Symptoms, treatment and prevention of oral candidiasis/oral thrush

The fungal infection of the oral cavity, also known as oral thrush, is caused by the proliferation of the fungus species Candida albicans, which is present in the mouth, skin and digestive system even under normal circumstances. There are factors, however, that cause this fungus to proliferate, giving rise to complaints in different areas of the body such as the oral cavity.

The etiology of oral candidiasis

The proliferation of Candida (aka candidiasis), naturally found in the mouth, may also be triggered by factors like smoking, inadequate oral hygiene, wearing dentures, medical treatment (high-dose antibiotic treatment, contraceptives, steroids), diabetes, or a depleted immune system.

Dry mouth, pregnancy, having undergone an organ transplant and a stressed lifestyle contribute to an increased susceptibility to develop oral candidiasis, the disease usually presenting in infants during lactation.

The symptoms associated with oral candidiasis

The fungal infection of the oral cavity develops all of a sudden but tends to linger on with a long recovery time.

Symptoms in adults and children are identical: the tongue is infused with a white coating. Accompanying symptoms of oral candidiasis include cracks in the corner of the mouth, difficulties swallowing, bad breath and an unpleasant metallic taste in the mouth.

Fungus may present on the tongue, the inner surface of the cheek, corner of the mouth, but may also propagate to the palate, gums, tonsils, and the rear area of the throat.

The fungal infection appears as a white coating on the affected area leaving behind a bleeding and sore mucosa when wiped.

If the infection propagates to the esophagus, painful swallowing, inflammation and fever may also present.

If treatment of the oral fungal infection is not begun it may extend to the lungs, liver and the skin, though this can typically be observed in patients with a depleted immune system suffering from a neoplastic disease or HIV virus, for instance. Timely treatment is essential in order to prevent propagation.

 Prevention and treatment of oral candidiasis

The diagnosis of oral thrush is established, and its treatment modality is prescribed, by a dental specialist taking into consideration the age of the patient and the extent of the fungal infection.

Systemic treatment includes tablets (Nystatin pills) or Diflucan suspension, whereas external treatment is best performed with rinses, antifungal topical applications (Nystatin solution), gels and creams. Since there may be a number of other diseases conducive to the formation of oral thrush, other medical examinations and the replacement or discontinuation of previously taken medicines may also be in order to prevent the recrudescence of fungal infection.

• Appropriate oral hygiene, brushing twice a day and interdental brushing (the use of interdental brush or dental floss) at least once a day and the regular use of a tongue scraper are essential
• Patients wearing a denture should see that the denture is cleaned on a daily basis in order to prevent the proliferation of pathogens. Seven out of ten patients wearing a denture suffer from a fungal infection of the oral cavity of some kind or another. Use a special denture brush to clean the denture. Remove the denture several times a day letting the gum „breathe”, relax and refresh. It is advisable to have the denture subjected to ultrasonic cleaning by a technician.
• If possible, refrain from the excessive use of mouth sprays and mouth rinse. Although these devices contribute to a fresh and clean feel of the oral cavity their excessive use may topple the normal chemical balance of the oral cavity, favouring thereby the proliferation of fungi.
• As smoking not only promotes the fungal infection of the oral cavity but also increases susceptibility to oral cancer, it is advisable to let go of this harmful addiction as soon as possible.
• Regularly monitored blood sugar levels: diabetics are five times more exposed to the risk of oral thrush, making regularly monitored and controlled blood sugar levels essential.
• If possible, refrain from food containing excessive amounts of sugar and yeast as it may promote the proliferation of Candida, which is a common type of yeast.
• Regular dental examinations are of crucial importance. By reporting for regular dental check-ups on a half-yearly basis you stand a good chance of timely detecting the infection which is a great deal easier to treat in the initial phase.

 

We must ensure appropriate oral hygiene for our children. If we are looking to prevent the formation of oral thrush in infancy, we should ensure appropriate oral hygiene for our child as early as the beginning of lactation. To this end we may use a damp gauze pad or avail of a special cleaning wipe. In diagnosing and treating fungal infection/ oral thrush in infancy not only a dentist, but also a paediatrician can assist.