Oral thrush - fungal infection in the mouth

Oral thrush is one of the most common forms of thrush, a fungal disease that can affect the skin and mucous membranes and is triggered by the yeast Candida. The umbrella term for all infections caused by this fungus is candidosis. Oral thrush is therefore also known as oral candidosis. The fungal infection can occur on or in the mouth or around the pharynx. Babies are often affected, but the infection is often seen in adults with a weak immune system. Read here how to recognize and treat oral thrush.

Forms of candidosis in the mouth

Oral thrush is defined as a thrush in or on the mouth. Typically, the oral fungus develops on the inside of the cheeks or lips. But also the throat, the tongue (tongue mushroom) or the palate can be affected.

Oral thrush can come in a variety of forms, with one form of oral thrush also developing from another. These are the different types of thrush in the mouth and their signs:

  • pseudomembranous candidiasis: white, wipeable coating on reddened, inflamed mucosa
  • Acute erythematous candidiasis: burning, very reddened mucous membrane without deposits, especially on the tongue
  • hyperplastic candidosis: tight white coating with red edges on the mucosa and tongue

Pseudomembranous candidosis as the most common form

In the most common form of oral thrush, pseudomembranous candidiasis, isolated white speckles form in the oral cavity, which are easily detached. Underneath, the oral mucosa usually appears shiny, dry and red.

In the course of the fungal infection increasingly larger white, cream-like-looking spots are formed, which can lead to bleeding of the mucous membrane on detachment. If left untreated, oral thrush can spread to the pharynx, esophagus (esophagitis), or gastrointestinal tract.

Other symptoms of oral thrush

In addition to the described deposits and redness of the mucous membrane, oral thrush can cause further symptoms, especially in advanced stages. This includes:

  • furry or burning sensation in the mouth
  • dry mouth
  • increased thirst
  • halitosis
  • unpleasant or metallic taste in the mouth
  • swollen lymph nodes
  • Dysphagia or pain when eating or drinking (especially in babies or when spreading on throat and esophagus)

In case of untreated oral thrush, vomiting or heartburn may be added.

In contrast to oral blush, which is triggered by the herpes simplex virus, oral thrush in children is at most associated with mild fever.

Causes and risk factors

Cause of oral thrush are always the yeast fungi belonging to candida fungi, mostly Candida albicans. In many healthy people, the fungus occurs in the mouth, intestine, or on the skin, and usually does no harm there, as long as they are kept at bay by the immune system and other microorganisms. However, if they find a gap in this body's defense, they can multiply rapidly and cause discomfort.

Therefore, people with a weakened immune system are often affected by oral thrush. These include, in particular, babies, old people or persons suffering from diseases such as cancer, HIV or diabetes.

Common triggers of oral thrush

In babies, oral thrush is often the cause of infection with the mother - they often become infected at birth with an unnoticed vaginal fungus of the mother or later on the pacifier. Often oral thrush in babies occurs together with Windelsoor, a thrush in the diaper area.

In adults, missing teeth, braces or a dysfunctional denture often causes irritation to the oral mucosa. The fungi then nest under the prosthesis, for example, or penetrate into the oral mucosa through injuries. Smoking and a dry mouth can also promote the development of oral thrush.

In addition, the long-term use of certain drugs is one of the possible triggers of oral thrush. Antibiotics, cortisone (for example in the form of cortisone spray in asthma) as well as cytostatics (during chemotherapy) can unbalance the immune system or the oral flora and pave the way for the development of the fungal infection.

Diagnosis based on characteristic symptoms

The diagnosis of oral thrush is usually based - especially in infants - on the characteristic, usually well visible symptoms. In addition, there is usually a questioning of the person affected (or the parents) about the complaints, accompanying circumstances and previous illnesses. The diagnosis can be made as well by a dentist or dermatologist as by a pediatrician or general practitioner.

For a clear diagnosis, a smear of the oral mucosa is usually made and examined microscopically. In addition, fungal cultures can be used to determine the exact nature of the Candida fungus. This may be especially necessary if the thrush infection does not respond as expected to drug treatment and a drug change is considered.

Ideally, the doctor will also clarify where the entry portal for the fungi is and, if necessary, treat the corresponding injury in the mouth. If diseases are responsible for the weakening of the immune system, they should also be treated.

Treat oral thrush

For the treatment of oral thrush, the doctor usually prescribes antifungals (antimycotics) that are especially suitable for the oral area. Often, these contain the active ingredients nystatin, miconazole or amphotericin B. Often, the drugs in the form lozenges, gel, mouthwash or suspensions are present. The remedy should be kept in the mouth as long as possible.

When treating oral thrush, it is important to strictly adhere to the dosage of medication prescribed by the doctor and the duration of therapy. Even if no topsoil is visible, the therapy must be completed as planned. A break may cause the fungus to return or even spread to another area.

From the unauthorized treatment of the oral fungus experts advise urgently. Home remedies such as gargling with chamomile tea can aggravate the infection by further drying out the oral mucosa.

Attention, contagious!

To combat oral thrush good oral hygiene is essential. Since candida fungi like to hide in caries-infected teeth, the brushing should be done very carefully during the treatment of oral soy. Dentures, pacifiers, teats, toothbrushes or braces should be thoroughly sterilized or replaced if possible.

Also, be careful not to infect other people around you. Already a kiss or the sharing of crockery may be enough to transfer the candida fungus.

Although oral thrush is often persistent, it can usually be treated within eight to ten days using the measures mentioned above. If the fungal disease does not go away for a long time, usually stronger drugs are used.

Prevention: Hygiene is the alpha and omega

Risk groups can take various measures to prevent a thrush infection in the mouth. Above all, hygiene is crucial. Specifically, the following measures help to prevent the oral fungus:

  • Dental prosthesis wearers should clean thoroughly after each meal and make sure that the prostheses are seated properly. It is also advisable to clean them with cleaning tablets twice or three times a week.
  • In immunocompromised people (for example, during chemotherapy) is often prescribed an antifungal agent for the prevention of oral thrush.
  • If people are fed artificially or for other reasons their salivation is greatly reduced, the nursing staff usually operates a so-called thrush and parotitis prophylaxis. This includes, for example, regularly moisturizing the mucous membranes of the affected person.
  • For babies, pacifiers, teats and toys that are placed in the mouth should be cleaned regularly and thoroughly. Keep in mind that parental saliva can also be a potential source of infection for the child. To "cleanse" a fallen pacifier with its own saliva can even benefit the infection.
  • Since babies are often infected with candida fungi due to an unrecognized vaginal fungus of the mother at birth, appropriate treatment of the mother before birth may be advisable.
  • Nursing mothers often suffer from a soor infection of the nipples (breasts). For affected women not to infect their child, they should not breastfeed for a while, and if necessary, include the baby in the treatment of the thrush. Keep in mind that the infection can be in both directions.

Basically, it is advisable to consult a doctor immediately in case of suspected oral thrush in order to prevent spread of the fungus on the throat and esophagus or infection of other people.

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