129405
- **Project number:** 7K23DE032419-02
- **Recipient organization:** TEMPLE UNIV OF THE COMMONWEALTH
- **Principal Investigator:** Yuan Liu
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $167,940
- **Award type:** 7
- **Project period:** 2024-09-01 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11129405

## Citation

> US National Institutes of Health, RePORTER application 11129405, Association between early Candida infection (oral thrush) and severe early childhood caries (7K23DE032419-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11129405. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*