Candidal stomatitis (or oral thrush , or fungal stomatitis ) is a fungal infection of the oral mucosa and in some cases can even affect muscle tissue. The patient not only sees a white coating in the mouth of various structures, but also experiences unpleasant and sometimes painful sensations throughout the entire oral cavity. The disease can appear at any age, but most often in early childhood (20% of children under one year old) or in older people (10% after 60 years). If thrush is left untreated, the fungal infection can spread to the surface of the throat and esophagus.
Causes of candidal stomatitis
The most common cause of candidiasis stomatitis is a fungus of the Candida albicans group. It is worth noting that these fungi are always present on the mucous membranes of the mouth, and do not cause any harm to the body until they begin to multiply.
The causes of the development of candidal stomatitis are the following factors and diseases:
- Weak immunity;
- People with Sjögren's syndrome;
- Neglect of general rules of oral hygiene;
- Constant stress;
- Various diseases of the oral cavity;
- Taking antibiotics or corticosteroids;
- Having a disease such as diabetes. This is all due to the fact that the blood contains a large amount of sugar, and this serves as an excellent environment for the development of fungus of the genus Candida.
It is also worth noting that adults who suffer from excessive dry mouth can get candidal stomatitis. The most common cause of such dryness is the abuse of dental elixirs.
Another factor that can cause the development of candidal stomatitis is pregnancy. After all, it’s no secret that it is during this period that significant hormonal changes occur in a woman’s body, which, in turn, greatly affect the bacterial balance in the mouth.
Predisposing factors and risk groups
It is known that 50% of people are carriers of fungal microflora, and under normal conditions it can be in a kind of “dormant” or suppressed state in the form of chlamydospores, resistant to the external environment. This is why fungal microflora can be transmitted from person to person (i.e., it is contagious). However, under certain conditions, the fungus can begin to multiply rapidly, form colonies and lead to thrush in the mouth (candidal stomatitis). Moreover, under certain conditions, this disease can recur in both children and adults (chronic candidal stomatitis). There are many factors that predispose to this disease and form risk groups for candidal stomatitis in adults and children.
General decrease in immune defense. Can be caused by pregnancy, general diseases (diseases of the gastrointestinal tract, diabetes mellitus, tuberculosis, immunodeficiency states), long-term use of medications (especially antibiotics, corticosteroids, cytostics), dysbacteriosis, avitaminosis (lack of vitamins B, C, PP) , bad habits (alcohol, smoking).
Infants and elderly people. Children, up to about the seventh month of life, and the elderly, due to imperfect or reduced immune defense, are especially susceptible to this disease. Moreover, when diagnosed with chronic candidal stomatitis, a thorough immunological examination is necessary.
Local factors. For example, injuries to the oral mucosa (due to malocclusion of the dentition, chipped tooth enamel). Another common case is removable dentures, which, with insufficient hygiene, contribute to the proliferation of fungal microflora or injure the mucous membrane. Local factors include allergic reactions to dental materials, when allergic stomatitis initiates the appearance of fungal stomatitis.
Symptoms
A number of symptoms are characteristic of candidal stomatitis:
- The appearance of a white or yellowish coating on the tongue, cheeks or palate. When trying to eliminate it, bleeding wounds may appear on the mucous membrane.
- Constant metallic taste.
- Feeling of heartburn on the tongue.
- Painful sensations from touching plaque.
- Later, as plaque spreads, difficulty swallowing occurs.
- Deterioration of tongue sensitivity and poor taste perception.
What is oral candidiasis?
Oral candidiasis (also called oral thrush) is an infection of the mouth caused by the yeast-like fungus Candida. These microorganisms are part of a healthy microflora, but under certain circumstances their reproduction disrupts the favorable environment and becomes a source of disease processes. Inflammation and plaque on the tongue, ulcers on the mucous membrane and discomfort in the mouth - this disease is called oral candidiasis.
Infants are most susceptible to this disease, but at this age it is treated faster and is tolerated almost painlessly. Oral thrush is often observed in adults after 50 years of age, when the immune system is already weakened. Oral candidiasis is less common in men than in women. Recently, the percentage of cases has increased significantly, which is associated with uncontrolled use of medications: weakening of cellular immunity increases the risk of oral candidiasis after antibiotics, or rather their improper use. Microbiology, the science of microorganisms, studies the essence of oral candidiasis. And she successfully copes with her task, at the moment this disease has been studied in detail, and doctors know all the methods of treating and preventing infection.
Forms of the disease
Candidal stomatitis is a fairly common disease that manifests itself in various forms. The symptoms can determine how much it is progressing. Treatment depends on the severity of the disease.
In the earliest stages, a mild form of the disease appears. It is characterized by the formation of single small white spots on the tongue or cheeks.
In the next middle stage, ulcers may form, and white spots themselves cover most of the tongue and mouth.
And at the most severe stages, plaque cannot be removed - it completely covers the entire oral cavity and forms a white film. Also, candidal stomatitis is classified separately depending on the location:
- Candidal stomatitis of the corners of the mouth. Very small cracks appear at the corners of the mouth, which cause pain. This is especially evident when opening the mouth.
- Yeast glossitis usually occurs on the surface of the tongue. It is characterized by a white coating and even swelling of the tongue.
- Thrush - the so-called yeast stomatitis - is a disease in which plaque forms on the cheeks and gums. The mucous membrane itself becomes reddened.
Types and forms of pathology
In practice, acute and chronic oral candidiasis occurs. The first develops rapidly, the second is characterized by a sluggish course and vague symptoms, periodic relapses and inflammation.
Acute fungal candidal stomatitis can be pseudomembranous (white plaque is easily removed and reveals reddened areas) and atrophic (there is no plaque, the mucosal surface dries, turns red and becomes painful).
Chronic thrush can be hyperplastic (white or grayish cheesy plaques form on the soft tissues) and atrophic (the oral mucosa dries out, becomes thinner, the patient complains of pain and discomfort).
Treatment
First of all, when treating candidal stomatitis, you need to determine and eliminate the cause, adhere to the principles of proper nutrition and strengthen the body's immune system. And, of course, it is necessary to monitor oral hygiene. In most cases, this is quite enough for recovery.
If the disease is in a moderate or severe stage, the doctor often prescribes special medications for oral administration and antifungal ointments. Taking medications continues until the symptoms in the oral cavity are completely eliminated, in order to exclude possible relapses.
Treatment of mild forms of candidal stomatitis is carried out at home and does not require special conditions. Antifungal elixirs and lozenges are used. On average, the treatment course takes no more than two weeks.
More severe forms are characterized by the fact that the infection enters the digestive tract. Antifungal drugs are used to combat the disease. The course of treatment lasts from 2 to 4 weeks.
Recurrent forms of candidal stomatitis require much more time and money. Treatment is carried out until all symptoms disappear completely. Various antifungal agents are used.
Treatment of candidal stomatitis must be combined with a special diet. First of all, you should stop eating foods that are rich in starch and various confectionery products, minimize the consumption of cereals, baked goods, potatoes, etc.
When treating candidal stomatitis, other concomitant diseases should be eliminated, in particular:
- Caries;
- Periodontal disease;
- Chronic diseases of internal organs.
Clinical researches
Repeated clinical studies have proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.
Sources:
- The role of anti-inflammatory rinse in the treatment of periodontal diseases (L.Yu. Orekhova, A.A. Leontyev, S.B. Ulitovsky) L.Yu. OREKHOVA, Doctor of Medical Sciences, Prof., Head of Department; A.A. LEONTIEV, dentist; S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry of St. Petersburg State Medical University named after. acad. I. P. Pavlova
- The use of adhesive balm "Asepta®" in the treatment of inflammatory periodontal diseases L.Yu. OREKHOVA*, Dr. med. Sciences, Professor, Head of Department V.V. CHPP**, Dr. med. Sciences, Professor, Head of Department S.B. ULITOVSKY*, Dr. med. Sciences, Professor A.A. LEONTIEV*, dentist A.A. DOMORAD**, O.M. YAKOVLEV** SPbSMU named after. acad. I.P. Pavlova, St. Petersburg - *Department of Therapeutic Dentistry, **Department of Microbiology
- https://cyberleninka.ru/article/v/puti-sovershenstvovaniya-pervichnoy-profilaktiki-zabolevaniy-parodonta Acute herpetic stomatitis in children, Baranaeva E.A. Merkulova E.P. magazine "Medicine and Healthcare"
- https://cyberleninka.ru/article/v/osobennosti-protivoretsidivnogo-lecheniya-allergicheskogo-stomatita Acute stomatitis in children, Drobotko L.N., Strakhova S.Yu.
Prevention
To ensure that candidal stomatitis never bothers you, you should follow a few simple but very useful rules:
- Follow basic hygiene rules. Namely: wash your hands well with soap, especially when returning from the street, brush your teeth, use dental floss at least once a day, and also rinse your mouth with special means.
- You should definitely buy a new toothbrush. For those who have dentures, it is recommended to place them in a disinfectant solution overnight.
- After consuming liquid antibiotics, you should immediately rinse your mouth with water.
- When using spray corticosteroid drugs, you should wear a special nozzle.
Diagnosis of oral candidiasis
Candidiasis (thrush) of the oral cavity can be detected during an examination by a dentist if the patient has characteristic complaints. The doctor examines the condition of the oral mucosa, examines scrapings, and carefully examines the hair and skin. If you have oral candidiasis, you also need a blood test to check your glucose levels and rule out diabetes. The sooner you detect the presence of this infection, the easier it will be to get rid of it, so you should not delay diagnosis just because the symptoms do not cause you discomfort.
Allergic stomatitis
They arise as a reaction of the mucous membrane to an allergen. An allergic agent can be toothpastes, mouthwashes, food, medicines, materials for crowns, fillings, etc. Allergies often occur to removable dentures. The mucous membrane is affected precisely at the point of contact with the damaging agent, for example, the hard palate under a removable denture. With allergic stomatitis, the mucous membrane is swollen, red, bubbles appear, which burst with the appearance of painful erosions.
Allergic stomatitis also includes chronic recurrent aphthous stomatitis , it begins with swelling and burning, then a painful aphtha appears, and then a healing period begins. This disease is characterized by constant relapses with a certain frequency.
Prevention of oral candidiasis
The occurrence of this disease is a very unpleasant and painful phenomenon, fortunately, it is quite easy to avoid by following the recommendations. One of the main causes of infection is weakened immunity, so the basic rule for preventing the disease is to treat any disease at the right time and take medications strictly as prescribed by the doctor. To avoid candidiasis of the oral cavity, pharynx and larynx, hygiene, visiting a good dentist, professional ultrasonic cleaning and other preventive measures will help. Oral candidiasis in women is often due to hormonal imbalance; if you have symptoms of the disease, you should pay attention not only to the affected area, but also to the condition of the body as a whole.
Traumatic stomatitis
Traumatic stomatitis develops as a result of mechanical, thermal or physical trauma. This type of stomatitis occurs:
- superficial (burn of the mucous membrane by hot tea)
- deep (burn with a strong alkali or acid, strong biting of the mucous membrane)
Acute mechanical stomatitis: rare, it can be caused by trauma to the mucous membrane when biting the cheek, tongue, lip while eating, an attack of epilepsy, a blow, trauma during dental treatment and other traumatic factors.
It is manifested by pain, hyperemia, swelling at the site of injury, erosion. With secondary infection, the wound can develop into long-term non-healing ulcers. Most often, traumatic stomatitis is acute, but can also be chronic, for example, constant biting of the cheeks under stress, chronic injury from braces, a sharp tooth edge, or a bad crown. As a result of trauma, painful erosions or ulcers with jagged edges form on the mucous membrane, which can become infected.
The cause of physical injury is most often a thermal burn due to contact with hot liquid, inhalation of steam, or exposure to fire, the latter, as a rule, accompanied by damage to the respiratory tract. The lesion is most often located on the tip of the tongue, lips, and the front of the palate. The mucous membrane becomes swollen, red, painful, and blisters may form, which then burst. With deep damage, the mucous membrane dies, and the damage involves muscles and even bone.
Chemical stomatitis occurs when burned with acid or alkali. In everyday life, this is most often acetic acid; also at a dental appointment, burns can occur with various drugs (phenol, formaldehyde, alcohol, hydrofluoric acid, etc.). The depth of damage depends on the damaging substance and its concentration, and the duration of exposure. First, the mucous membrane becomes bright red and painful, and with severe lesions, foci of necrosis then appear within a few hours.
In case of burns with acids, alkalis, or thermal burns, it is recommended to call an ambulance!
Bacterial stomatitis
Vincent's ulcerative necrotizing stomatitis
It manifests itself as ulcerations of the mucous membrane, strong odor from the mouth, fever, weakness, pain when eating. In severe forms, ulcerations can occupy almost the entire oral cavity, and the temperature rises above 38°C.
Gonorrheal stomatitis
Caused by Neisser's gonococcus. The mucous membranes of the lips, gums, lateral and lower surfaces of the tongue are mainly affected. The mucous membrane has a brightly hyperemic color and a large amount of gray purulent plaque with an unpleasant odor. But, as a rule, there are no complaints.
Acute streptococcal gingivostomatitis
It is characterized by general damage to the gums, severe pain, fever, enlargement and tenderness of the lymph nodes. The mucous membrane of the mouth and tonsils is hyperemic, abscesses may form.
