Thrush – oral
DEFINITION
Oral Thrush is an infection of the skin tissue lining the
mouth (mucous membrane) with a yeast organism known as candida.
There are eight types of candida known to cause infection in humans
and candida albicans is by far the most common.
mouth (mucous membrane) with a yeast organism known as candida.
There are eight types of candida known to cause infection in humans
and candida albicans is by far the most common.
DESCRIPTION
Thrush is a very common fungal infection affecting areas of
the body where mucous membrane is present i.e., the soft, moist,
pink skin found inside the cheeks, covering the palate and inside
the vagina and anus. Candida is normally considered to be a
harmless parasite that exists within the human body along with
other similar micro-organisms. Together, these make-up what is
known as the body’s ‘normal flora’. Illness, medications and
lifestyle factors can contribute to an imbalance in the body which
allows a previously harmless organism to multiply and change. This
imbalance, which adversely affects the immune response, causes the
organism to change, enabling it to attach itself to cells on the
surface of Mucous membrane then to grow and invade the surrounding
and deeper skin layers.
the body where mucous membrane is present i.e., the soft, moist,
pink skin found inside the cheeks, covering the palate and inside
the vagina and anus. Candida is normally considered to be a
harmless parasite that exists within the human body along with
other similar micro-organisms. Together, these make-up what is
known as the body’s ‘normal flora’. Illness, medications and
lifestyle factors can contribute to an imbalance in the body which
allows a previously harmless organism to multiply and change. This
imbalance, which adversely affects the immune response, causes the
organism to change, enabling it to attach itself to cells on the
surface of Mucous membrane then to grow and invade the surrounding
and deeper skin layers.
When candida is the organism that is rapidly multiplying and
changing in this fashion, the infection is known as ‘Thrush’. Not
all people have candida colonies in the mouth and these people are
unlikely to ever develop Oral Thrush. Between 40 to 65% of the
population, however, do have harmless candida albicans colonies in
the mouth. Certain people within this group are at greater risk of
developing Oral Thrush. These people include those with dry mouth,
dentures, poor immunity, those who take medication, those who smoke
and infants.
changing in this fashion, the infection is known as ‘Thrush’. Not
all people have candida colonies in the mouth and these people are
unlikely to ever develop Oral Thrush. Between 40 to 65% of the
population, however, do have harmless candida albicans colonies in
the mouth. Certain people within this group are at greater risk of
developing Oral Thrush. These people include those with dry mouth,
dentures, poor immunity, those who take medication, those who smoke
and infants.
SIGNS AND SYMPTOMS
Oral Thrush appears as creamy white patches on the tongue,
roof of the mouth, back of the throat and inside the cheeks. In
some cases the white patches may not be visible and the patient may
have an irritated and tender mouth with reddened, inflamed areas.
Some adults complain of a sore throat. If the infection is severe,
ulcers may form in the mouth. Occasionally the corners of the mouth
will become red and split due to Oral Thrush. This condition is
called perleche and may cause erosion and fissuring.
roof of the mouth, back of the throat and inside the cheeks. In
some cases the white patches may not be visible and the patient may
have an irritated and tender mouth with reddened, inflamed areas.
Some adults complain of a sore throat. If the infection is severe,
ulcers may form in the mouth. Occasionally the corners of the mouth
will become red and split due to Oral Thrush. This condition is
called perleche and may cause erosion and fissuring.
Adults may complain of a bad taste in the mouth and discomfort
in eating, especially if they wear dentures.
in eating, especially if they wear dentures.
TREATMENT OPTIONS
Ask your Doctor for advice. Your Doctor will diagnose and
treat this ailment. In most cases your Doctor will be able to make
a diagnosis based upon your symptoms. In some cases the Doctor may
recommend a simple test to analyse the organism which is causing
the problem. Your Doctor may prescribe some anti-fungal medication
in the form of lozenges, drops or gel to treat the infection.
treat this ailment. In most cases your Doctor will be able to make
a diagnosis based upon your symptoms. In some cases the Doctor may
recommend a simple test to analyse the organism which is causing
the problem. Your Doctor may prescribe some anti-fungal medication
in the form of lozenges, drops or gel to treat the infection.
DIET HINTS
- It is important to always have a healthy diet which is high in
wholesome foods such as fruits, vegetables, wholegrains, lean
protein etc., and low in fatty, sugary foods which are generally
high in calories and low in nutritional value. - Some dietary measures can be taken to minimise the growth of
yeast in the bowel which, in turn, reduces the likelihood of Oral
Thrush. - Sugar provides the right environment in the bowel for Candida
albicans to thrive. If a person has Oral Thrush it is advisable to
avoid sugary foods including honey, soft drinks, lollies,
chocolates, sweet desserts, cakes, biscuits etc. - Eat acidophilus yoghurt regularly and take a course of
acidophilus capsules after a course of antibiotics to help
re-establish a healthy balance of organisms in the bowel. - The diet should be high in foods which are good sources of
fibre such as wholegrain cereals, fruits and vegetables. Only 2-3
pieces of fruit daily due to the high sugar content. - Garlic is a natural antibiotic and can be included in the diet
every day. It is best to have garlic at a separate time to
acidophilus as the antibiotic activity of garlic may interfere with
the acidophilus organism.
VITAMINS/MINERALS/HERBS
Zinc supplementation has been found to improve the body’s
resistance to infection by candida albicans. Dissolving a zinc
lozenge in the mouth may be more beneficial than swallowing a
tablet or capsule.
resistance to infection by candida albicans. Dissolving a zinc
lozenge in the mouth may be more beneficial than swallowing a
tablet or capsule.
- Probiotic supplements containing acidophilus and bifidus
cultures help to restore the normal, healthy flora in the bowel
that form a barrier to harmful bacteria. A probiotic supplement may
help to prevent infection or reduce the severity of
candidiasis. - In cases of low immune function, an oversupply of harmful
molecules (free radicals) may be present. Antioxidants such as
vitamins A, C, E, zinc, grape seed extract, coenzyme Q10 and
selenium help to reduce the number of free radicals in the
body. - Echinacea and Golden seal are herbs which help to boost the
immune system and prevent infection. An effective gargle and
mouthwash against Oral Thrush may be made from a combination of
these herbs and propolis liquid. Propolis, a natural bee product,
has antimicrobial properties which may help to eliminate the
candida organism. - Astragalus is a herb with a long history of traditional use in
Chinese herbal medicine. Clinical trials have shown Astragalus to
have immune enhancing properties. This herb may be especially
beneficial in cases of chronic, recurring Oral Thrush.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints.
- If you suffer from a dry mouth, which can increase the risk of
Oral Thrush, ask your Pharmacist for advice about saliva
substitutes such as carboxymethylcellulose gels, salivary
peroxidase products and mouthwashes. - Ask your Pharmacist about nystatin drops. The usual dose is 1ml
for infants, children and adults four times a day. The medicine is
dropped into the mouth or under the tongue and then swallowed.
Older children and adults can hold the medication in the mouth
before swallowing. Another preparation which can be used in cases
of oral thrush contains miconazole and is marketed in a gel. - It is important for dentures to be cleaned and fitted properly
as this helps to reduce the risk of Oral Thrush. Ask your Dentist
for advice if your dentures need to be adjusted. Denture cleaning
products are available from your Pharmacy. - If breastfeeding is painful this may indicate a thrush
infection of the nipples which could be passed onto the baby. An
antifungal cream applied to the nipples may help to eliminate the
Candida organisms. Ask your Pharmacist for advice. - Proper sterilisation of teats, bottles and soothers ensures
that the baby does not suffer from recurring Oral Thrush
infections. Ask your Pharmacist for advice about sterilising
techniques. - If the dietary intake is inadequate, consider some nutritional
supplements.