Fungal infections in the mouth, also known as an ORAL TRUSH is a very common ailment in almost half of the population, especially those with a weaker immune system and everyone who wears dentures or smokes. Oral thrush is an infection of yeast fungus, Candida albicans, in the mucous membranes of the mouth. Usually, thrush is known as a temporary candida infection in the oral cavity of babies. But it can also include candida infections occurring in the mouth and throat of adults, also known as candidiasis or moniliasis.
Fungal infections in the mouth become visible in the form of tiny, moist, pale pink spots occurring on the palate, lips (known as angular cheilitis), and at the end and sides of the tongue. A symptom of fungal infection may also be the throat, changes on the cheeks and gums problems. These changes can happen as a side-effect of taking antibiotics or drug treatment, such as chemotherapy. It can also be caused by certain conditions – such as diabetes, drug abuse, malnutrition – and as a consequence of immune deficiencies relating to old age or infection.
It is said that oral thrush is external fungal infections and occurs as a result of systemic (overall body) fungal infection.
The most common group of patients suffering from fungal infection in the mouth are:
- Newborn babies
- Denture users
- Adults with diabetes or other metabolic disturbance.
- People with a dry mouth relating to side-effects of their medication or medical conditions
- People undergoing antibiotic or chemotherapy treatment.
- People prescribed oral steroid medication
- Drug users
- People with poor nutrition or with an immune deficiency
Treatment of fungal infection of the mouth should begin with a teeth and gums review. We should also check the space between the teeth. It is the habitat of the remaining food friendly environment for the development of fungi.
Types of fungal infection in the mouth
- Pseudomembranous Candidosis / Thrush
White patches on the surface of the oral mucosa, tongue, throat or cheeks. Lesions develop into confluent plaques covered with chalk-white substance and can be wiped off to reveal a raw erythematous and sometimes red, bleeding base. You can feel unpleasant symptoms such as dryness of the tongue, lips and so-called inflammation and cheilosis in the corners of the mouth.
- Erythematous candidosis
Erythematous areas found generally on the dorsum of the tongue, palate, or buccal mucosa.
Very often it occurs in people wearing dentures. Lesions on the dorsum of the tongue present as depopulated areas. Red areas often are seen on the palate of people that have HIV infection Surrounding this fungal infection are very annoying because it is very painful and leads to problems with biting.
- Chronic hyperplastic candidosis – candidal leukoplakia
Leukoplakia is a reaction to an irritant, like rough teeth, badly fitting dentures, smoking or smokeless tobacco. A chronic, discrete lesion may vary from a small, palpable, translucent, or whitish area to a large, dense, plaque-like lesion that is hard and rough to the touch. Candidal leukoplakias usually occur on the inside surface of one or both cheeks; they occur less commonly on the tongue – infection mainly related to men. It is generally painless, and can’t be scraped off.
- Acute atrophic candidiasis
Acute atrophic candidiasis is usually associated with a burning sensation, soreness in the mouth or on the tongue. Often found in people with diabetes, but also in those taking antibiotics or steroids for a long time. The tongue may be bright red similar to that seen with a low serum B12, low folate, and low ferritin.
- Angular stomatitis (perlèche, angular cheilitis)
Lesions affect the angles of the mouth. General characteristic of this infection is soreness, erythema and fissuring. Both yeasts (candidal) and bacteria (especially Staphylococcus aureus) may be involved.
Angular stomatitis commonly is the sign of anaemia or vitamin B-12 deficiency and resolves when the underlying disease has been treated. Iron deficiency anaemia and other vitamin deficiencies have been quoted as a predisposing factor. Diagnosis may be also associated with denture-related stomatitis. Angular stomatitis also may be seen in individuals with HIV infection.