Summary about Disease
Oral candidiasis, also known as oral thrush, is a fungal infection caused by an overgrowth of the yeast Candida albicans in the mouth. While Candida is normally present in the mouth without causing harm, certain conditions can lead to its proliferation, resulting in the characteristic white, creamy lesions on the tongue, inner cheeks, gums, and sometimes the palate. It can affect people of all ages, but is more common in infants, elderly individuals, and those with weakened immune systems.
Symptoms
White, creamy lesions on the tongue, inner cheeks, gums, or palate
Redness or soreness in the mouth
Difficulty swallowing or eating
Cotton-like feeling in the mouth
Cracking and redness at the corners of the mouth (angular cheilitis)
Slight bleeding if the lesions are scraped
In severe cases, lesions may spread to the esophagus, causing pain and difficulty swallowing (Candida esophagitis)
Causes
Weakened immune system (e.g., HIV/AIDS, cancer treatment, organ transplant)
Diabetes (especially if poorly controlled)
Certain medications (e.g., corticosteroids, antibiotics, chemotherapy)
Dry mouth (xerostomia)
Dentures, especially if they don't fit properly or are not cleaned regularly
Infancy (due to an immature immune system)
Poor oral hygiene
Smoking
Stress
Medicine Used
Antifungal medications are the primary treatment. The specific medication and its form (liquid, lozenge, or pill) depend on the severity and location of the infection, as well as the individual's overall health.
Topical antifungals: Nystatin oral suspension (swish and swallow), Clotrimazole troches (lozenges). These are often the first-line treatment for mild to moderate cases.
Oral antifungals: Fluconazole, Itraconazole, or Posaconazole (pills or liquid). Used for more severe or resistant infections, or when the infection has spread to the esophagus.
Gentian violet: An over-the-counter dye with antifungal properties. Can be applied to the lesions, but it stains and has an unpleasant taste. Use is less common now due to the availability of effective prescription medications.
Is Communicable
Oral candidiasis is generally not considered highly contagious in healthy individuals with normal immune function. However, it can be transmitted through direct contact, such as kissing, or from mother to baby during breastfeeding. People with weakened immune systems are more susceptible to acquiring the infection.
Precautions
Maintain good oral hygiene: Brush your teeth at least twice a day and floss daily.
Rinse your mouth: After using corticosteroid inhalers (for asthma), rinse your mouth with water.
Clean dentures properly: Remove and clean dentures daily, soaking them overnight in a denture-cleaning solution. Ensure dentures fit properly.
Control diabetes: Keep blood sugar levels under control if you have diabetes.
Address dry mouth: If you experience dry mouth, talk to your doctor about possible causes and treatments, such as saliva substitutes.
Limit sugar and yeast: Reduce the intake of sugary foods and foods containing yeast, as these can promote Candida growth.
Consider probiotics: Probiotics may help restore a healthy balance of microorganisms in the mouth and gut.
How long does an outbreak last?
With proper treatment, oral thrush usually clears up within 1 to 2 weeks. However, if left untreated or in individuals with significantly compromised immune systems, the infection can persist for longer and may spread. Recurrences are also possible, especially if underlying risk factors are not addressed.
How is it diagnosed?
Visual examination: A doctor or dentist can often diagnose oral thrush by simply looking at the lesions in the mouth.
Scraping and microscopic examination: A scraping of a lesion may be taken and examined under a microscope to confirm the presence of Candida albicans.
Culture: In some cases, a culture of the lesion may be performed to identify the specific strain of Candida and determine its susceptibility to antifungal medications.
Endoscopy: If oral thrush has spread to the esophagus, an endoscopy (a procedure where a thin, flexible tube with a camera is inserted into the esophagus) may be performed to visualize the lining and take biopsies.
Timeline of Symptoms
The timeline of symptoms can vary, but generally follows this pattern:
Early Stage: Mild redness or soreness in the mouth, sometimes unnoticed. Small, white spots may appear.
Progression: White patches become more noticeable and may increase in size and number. Discomfort or pain may develop.
Advanced Stage: Patches become more raised and resemble cottage cheese. Cracking or redness may appear at the corners of the mouth. Difficulty eating or swallowing may occur.
Important Considerations
Underlying Conditions: It's crucial to identify and address any underlying medical conditions (like diabetes or immune deficiencies) that may be contributing to the thrush.
Medication Interactions: Inform your doctor about all medications you are taking, including over-the-counter drugs and supplements, as some may increase your risk of thrush.
Infants and Nursing Mothers: If a breastfeeding infant has oral thrush, the mother may also develop a Candida infection on her nipples (nipple thrush). Both mother and baby may need treatment to prevent reinfection.
Follow-Up: If symptoms do not improve or worsen after starting treatment, follow up with your doctor or dentist.
Prevention is key: Practicing good oral hygiene and addressing risk factors can help prevent oral thrush.