Oral thrush

Oral thrush: description

Oral thrush is a yeast infection in the mouth. It occurs relatively frequently in newborns and babies. Oral thrush in adults, on the other hand, usually affects old and ill people or those taking certain medications (such as antibiotics). Doctors also refer to oral thrush as oral candidiasis, as it is an infection with a fungus of the Candida family.

In most cases, oral thrush expresses itself in the form of white, removable deposits on a reddened, inflamed oral mucosa (pseudomembranous candidosis). Less common are burning, red mucous membranes (acute erythematous candidosis) or the lining is stuck on the mucous membrane (hyperplastic candidosis). In any case, the oral fungus must be treated with special medicines for fungal infections – so-called antimycotics.

Oral thrush: symptoms

The classic symptom of oral thrush are reddened oral mucous membranes, on which rest white specks. In the beginning, these tips look like small, milky white speckles, often on the inside of the cheeks and lips, but also on the palate or under the tongue (tongue mushroom). These small pads are usually easy to wipe off, and under them a red, shiny spot appears. Particularly often, the fungi nest in the mouth under a denture. As the process progresses, the stabs multiply and enlarge and in some cases flow together to form larger white spots. If you detach them, the skin starts to bleed easily. Sometimes the oral fungus spreads to the pharynx and esophagus.

This appearance, medical professionals also call acute pseudomembranous candidiasis – the most common form of oral thrush. Symptoms of a yeast in the mouth are also:

• Feeling of “fuzziness” and dryness in the mouth
• increased thirst
• Taste disturbances (possibly metallic taste)
• halitosis
• burning sensation on the oral mucosa

However, these symptoms do not occur in many cases, as long as the oral fungus is still in the initial stages. For babies, however, oral thrush is often very uncomfortable, so they do not want to drink anymore. When the fungus spreads, fungus deposits on the lips or in the corners of the mouth sometimes appear in the infant.

Oral thrush can look different

Basically, there are different manifestations of thrush. The mouth and throat do not always have to be marked by white coverings. Somewhat rarer is the acute erythematous candidosis – it develops mainly under antibiotic therapy or in HIV infection, often as a result of pseudomembranous candidiasis. Instead of the pads show above all a strong mucous membrane flushing and burning in the mouth, especially the back of the tongue is often affected.

There is also the form of chronic hyperplastic candidosis (also: Candida-Leukopathie). Here are on the mucous membrane and tongue stuck, white deposits with red edges that can not be easily solved. This form of oral thrush is common in people with immune system disorders and can persist for months or years.

Oral thrush: causes and risk factors

Oral thrush is usually due to infection with Candida albicans, a common fungus in the yeast family. Even in about 50 percent of healthy people, it can be detected in the oral cavity, and also in the intestine and on various mucous membranes occurs frequently.

Only in people with a weakened immune system does colonization become a so-called opportunistic infection: the fungi use a defensive gap and begin to proliferate. Therefore, oral thrush is typical in newborns and babies who do not yet have a pronounced immune system.

But even older children and adults can develop a fungal infection in the mouth – especially if the defense is suppressed by drugs or weakened by an illness. Older people with missing teeth and dentures are also at risk.

In addition to Candida albicans, oral thrush can also be triggered by other yeasts such as Candida tropicalis and Candida stellatoidea. These fungi rarely colonize the oral cavity in humans.

Oral thrush: Baby is usually infected with the mother

Newborns with oral thrush have usually been infected at birth, by a possibly unnoticed vaginal fungus in the mother. The fungus in the mouth is then usually already in the first days of life – this happens in up to five percent of infants. Older babies, for example, pacifier pacifiers, which had contact with the saliva of a caregiver. During their lifetime, almost all people come into contact with Candida albicans, but the infection only breaks out in certain circumstances. In addition to very low and very high age are other risk factors for oral fungus:

• HIV infection and AIDS disease
• Diabetes mellitus
• Cancers (e.g., leukemia, Hodgkin’s disease)
• acute infectious diseases (e.g., pneumonia)
• Medications: antibiotics, chemotherapeutics, cortisone-containing asthma sprays
• Nutritional deficiencies (e.g., iron deficiency, vitamin B deficiency)
• decreased saliva production
• nicotine consumption
• Dentures and other forms of dentures

Oral thrush: examinations and diagnosis

The Mundsoor diagnosis can be a dentist, a pediatrician, a dermatologist or a general practitioner. First, he inquires of the person affected (or in the case of babies with the respective caregiver), which symptoms he has noticed and since when they exist. He also asks about existing medical conditions and wants to know if the patient is on medication.

The clinical picture determines the diagnosis of oral thrush

The most important factor in the diagnosis of oral fungus is the clinical picture. The doctor usually recognizes at first glance if thrush is present in the mouth – the white specks are characteristic. However, there is a risk of confusion with a leukoplakia, a tumor precursor. Using a wooden spatula, the doctor carefully wipes off the coating at one point in order to check how the mucous membrane behaves under the oral thrush tips. This allows him to quickly diagnose pseudomembranous candidiasis.

If the fungus shows an atypical picture in the mouth, the diagnosis is not that easy. In any case, it makes sense to secure the diagnosis oral thrush by a smear of the affected mucosa. This way the pathogens can be detected under the microscope. In a blood test can be found in oral thrush antibodies to the candida fungus, usually for the diagnosis but no blood sample is necessary.

Oral thrush: treatment

For oral care, the doctor prescribes special antifungals (antimycotics) that are suitable for the mouth and throat area. These include, for example, the active ingredients amphotericin B and nystatin. They can be used in the form of lozenges, oral gel, solution or suspension (liquid with a pipette).

It is important that you stick to the intended duration of treatment and do not stop the treatment prematurely if no fungal coating is visible. Also, be careful of a fungal disease in the mouth on a careful oral hygiene. If your baby suffers from a mouth mold, you should also replace all pacifiers and bottle teat, or at least sterilize thoroughly.

Oral thrush: Prevent

There are a number of ways in which you can prevent oral thrush on your child and yourself:

• In babies and toddlers hygiene for oral thrush prevention is particularly important. Clean pacifiers, teats and biting toys regularly and avoid using them, e.g. to “clean” fallen pacifiers with their own saliva.
• When you are wearing a denture, make sure that it fits properly. Thoroughly cleanse them after each meal and otherwise perform a thorough oral hygiene to prevent oral thrush.
• If you have an immune deficiency and repeatedly develop thrush in the mouth, it may be useful to use an antifungal drug daily for prevention. Be sure to discuss this with your doctor.
• A vaginal fungus can be transmitted from the mother to the baby at birth and expressed as oral thrush in the newborn. If you are pregnant, treatment of a possible Candida infection makes sense before birth.
• In very sick and old patients who are fed artificially, the salivation is usually so greatly reduced that bacteria and fungi multiply rapidly in the mouth. Retirees and nurses therefore operate a so-called thrush and parotitis prophylaxis, for example by regularly moistening the mucous membranes of the well-groomed person.

Oral thrush: Disease course and prognosis

As long as the therapy is consistently carried out, oral thrush can usually be treated well. In rare cases, oral thrush but can persist and keep coming back. Then the doctor sometimes prescribes a stronger antifungals, which is also effective in the rest of the digestive tract – especially in the intestine – reduces the number of fungi and the Oral thrush so become master.