Oral Thrush – Overview

Oral Thrush is also known as Oral Candidiasis. It is the most widespread resourceful infection affecting the oral mucosa. It is a fungal infection caused by the Candida albicans, one type of fungus. It can affect the very young, the very old, and the very sick people. Pseudomembranous candidiasis is linked with fungal infections in young children as there is neither fully developed immune system nor a fully developed oral microflora. Oral candidiasis is divided into primary and secondary infections. Primary infections are restricted to the oral and perioral sites only whereas secondary infections are going together with by systemic manifestations.

What causes Oral Thrush?

Candida albicans can be seen in the healthy individuals in certain parts of the body such as mouth, skin and digestive tract. They are well balanced but due to predisposing factors, there is an uncontrolled growth of the fungus which leads to Oral Thrush.

Which are the predisposing factors for Oral Thrush?

There is an apparent association between Oral Thrush and the influence of local and general predisposing factors. The local predisposing factors are able to promote a growth of the yeast or to affect the immune response of the oral mucosa. The local predisposing factors are Denture wearing, smoking, Atopic components, inhalation of steroids, topical steroids, hyperkeratosis, the disproportion of the oral microflora, quality and quantity of saliva. General predisposing factors are frequently related to a person’s immune system and endocrine prominence. Drugs such as corticosteroids, antibiotics, contraceptive pills, as well as diseases suppress the body immune system leads to Oral Thrush. General predisposing factors are immunosuppressive diseases such as HIV Infection, Cancer, impaired health prominence such in Uncontrolled diabetes, Treatments including immunosuppressive drugs, chemotherapy, endocrine disorders, hematinic deficiencies.

What are the Symptoms of Oral Thrush?

Primary infection shows sign of creamy white, slightly raised lesions on the tongue. It may involve buccal mucosa (cheeks), palate, gingiva (gums) tonsils and in severe cases, candida fungal infections may involve esophagus shows symptoms such as Pain while swallowing, Dysphagia, Surge feeling of food gets stuck in the throat. The infected area may be inflamed and sometimes bleeds. Secondary infection is associated with systemic involvement such as in vagina, skin, liver, lungs, etc.

Who can best diagnose Oral Thrush?

Oral Thrush can diagnose by any dentist but can be well diagnosed by Oral Medicine and Radiologist and Oral Pathologist.

How is Oral Thrush Diagnosed?

Your dentist checks for the distinctive white lesion on the tongue, buccal mucosa, palate, uvula, etc. he or she will look whether the affected area is painful or not and also to the presence of bleeding. Oral thrush can be confirmed with the help of various test such as Smear test with help of PAS stain – Periodic acid – Schiff, Pagano-Leyin agar culture, Sabouraud agar culture, Salivary culture test. For these tests, the dentist takes a culture with the help of throat swab. In severe cases, digestive tract endoscopy and various radiographic methods such as CT scan, MRI, etc. are suggested.

How is Oral Thrush treated?

Oral Thrush is treated usually with antifungal regimens based on the predisposing factors. In a case of smoking, cessation of smoking may result in the vanishing of the infection even without antifungal treatment. Most commonly used antifungal drugs are from Polyenes or azoles group. Polyenes such as nystatin and amphotericin B are usually the first picks in a treatment of primary infection. Other antifungal drugs include clotrimazole, miconazole, ketoconazole, fluconazole, itraconazole, etc. The first line of treatment should be exclusion or reduction of predisposing factors for treatment of denture stomatitis. Systemic azoles may be used for profoundly accommodated primary thrush. Patient with HIV may show resistance to fluconazole. In such case, ketoconazole and itraconazole are used. Azoles may also use to treat secondary infections with systemic predisposing factors.

How can Oral Thrush be Prevented?

Maintain good oral hygiene. Every six months, dentist visit is required for periodic maintenance. Quit adverse habits.

Prognosis of Oral Thrush

Prognosis of Oral Thrush is good when associated predisposing factors are reduced or eliminated. Patient with secondary infections is at high risk. For example, a patient with severe immunosuppression as seen in combination with leukemia and AIDS may encounter spreading candidiasis with a fatal course.