Oral Candidiasis/Oral thrush: Infection of mouth

Know everything about oral candidiasis or oral thrush

We all have heard the word fungus. Right.  I have also shared a post on fungal infections that are commonly seen including their symptoms, causes and treatment. For more details read the post on fungal infections here.

In this informational post, let us talk about one of the most common fungal infections of mouth, Oral candidiasis. Have you ever seen a tongue that is covered like cottony-or cheesy white layer? Have you seen it in kids or breastfed babies? Have you seen lots of white layer or dirt on tongue with cracks or some sort of bleeding? 

If you notice your tongue is abnormally covered with white layer, it can be something that you need to pay attention to.  Well, It can be an oral infection. Oral infection due to fungus can be seen in children more than adults. 

What is oral candidiasis or oral thrush? 

Oral candidiasis or Oral thrush is an infection caused by a yeast named Candida. Candida is a type of fungus, a microorganism that normally resides in our mouth.  It is a opportunity grabbing germ that invades our body whenever it gets opportunity. Under normal and healthy conditions, Candida does not attack us, but on getting favorable conditions, it grows uncontrollably and causes infection. 

Who gets Oral candidiasis or Oral thrush?  Who is at highest risk to get Oral candida infection?

Actually as the fungus is found normally residing on our skin, mouth, vagina and other parts of body, it can affect almost anyone regardless of their age.  However certain conditions and factors can increase the risk of getting infection. People with any of this factor puts them at a higher risk of having oral thrush.

• Breastfeeding babies
• Nursing mothers
• Elderly people
• People with HIV/AIDS
• People who are in coma or are bed ridden
• People who wear dentures
• People who are taking medications such as antibiotics or corticosteroids such as prednisone, etc
• People living with asthma and using inhaled corticosteroids
• People who have diabetes
• People who have cancer
• People who have suppressed immune systems
• People with weak immunity
• People who do not maintain their oral hygiene
• Any condition that makes our mouth and throat dry

What are the symptoms of Oral candidiasis /Oral thrush?

Candidiasis symptoms are:

• White cottony patches on the tongue. It may seem like layered appearance.
• White raised lesions may also form on the sides, cheeks, roof of the mouth and gums.
• Redness in the mouth 
• Pain while eating or swallowing
• Foul smell or bad breath(Halitosis)
• Decreased or loss of  taste sensation due to obstructed taste buds
• Unable to chew, eat or swallow the food due to burning sensation and pain
• Cracks on the lesions. Cracks are evident at the angles of the lips also called angular cheilitis
• Inflammation or redness of the gum line also called gingival erythema
• Bleeding lesions
• Feeling something cottony on the tongue. The tongue feels dry.

What are the causes of Oral candidiasis/Oral thrush?

Oral candidiasis is an opportunistic fungal infection and it chooses the host that is considerably weaker in terms of immunity.  You can be a target host for such fungus if you have weak immunity or have some associated mouth infections. 

Following causes and risk factors may be responsible for Oral candida infection or oral candidiasis:

• Age: it is common in infants and older children. However people can have this infection at any age. 
• Oral hygiene: People who have poor oral hygiene are at more risk of having infection.
• Medications: Antibiotics may destroy some normal or healthy bacteria and put us at risk of getting fungal infection.  Inhaled corticosteroids may cause dryness of mouth and throat.
• Medical conditions: If a person has uncontrolled diabetes, cancer, HIV/AIDS, etc. then the chances of getting oral thrush is high.
• Chemotherapy and radiation therapy may also contribute to the risk of oral thrush.
• Kissing a person with oral thrush may spread the infection to other. 
• Breastfeeding babies with oral thrush may transmit the infection to the mother's, causing mastitis, inflammation of areola and nipples due to fungus overgrowth.
• Smoking: If you are a chronic smoker, then the chances of having oral thrush are high.
• Wearing wrong-sized dentures may cause infections of the oral mucosa beneath called denture stomatitis and this may help in the overgrowth of the fungus. 

Oral thrush of mouth and throat is called as oropharyngeal thrush. When the infection spreads deep down the throat into the esophagus, it is termed as esophageal thrush or candida esophagitis or esophageal candidiasis. The later is commonly seen as an opportunistic infection in person having HIV/AIDS. 

How is oral thrush/oral candidiasis diagnosed?

Oral thrush can be diagnosed by physical examination of your tongue and oral cavity using a torch light.  A physician will examine your mouth carefully. 

• Swabs may be taken from your tongue and throat to sent them for culture tests to detect the fungus. The samples are sent to the laboratory and studied under a microscope to test it for the presence of fungus Candida albicans.
• In some cases biopsy may be taken to make accurate diagnosis of oral thrush,
• Esophageal candidiasis may be diagnosed by perforoming diagnostic endoscopy procedure. 

What is the treatment of oral thrush?

Oral thrush or oral candidiasis can be treated by taking the antifungal medications such as fluconazole, clotrimazole, Amphotericin B as prescribed by your doctor. Antifungal oral rinses help us get rid of the fungus present in our mouth and on tongue. Fluconazole is a drug of choice for esophageal candidiasis. 

The antifungal medications may be prescribed for a duration of a week or couple of weeks.  The symptoms usually start subsiding within 7-14 days of starting treatment. 

If your baby has oral thrush see your baby's doctor and give antifungal medicine as prescribed.  

Apply antifungal creams on your breast around and on the nipples if you too have signs of fungal infection.

Are there any home remedies for oral thrush or oral candidiasis?

Home remedies can make you feel at ease and help you recover fast from oral thrush. 

1. Brush your teeth properly twice a day. Floss your teeth regularly.
2. Do not rub or scrape the white layer as it can cause bleeding.
3. Applying a solution of water and few drops of lemon juice may help lower the layers of white lesions.
4. Use warm water to gargles and rinse your mouth.  Add some salt or apple cider vinegar into water and apply gently on the tongue and sides of mouth with cotton.
5. Use oral rinses as recommended by your doctor.
6. Include probiotics in your diet. Consume vitamin-C rich diet to facilitate healing.
7. Eat foods that are soft and easily chewable to avoid any discomfort or pain during swallowing.
8. Limit the intake of your refined carbohydrate to limit the overgrowth of the fungus.
9. Quit smoking to recover fast.
10. Gentle wiping and cleaning with cotton swabs may be done using a mild hydrogen peroxide solution,
11. Clean your dentures with proper disinfectant solution as advised by your dentist to avoid any other oral infections. 
12. Apply petroleum jelly or glycerine on the cracked angles of lips to let them heal faster and reduce the pain.

Can we prevent oral candidiasis or Oral thrush?

Yes. Oral thrush can be prevented. Preventive measures for oral thrush are:

Prevention tips: 

1. Maintain your oral hygiene. Brush your teeth twice a day. Brush teeth after you use your inhalers.
2.  Regular monitoring of your blood glucose levels and keeping it controlled. 
3. Anti-fungal oral rinses and warm saline gargles help us get rid of any fungus or bacteria to build up in the mouth.
4. Choose perfectly fitting dentures and keep the dentures clean to prevent infection.
5. Rinse your mouth with water after using your inhalers for inhaled corticosteroids.
6. Drink plenty of water. Avoid dryness of your mouth. 
7. Quit smoking if you don't want to have oral thrush.
8. Take regular treatment for diabetes, cancer or any other immune disorders.
9. Take appointment of your dentist and get your dental checkup done every six months.

Oral thrush is a candida albicans infection that affects the tongue, roof of mouth and cheeks. The symptoms are characteristic white creamy layer on the tongue and other areas of mouth. It can be treated by antifungal medications. Prevention can be done by good oral hygiene and avoiding dryness of mouth.

Note: This blog post is for educational and informational purpose only. It is not a substitute to any medical advice, consultation or treatment. Seek medical help in any case.