What is oral thrush

Oral thrush

Who is common with oral thrush?

Oral thrush is particularly common in babies because their skin is not yet very well developed. In addition to oral thrush, infants very often have another fungal infection in the diaper area known as "diaper thrush".

Elderly people and people who suffer from an immunodeficiency disease such as AIDS are also particularly at risk of developing candidiasis. In healthy people, oral thrush often occurs after cortisone or antibiotic treatment, as these drugs also kill healthy bacteria and mess up the oral flora.

Frequency of oral thrush

Studies have shown that Candida infections have increased in the last ten to twenty years, with the transition from a harmless to a symptomatic infection very often being fluid. In babies, Candida fungus was detected in about 22 to 24 percent of all examined in the first two months, with 95 percent of the infants exhibiting symptoms of oral thrush. Oral thrush also occurs very frequently with tooth decay, with those who wear dentures, but also with various underlying diseases.

Causes of Oral Thrush

Oral thrush is mainly caused by Candida fungi, one of the so-called opportunistic pathogens, which means that they only cause an infection when living conditions are very favorable. Many healthy adults have Candida without causing any symptoms or symptoms. As long as the immune system is intact, it can keep the fungi in check too.

In infants and young children, however, the immune defense is not yet fully developed and therefore the conditions for Candida fungi are very favorable. Newborns often come into contact with fungi during birth, as yeast can be found in the birth canal of many pregnant women. However, fungi can also be transmitted through the hands of hospital staff, the mother's breast or from the oral cavity.

The ingested Candida fungi always first settle in the oral mucosa. Robust newborns excrete the yeast without developing oral thrush. Starting from the oral cavity, the fungi then reach the throat, esophagus and gastrointestinal tract and can spread there.

In addition, there are numerous systemic and local factors that can lead to oral thrush. These include:

  • elderly
  • People who suffer from a weakened immune system or other underlying diseases such as tumors, HIV infections, diabetes mellitus, hormonal changes, leukemia or deficiencies.
  • Dentures
  • various drugs such as cytostacics, antibiotics, inhaled glucocorticoids (cortisone sprays for bronchitis and asthma), immunosuppressants
  • Dry mouth caused, for example, by taking antidepressants.
  • Virulence of the pathogen
  • high carbohydrate diet

Symptoms of Oral Thrush

Acute oral thrush usually begins with reddening of the mucous membrane, which over time takes on a dry, shiny and smooth appearance. Often the papillae of the tongue also disappear with oral thrush. After about three to four days, pin-sized, irregular, whitish pebbles appear that resemble semolina and look like a cream. In addition, a yellowish layer forms and the white coverings can be moved.

Since the mushrooms are very active, bad breath can also occur with oral thrush and the body begins to fight the pathogens. For this reason, the lymph nodes also swell, which indicates that the immune system is more active. The damaged oral mucosa causes pain, which can be problematic, especially in infants who suffer from oral thrush, as they naturally react more sensitively and often refuse to drink.

If the oral thrush is not treated in the early stages, the pathogens can spread. Possible subsequent symptoms are vomiting and heartburn, which can add to the typical symptoms.

Diagnosing oral thrush

To diagnose oral thrush, the doctor takes a smear, since there are corresponding antigens in the blood when there is an infection. In the case of oral thrush, material is removed from where the pathogen is most likely, for example from the white deposits or under the dental prosthesis. The material is then examined under the microscope with the addition of a saline solution. In the case of oral thrush, a fungal culture can also be grown on a suitable nutrient medium in order to determine the type of pathogen.

However, the detection of antibodies in oral thrush is often relatively unreliable in immunosuppressed patients. When diagnosing oral thrush, the risk of invasive forms and chronic candidasis should therefore always be assessed. This includes looking for specific risk factors for oral thrush such as:

  • Tumors
  • underlying haemato-oncological diseases such as lymphoma or leukemia
  • Diabetes mellitus
  • Condition after organ or bone marrow transplants
  • HIV infection
  • Immunodeficiency
  • long-term antibiotic treatment
  • long-term treatment with glucocorticoids
  • Cytostatic therapies

In addition, it makes sense to clarify possible entry points for the pathogens of oral thrush. This includes:

  • Dentures that do not fit properly
  • erosive diseases of the mucous membranes
  • contaminated CVC (central venous catheter)

Treating oral thrush

Since oral thrush is usually quite persistent, drug treatment with anti-fungal agents (antimycotics) is usually carried out. These are available in the form of suspensions or ointments that are applied to the affected areas. If other organs or the intestines are also affected by thrush, a stronger antifungal medicine that works throughout the body should be taken. A sufficient duration of treatment is also very important. In addition, any type of medication should remain in the mouth for as long as possible. Usually nystatin, miconazole or amphotericin B in the form of lozenges or suspensions are used for oral thrush.

Frequency of oral thrush

If oral thrush cannot be controlled with topical treatment, systemic therapy with azoles can also be indicated. One effective drug is fluconazole, which is available as dry juice, juice, or in capsule form.

In immunocompetent infants, the polygenes amphotericin B and nystatin are very suitable for the treatment of oral thrush.

To support the treatment of oral thrush, those affected can also regularly rinse the mouth with myrrh, since tinctures of myrrh also have an antifungal effect. With this form of therapy, however, you should keep at least one hour away from the antifungal agent, otherwise you could provoke irritation. Rinses with sage or arnica, which also have an antiseptic effect, have a comparable effect to the treatment of oral thrush.

Since mushrooms feed on sugar, you should also avoid foods containing sugar and yeast. Fruit juices and acidic foods also cause oral thrush pain in the oral cavity. Furthermore, dairy products should not be consumed, as they have a mucilaginating effect.

Candida fungi also use teeth affected by tooth decay as a reservoir, so careful dental hygiene should also be observed during antifungal therapy, and the toothbrush should also be changed regularly. Dentures should also be cleaned with suitable antimycitic substances. In the case of infants, it is advisable to disinfect and boil soothers and teats.

Prevention of oral thrush

To prevent mouth fungus, you should generally pay attention to thorough oral hygiene in order to prevent the Candida fungus from multiplying. Thorough hygiene and care of the nipples is recommended for breastfeeding mothers in order to save the newborn from developing oral thrush. If mothers notice a fungal infection or oral thrush themselves, contact with the oral mucosa of the babies should be avoided and teats and pacifiers disinfected more often.

In principle, it is advisable to consult a doctor immediately after detection of a suspected oral thrush, so that the spread of the fungus in the throat or esophagus can be prevented. Non-prescription drugs should only be taken after consulting a doctor if you have oral thrush. The same applies to the self-treatment of oral thrush with home remedies, especially for older people and infants.