DentistryEar, Nose and ThroatInfectious Diseases / Bacteria / Viruses

Oral thrush: Things you need to know

Oral thrush, also referred to as oral candidiasis, is an infection of the genus Candida of yeast/fungi that occurs on the mucous membranes of the mouth.

The Candida albicans fungus is most commonly caused, but can also be caused by Candida glabrata or Candida tropicalis.

For most cases, no significant complications are caused by oral thrush. However, for people with a compromised immune system, whose signs and symptoms can be even more severe, this is not the case.

The result is normally really positive for oral thrush. Most individuals respond to treatment well. However, oral thrush tends to reappear, especially if it does not eliminate the causal factor (smoking, for example).

We’ll cover all aspects of oral thrush in this post, including the causes, symptoms, and treatment.

Important facts about oral thrush

Here are several essential points related to oral thrush. The main article provides more comprehensive and supporting material.

  • Oral thrush is a common disease, but for most, it does not cause major problems.
  • The oral thrush is worst affected by people with a reduced immune system.
  • Following chemotherapy or radiotherapy to the head and neck, oral thrush may occur more frequently.
  • It is more prevalent in individuals who take steroids, wear dentures, or have diabetes.
  • Creamy or white-coloured deposits in the mouth are the most visible symptom of oral thrush.

Treatment

Oral thrush mouth
Oral thrushes are caused by the Candida fungus species.

Anti-thrush medicines such as nystatin or miconazole are typically administered by physicians in the form of drops, gel, or lozenges.

Alternatively, a topical oral suspension that is washed around the mouth and then swallowed can be administered for the patient.

For patients with compromised immune systems, oral or intravenous administered antifungals may be the alternative.

Amphotericin B can be used if therapy is not working, but it can only be used as a last resort because of the unpleasant side effects that include fever, nausea, and vomit.

Home remedies

In addition to medical treatment, the following can help reduce the risk of the condition getting worse:

  • Rinse mouth with salt water.
  • To prevent the scratching of the lesions, use a gentle toothbrush.
  • Till the infection is gone, use a new toothbrush every day.
  • To restore healthy bacteria levels, eat unsweetened yogurt.
  • Do not use sprays or mouthwashers.

Symptoms

A doctor performing oral examination
An oral thrush is typically diagnosed after an oral examination.

Oral thrush in adults usually occurs on the mucous membrane of the mouth as thick, white or cream-colored deposits (spots) (wet parts of the inside of the mouth).

Swollen and slightly red can appear in the mucosa (mucous membrane). The spots might be elevated. Discomfort or a burning sensation can occur.

There could be bleeding if the cream or white-colored deposits are scraped.

To form larger ones, also known as plaques, the white spots may join together; these may then take on a grayish or yellowish hue.

Occasionally, with no detectable white spots, the region affected simply becomes red and sore.

Individuals who wear dentures under a denture can have areas that are continuously red and swollen. The risk can be increased by bad oral hygiene, or not taking the dentures out before going to sleep.

Based on appearance, oral thrush is often split into three classes, although the disorder may often fall between categories:

Pseudomembranous – the classic and most common version of oral thrush.

Erythematous (atrophic) – the situation appears red raw rather than white.

Hyperplastic – also referred to as “plaque-like candidiasis” or “nodular candidiasis” due to the presence of a hard to remove solid white plaque. This is the least common variant; it is seen in HIV patients most frequently.

With oral thrush, there are a variety of other lesions that may also occur. Often, other forms of bacteria that are also present in the region may be due to these lesions. This may include:

  • Angular cheilitisinflammation and/or splitting in the corners of the mouth
  • Median rhomboid glossitis – a large, red, painless mark in the center of the tongue
  • Linear gingival erythema – a band of inflammation running across the gums

Causes

In different parts of our body, including the digestive system, skin, and mouth, small amounts of Candida fungus occur, causing healthy people virtually no problems. In fact, C. Albicans are carried in the mouths of up to 75% of the population of the planet.

Fortunately, individuals on certain medications, with decreased immune systems, or certain medical conditions are susceptible to oral thrush when C. albicans rises out control.

Risk factors

For the following classes, the adult oral thrush is more likely to become a problem:

  • Individuals wearing dentures – especially if they are not kept clean, do not fit properly, or are not taken out before going to bed.
  • Antibiotics – There is a greater risk of developing oral thrush in persons who are on antibiotics. The bacteria that keep Candida from growing out of control can be destroyed by antibiotics.
  • Excessive use of mouthwash – Bacteria that hold Candida at bay may also be killed by people who overuse antibacterial mouthwash, thereby raising the risk of developing oral thrush.
  • Steroid medication -The risk of oral thrush can be increased by long-term use of steroid medication.
  • Weakened immune system -The oral thrush is more likely to occur in people with weakened immune systems.
  • Diabetes – People with diabetes are more likely to have an oral thrush, especially if it is poorly regulated.
  • Dry mouth – individuals are more vulnerable to oral thrush with less than average levels of saliva (xerostomia).
  • Dietmalnutrition predisposes individuals to oral thrush; this may be induced by a bad diet or disease affecting nutrient absorption. In particular, infection rates tend to be impaired by diets low in iron, vitamin B12, and folic acid.
  • Smoking – heavy smokers are more at risk, it is uncertain why.

Diagnosis

By looking into the patient’s mouth and asking some questions about symptoms, the doctor will diagnose oral thrush in the vast majority of cases.

For examination, the doctor may scrape some tissue from the inside of the mouth.

If the doctor suspects that a drug or some other underlying cause is causing the oral thrush, the cause must be dealt with. Treatments rely on the underlying cause in such situations.

Sources

  • Amphotericin B (intravenous route, injection route). (2015, December 1)
    (LINK)
  • Awatif Y. Al-Maskari, Masoud Y. Al-Maskari, Salem Al-Sudairy. (2011, May). Oral manifestations and complications of diabetes mellitus. Sultan Qaboos University Medical Journal. 11(2): 179–186
    (LINK)
  • François L. Mayer, Duncan Wilson, Bernhard Hube. (2013, February 15). Candida albicans pathogenicity mechanisms. Virulence. 4(2): 119–128
    (LINK)
  • Oral thrush in adults. (2014, August 14) (LINK)
  • Oropharyngeal/esophageal candidiasis (“thrush”). (2014, February 2013)
    (LINK)
  • Treatments for oral thrush. (2014, August 14)
    (LINK)
  • Medical news today – Oral thrush: All you need to know (LINK)

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