Forms of candidiasis in the mouth
The classic, most recognizable form is pseudomembranous: white cheesy plaques on the tongue, cheeks, palate and gums that are removed with a spatula, revealing a bright red, sometimes bleeding surface. The atrophic form looks different: there is almost no plaque, the mucous membrane is smooth, red, the tongue is shiny and painful - this is how candidiasis often occurs under a removable denture. Separately, angular cheilitis is distinguished - cracks and weeping in the corners of the mouth, which are often combined with mucosal candidiasis.
- Pseudomembranous - curdled plaques
- Atrophic - red smooth mucous membrane
- Hyperplastic - dense, indelible plaques
- Denture stomatitis under a removable denture
- Angular cheilitis - sticking in the corners of the mouth
Causes and provoking factors
Candidiasis almost always has a cause, and it is the search for it that distinguishes competent treatment from endless repetitions. In adults, a common situation is a recently completed course of antibiotics or inhaled hormone for bronchial asthma, if you do not rinse your mouth after inhalation. Dry mouth due to medications or diseases of the salivary glands deprives the mucous membrane of natural protection. In older people, removable dentures play a role, especially if they are not removed at night. The first occurrence of persistent candidiasis in an adult requires checking blood sugar.
- A course of broad spectrum antibiotics
- Inhaled and systemic glucocorticosteroids
- Diabetes and high glucose levels
- Dry mouth, taking diuretics and antidepressants
- Removable dentures and poor hygiene
- Infancy and old age
- Immunodeficiency conditions, chemotherapy
- Smoking
Symptoms in children and adults
In infants, thrush appears as white specks and films on the tongue, gums and inside of the cheeks. The main difference from milk residues is that milk plaque is easily washed off and lies only on the tongue, while candidal plaque is difficult to remove and leaves a red spot. The baby may be capricious at the breast, pull away and cry during feeding. In adults, burning, dryness, a metallic or cottony taste, decreased taste sensitivity and pain when eating spicy and sour foods come to the fore.
- White cheesy coating that comes off with redness
- Burning and dry mouth
- Perversion or loss of taste
- Pain when eating and swallowing
- Cracks and jams in the corners of the mouth
- The baby has anxiety when feeding, breast refusal
Diagnostics
Usually the diagnosis is made during examination: the picture is quite characteristic, and the decisive sign is the red surface under the removed plaque. In controversial cases, scrapings from the mucosa are taken for microscopy and culture, especially in cases of persistent disease and suspected drug resistance. If candidiasis occurs for the first time in an adult without an obvious provocateur, the doctor checks blood glucose, and with repeated episodes and other alarming signs, he expands the examination.
- Oral examination
- Mucosal scraping, microscopy and culture
- Blood glucose
- General blood test
- Assessment of medications taken and inhalation technique
- Inspection and evaluation of removable dentures
Treatment and prevention
The basis of treatment is antifungal drugs, which are selected by the doctor: for limited damage, local forms in the form of a gel, suspension or solution are sufficient; for a widespread process and in patients with reduced immunity, systemic agents are prescribed. At the same time, the cause must be eliminated: they teach how to rinse the mouth after inhaling the hormone, adjust the sugar level, and improve the care of the prosthesis. Zelenka, soda and honey do not replace treatment, and in infants honey is also dangerous. In case of thrush in an infant, the breasts of the nursing mother are examined and, if necessary, treated.
- Local antifungal agents as prescribed by a doctor
- Systemic drugs for the common form
- Mouth rinse after inhaled hormones
- Blood glucose monitoring
- Removal and treatment of the prosthesis, refusal to wear it at night
- Sterilization of nipples and bottles, breast care during feeding
- Quitting smoking and limiting sweets