Favored by conditions such as the misuse of antibiotics, immunosuppression and diabetes mellitus, oral candida is typically responsible for a white coating on the mucous membranes of the oral cavity and / or throat, sometimes associated with symptoms, including: burning in the mouth, pain when chewing and / or swallowing, abnormal taste in the mouth and lack of perception of flavors.
For the diagnosis of oral candida, a physical examination and anamnesis are generally sufficient; sometimes, however, an oral biopsy or throat swab is required.
The presence of oral candida requires the use of drug therapy based on antifungals.
Oral thrush is also known as "thrush" and "oral thrush".
Brief reminder of what Candida is
Candida (or candidiasis) is a "fungal infection (or mycosis) caused by the fungus Candida albicans. This fungus is naturally present in the human body; in particular, it loves to live in humid and warm environments, such as the mouth, throat, esophagus, gastrointestinal tract and genitals (vagina, in women, and glans, in men).
Like Candida albicans causes Candida
Candida albicans it is, in fact, a fungus that is generally harmless to humans, as the so-called "good bacteria" constituting the bacterial flora and the immune system prevent its pathological proliferation.
However, when these two control systems fail, Candida albicans begins to multiply intensively, giving rise to the condition known as candida or candidiasis.
Mushrooms that behave like Candida albicans - that is, who take advantage of a difficult situation on the part of the host - are called opportunistic mushrooms.
Scientific classification of Candida albicans
Candida albicans it is a saprophytic fungus (that is, it feeds on decaying material), belonging to the saccharomycetes family. Saccharomycetes are particular unicellular organisms, which live in colonies and which fall into the category of so-called yeasts (exactly as Saccharomyces cerevisiae, the yeast used for bread).
For further information: Candida: What it is like Candida albicans;Immunosuppression is a typical problem of those suffering from diseases such as AIDS or cancer, those taking immunosuppressive drugs, chemotherapy or inhaled corticosteroids, those undergoing radiotherapy and those who are elderly;
It should be noted that, although it happens very rarely, even people who are in excellent health and do not fall into any of the aforementioned risk categories can develop oral candida.
Did you know that ...
In patients with diabetes, to promote the proliferation of Candida albicans in the oral cavity is the saliva, which, due to the metabolic disease in progress, is extremely rich in glucose.
Is Oral Candida Contagious?
Through the kiss, the individual with oral candida can transmit the same infection to non-infected people; therefore, oral candida is a contagious, transmissible disease.
It should be noted, however, that the phenomenon of oral candida transmission usually involves non-infected people who fall into one of the risk categories listed above (improper use of antibiotics, presence of immunosuppression or diabetes, etc.).
Oral Candida Neonatal and Breastfeeding: the Causes
Babies born in vaginal delivery to women with some form of candida may acquire oral candida or some other similar infection (eg esophageal candidiasis) from the mother; in these situations, there is a phenomenon of neonatal candida infection.
In addition, all babies breastfed by mothers with a form of breast candida can get sick with oral candidiasis.
In this regard, it should be noted that, during breastfeeding, just as the uninfected child can acquire oral candida from the mother with breast candida, so the uninfected mother can acquire breast candida from the child with oral candida.
Epidemiology
Oral candida is rare in healthy people; on the other hand, it is quite frequent in people with cancer, AIDS or diabetes, in individuals taking chemotherapy or immunosuppressants, in patients undergoing radiotherapy and in those who wear a dental prosthesis without taking care of its hygiene.
lingual, palatal and / or oral, of white patches or, alternatively, of a white patina, which, if removed by rubbing, show underlying red and sometimes bloody lesions.
Oral Erythematous (or Atrophic) Candida
Also existing both in acute and chronic form, oral erythematous candida is the type of oral candida that is characterized by the presence, on the lingual, palatal and / or oral mucosa, of red lesions.
It should be noted that sometimes erythematous oral candida represents the prelude to pseudomembranous oral candida.
Hyperplastic Oral Candida
Hyperplastic oral candida is the least common type of oral candida.
It is characterized by the presence, on the lingual, palatal and / or oral mucosa, of persistent whitish plaques or nodules with a rough surface.
, inner wall of the cheeks and / or throat (pseudomembranous oral candida); more rarely, instead of these white patches, it produces a reddened erythema (oral erythematous candida) or whitish nodules (hyperplastic oral candida).Sometimes, the above signs are associated with symptoms, such as:
- Pain when chewing and swallowing;
- Burning in the mouth, similar to burning with a hot liquid;
- Metallic, sour, salty or bitter taste in the mouth;
- Lack of perception of flavors.
Symptoms of Oral Candida in the Infant and Young Child
In the infant and young child, oral candida manifests itself with symptoms and signs similar to those of oral candida in adults; the only difference between the two situations lies in the fact that infants or children with oral candida also exhibit a certain degree of irritability and cry often.
Diseases Associated with Oral Candida
Oral candida can be associated with several other conditions, including:
- Esophageal candidiasis (or esophageal candida). Always caused by Candida albicans, this condition causes the appearance of whitish plaques on the inner surface of the esophagus and manifests itself with pain when swallowing, nausea, vomiting and weight loss.
- Angular cheilitis. It is the skin affection characterized by the inflammation of the corners of the mouth; often, to favor this phenomenon during the oral candida, it is a "bacterial infection from Staphylococcus aureus.
- Denture stomatitis. In medicine, the term "stomatitis" indicates any inflammation of the oral mucosa.
When combined with the presence of a dental prosthesis, oral candida also tends to cause stomatitis. - The median rhomboid glossitis. It is the inflammation of the tongue characterized by the presence of a red, rhomboid-shaped lesion in the center of the tongue; usually, to favor this phenomenon during oral candida, it is the superimposition of a bacterial infection.
- Linear gingival erythema. It is an inflammation of the gums, characterized by erythema, which, in the presence of oral candida, occurs mainly among people with HIV, with herpes simplex virus or who do not take sufficient care of their oral hygiene .
Oral Candida: Complications
Like other forms of candida, in the presence of severe immunosuppression or particular conditions (e.g. diabetes), oral candida can degenerate into a systemic condition, known as invasive candidiasis (or invasive candida).
Invasive candida is the infection resulting from the fungus passing through the blood Candida albicans (fungemia or funghemia) and its spread to important organs, such as the heart (endocarditis), the brain (encephalitis), the lungs (pneumonia), the liver (hepatitis), the eyes (endophthalmitis) or the bones (osteomyelitis).
Invasive candida can be fatal for the patient, therefore it represents a "medical emergency, which needs immediate help.
For a healthy adult, an infection such as oral candida is not a particularly dangerous condition.
When to see a doctor?
An individual should contact their primary care physician when they fall into a risk category for oral candida and develop the classic symptoms and signs of the condition (white patches on the tongue, palate, inner wall of the cheeks and / or throat, burning in the mouth etc. ).
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The physical examination is the accurate medical observation of the symptoms and signs exhibited by the patient; the anamnesis, on the other hand, is the collection, by means of questions, of all those data relating to the patient, which are useful for deciphering the triggering causes and factors favoring the condition in progress (presence of chronic diseases such as diabetes, pharmacological therapies in act, lifestyle habits, etc.).
If the "physical examination and anamnesis do not provide sufficiently precise indications for the diagnosis or if there is a doubt of an" association between oral candida and esophageal candidiasis, the doctor will have to resort to further investigations: biopsy of the oral cavity and, sometimes, throat swab, in the first case; endoscopy of the esophagus, in the second case.
oral therapy is based, first of all, on a drug therapy based on antifungals, the aim of which is to eliminate the fungal colony responsible for the infection; secondly, it requires special attention to oral hygiene.Antifungals are drugs with a specific anti-fungal power.
Oral Candida: Drugs
The antifungal drugs most used in the presence of oral candida are fluconazole, clotrimazole, miconazole and nystatin: belongs to the category of triazoles; the second and third are two imidazole derivatives; the fourth, finally, is an antibiotic with anti-fungal properties.
If fluconazole, clotrimazole, miconazole and nystatin are ineffective, drug therapy turns to itraconazole, another triazole, or to amphotericin B, a polyene macrolide.
As regards the route of administration of the aforementioned drugs, this varies according to the severity of the infection: for mild-moderate infections, it is orally via capsules or tablets; for severe infections, however, it is intravenously via injection.
In the presence of severe oral candida, the intravenous administration of antifungal drugs serves to prevent the phenomenon of fungemia and the consequent invasive candida.
Pharmacological Therapy in AIDS Patients
If oral candida affects an individual with AIDS, drug therapy involves administering itraconazole by mouth or intravenously (depending on the severity of the infection).
Pharmacological Therapy in case of Invasive Candida
If oral candida degenerates into invasive candida, drug therapy involves intravenous administration of the aforementioned amphotericin B.
Duration of Pharmacological Therapy
Generally, the duration of drug therapy useful to counteract oral candida is around 14-21 days.
However, it is the treating physician who determines precisely how long the patient should take the antifungal drugs.
Rules of Oral Hygiene
Regarding oral hygiene, in the presence of thrush, it is good to:
- Brush your teeth gently and with a soft-bristled toothbrush, to avoid scraping the signs of infection inside the oral cavity;
- If you wear a dental prosthesis, take it off at night and wash it thoroughly;
- Avoid the use of mouthwashes and similar products, unless otherwise indicated by the doctor;
- Avoid consuming sweet foods.
It should be noted that, after healing, it would be advisable to change the toothbrush.
oral are:
- During an antibiotic therapy, respect the doses prescribed by the attending physician and take lactic ferments;
- In the presence of conditions favoring oral candida (eg: diabetes, AIDS, immunosuppression, etc.), take maximum care of your oral hygiene;
- Limit the consumption of foods rich in sugars;
- Carefully treat infections with Candida albicans borne by other parts of the body (eg breast candida, vaginal candida, etc.);
- For those with dental prostheses, remove the latter during the night and wash it periodically;
- Regularly undergo dental check-ups;
- For people with diabetes mellitus, keep blood sugar under control through diet, physical activity and possibly medications.
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