Oral candidiasis

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1. Overview

Oral candidiasis is a condition caused by candida albicans characterized by the presence of lesions and accumulation of white deposits on the tongue or inside the cheek.

Injuries can be painful and may bleed easily when scraped. Sometimes oral candidiasis can spread to the palate, gums, tonsils or the back of the throat (pharynx).

Although thrush can affect anyone, it occurs most often in children and people who wear dentures, using inhalers containing corticosteroids or those with a compromised immune system.

Oral candidiasis is a minor problem if the person is healthy, but if the immune system is weakened, the symptoms may be more severe and more difficult to control.


1. Overview
2. Symptoms
3. Causes
4. Risk factors
5. Complications
6. Tests and diagnosis
7. Treatment

2. Symptoms

- Children and adults – initially you may not notice symptoms of oral candidiasis. Depending on the cause underlying events, it may develop suddenly and may persist for some time.

Symptoms include: lesions with whitish deposits located inside the cheeks, tongue and sometimes the palate, the gums and tonsils, pain, bruising (if the wounds are rubbed or scraped), cracks and redness at corners of the mouth, loss of taste.

In severe cases, the lesions may spread into the esophagus and if this happens, you may experience difficulty swallowing or feel like pieces of food are stuck in the throat.

- Infants and nursing mothers – in addition to distinctive white lesions in newborns can experience difficulties, restlessness and irritability. Babies can pass the infection to their mothers during lactation and this can then be forwarded from the mouth of the child’s to the mother’s breasts.

Women whose breasts are infected with candida may have the following signs and symptoms: unusual red and sensitive nipples, itching, bright spots on the skin that can be seen in the dark, unusual pain during nursing or painful nipples between feedings, but also twinges in breasts.

3. Causes

Oral candidiasis may occur when the immune system is weakened by disease or some types of medication (prednisone) or when antibiotics disturb the natural balance of microorganisms in a person’s body.

Normally, the immune system rejects harmful invading organisms such as viruses, bacteria and fungi, while maintaining a balance between good and bad microbes that live normally in a person’s body. However, sometimes these protective mechanisms fail, which may allow installation of an oral infection.

Among the diseases that predispose to the development of oral candidiasis may include:

- HIV / AIDS – a repeated oral candidiasis may be the first sign of HIV infection.

- Cancer – in most cases, the immune system of patients diagnosed with cancer is very weakened by the condition itself, but also by the treatment, which increases the risk of mouth infections such as oral candidiasis.

- Diabetes mellitus – if this untreated diabetes is not controlled, the saliva may contain large amounts of sugar, which will favor oral candidiasis.

- Fungal vaginal infections – although fungal infections are not dangerous, women who are pregnant can pass newborn fungus during natural birth.

4. Risk factors

Any person may manifest oral candidiasis, but there are certain categories of people with a higher degree of risk. Risk factors include:
- Young age (condition is common in young children)
- Compromised immune system
- Wearing dentures
- The presence of various diseases, such as diabetes or anemia
- Use of drugs (antibiotics, for example)
- Result of chemotherapy or radiotherapy for cancer treatment
- Evidence of conditions that cause dry mouth (xerostomia)
- Smoking

5. Complications

Oral candidiasis is seldom a problem for healthy children and adults, although the infection can recur even after being treated.

If a person has a weakened immune system:
- Oral candidiasis may spread to various parts of the body, including the digestive tract, lungs and liver.
- Severe symptoms may occur, especially in the mouth and esophagus, which can make eating painful and difficult.
- The infection can spread to the intestines and the nutrients absorption will not be done in an appropriate manner.

6. Tests and diagnosis

- If oral candidiasis occurs only in the mouth, it can be diagnosed by a specialist simply by observation of lesions. Sometimes it may be necessary to harvest a sample from the infected area to confirm the diagnosis.

- Oral candidiasis in the esophagus is worse. To help diagnose the disease, the doctor will require you to perform tests, endoscopic examination or cultures of secretions in the throat.

7. Treatment

Seeing your doctor regularly is intended general health care. During the usual visits, the doctor will try to assess the risk of developing oral candidiasis (especially if certain risk factors are present) and recommend the necessary investigations. These measures will help to diagnose and treat the causes that could form the basis of oral candidiasis, since the early stages of the condition.

Treatment of oral candidiasis include:
- Oral antiseptic solutions
- Diagnosis and treatment of any disease that might contribute to the occurrence of oral candidiasis (such as HIV / AIDS and diabetes).
- Eating yogurt or taking acidophilus supplements may help to balance the microorganisms in the mouth.
- Taking antifungal drugs, including prescription ones such as fluconazole
- Gargling and rinsing the mouth with warm salt water.

In many cases, oral candidiasis in infants may disappear within two weeks and may not require any treatment other than monitoring the evolution of lesions.

Because oral candidiasis may be painful and will cause eating to be difficult, the physician should observe if symptoms worsen and to institute new measures of treatment.



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