Candidiasis of the mouth: symptoms and treatment
Candidiasis of the mouth caused by action of fungi of the genus Candida. This microflora in the norm is detected in the mouth in small amounts. Notes the presence on the skin, in the intestine, the vagina, the mucous membrane of the nasopharynx. Under certain conditions there is activation of pathogenic microbes. The disease affects both adults and children. If untreated, candidiasis may develop complications, some of which may be irreversible for the body.
The nature of the disease and the prevalence
This microflora is a conditionally-pathogenic representative of the oral cavity and on the skin. In most cases, the cause oral candidiasis: Candida albicans, Candida tropicalis, Candida pseudotropicalis, Candida krusei, Candida guilliermondi. To mark the presence of fungi may in the oral mucosa, cavities dental caries, the root-canal system of the tooth.
In 50-70% of cases in larger quantities notes the presence of Candida albicans in inaktivirovannoj condition in the oral cavity. It is noted the presence of an infection also not affected skin, urine, feces, sputum, and other places of the human body. Candida albicans is a budding cell in the shape of an oval with a size of 3-5 µm. The best background for the existence and reproduction of the fungi is acidic (pH of 5.8 to 6.5). Under these conditions, mushrooms are produced by a variety of enzymes that promote the breakdown of proteins, fats and carbohydrates. These enzymes actively propagating, able to penetrate up to the border of epidermis and dermis (up to the basal layer).
Affects disease, both children and adults. Symptoms in children are detected more often. Already before the year 20% of infants were exposed to the candidiasis of mucous membrane more than once. The course of the disease and performed medical interference tolerated by children better than adults.
Adults exposed to defeat, in 10% of cases after 60 years. The incidence is more often diagnosed in women and smokers. Very often candidiasis is noted when wearing older dentures and at the same time the decay of immunity. Under orthopaedic constructions the removable type are formed favorable conditions for the propagation of yeast fungus.
The appearance of reducing the activity of the immune system often due to various ailments of the body. Recently, the prevalence of candidiasis has increased in view of irrational use of medicines. This technique causes over time, the imbalance of microbial presence in the mouth and decay of immune function.
Causes of disease
In many ways, the development of the disease determines the state of the macroorganism. Because fungi of the genus Candida present in the mouth in the norm in small quantities, the disease may begin with a decrease in immunity or immunodeficiency. This usually occurs on the background of diseases of chronic. Emerging oral candidiasis causes conducive to, the following:
- Malignant tumors;
- HIV infection;
- disorders in the endocrine system: diabetes mellitus, Hypo — and hypoparathyroidism, Hypo — and hyperfunction of the adrenal glands;
- diseases of the digestive system: especially in reducing stomach acidity and achylia (absence of generation of hydrochloric acid);
- prolonged use of medications: antibiotics, corticosteroids, cytotoxic drugs;
- anticancer therapy: radiation exposure;
- the infection from the outside: from an infected person may transfer fungi through kissing, sexual contact, when movement of the child through the infected of the mother at birth;
- the intake of alcohol, drugs, contraceptives oral type.
Candidiasis is often disturbed metabolism of carbohydrates. Often the appearance of the disease is a symptom of a hidden occurrence of diabetes. If patient has candidiasis in a protracted stage, prone to frequent relapses, it is recommended to perform a survey on the concentration of blood glucose.
Often the oral candidiasis is due to the uncontrolled use of antibiotics. In the treatment of pharmacological agents for a long time there is a violation in the composition of the microflora. Is increased growth of conditionally pathogenic flora, which transformirovalsya in the pathogens. All this leads to the formation of dysbiosis.
It is noted candidiasis in the mouth on a background of reception of a number of antimicrobials: trichopolum, chlorhexidine, sangviritrin and others. In parallel, dysbiosis, candidiasis of the oral cavity combined with Hypo — and avitaminosis (especially groups b, B2, B6, PP). Imbalances vitamin metabolism lead to a change in the function of the oral mucosa: an increased susceptibility to oral background exposure.
A separate group environment causes candidiasis of the oral cavity are of pathology in the mouth:
- Chronic injury from the sharp edges of teeth, irrationally established orthopedic structures, removable and non-removable types;
- an allergic reaction to the composition of the removable structures made of plastic.
In the case of chronic ongoing injury, there is a decrease in the barrier function of the mucosa, against which a fungus penetrates, quickly cause the development of candidiasis of the oral cavity. If you violate the rules of use of removable dentures (wearing, methods of purification) is a rapid development of yeast fungi under construction. Some people have noted allergic reactions to acrylic plastic, which will contribute to weakening the protective function of the mucosa. Therefore, before installation of the prosthesis is recommended allergodil on the material. When not performing interference candidiasis of the mouth is stationed on other mucous membranes, up to lesions of the visceral organs.
The patient’s symptoms and the types of pathology
Mainly refers to the oral candidiasis in symptoms of discomfort from the dense white patches on different areas of the mucosa. In the ratio which the etiological symptom of the disease is dominant, candidiasis of the oral cavity will vary.
There are the following types of candidiasis:
- Pseudomembranous or thrush of the mouth;
- Candida Zayed.
Symptoms of thrush mouth occur for the first time during the passage ways during childbirth or through dirty toys and pacifier. Most susceptible to acute disease for premature infants, especially in the presence of somatic pathology. In the mouth there is hyperemia of the mucosa, swelling. Pretty quickly the occurrence of plaque cheesy consistency of the white. In the absence of intervention occurs quickly, the pain in mind the increasing destruction of the epidermis and mucous membranes.
Candidiasis of the mucosa of the oral cavity at the chronic stage is often diagnosed in the elderly and stanichnyj people. Characterized by the presence of dense plaque, taking pictures which revealed mucosa with areas of bleeding. Plaque is marked on the gums and throughout the entire mucosa.
Atrophic candidiasis in the acute stage corresponds to the predominant presence in the mucosa of the tongue. In addition to visually define the presence of plaque, the patient noted pain, itching, dryness of the mouth. When protracted course of severe symptoms from the patient is not marked. Often atrophy under construction. Under the removed orthopedic prosthesis marked flattening of the mucosa.
Hyperplastic form is often found in smokers. It is noted on the mucosa plaque in the form of plaques. In the absence of intervention there is a possibility of malignancy candidiasis. Zayed candidiasis can be combined with all forms of or to act as separate diseases. Visual inspection allows you to mark the defeat of the mouth corners, cracks, and redness. Overlay corners gradually exfoliate. When opening the mouth for eating or speaking, patients often note the discomfort and pain.
After first establishing candidiasis on the basis of complaints, symptoms, clinical picture begin to implement additional methods of examination. It is necessary to conduct the microscopy of scraping from mucous plaque and removable structures, the General analysis of blood, determination of glucose concentrations in blood serum. Perform seeing skin, nails. In the presence of lesions at other sites of the body mucosa and sent for consultation to other professionals: the mycologist, endocrinologist, gynecologist.
Implementation of the fence of the RAID should be carried out in the morning before eating, rinsing the mouth and performing oral hygiene. The procedure can be done after 4-5 hours of eating and irrigation of the teeth and mucosa.
Candidiasis is confirmed by the detection in the contents of the scraping of Candida. After performing the treatment, you need to re fence material.
Confirmed candidiasis on the basis of the characteristic forms of fungi and the presence of pseudomycelia. To identify the growth of microorganisms, the content of the scrapings placed in culture medium (solid, liquid) with a high content of carbohydrates. Sometimes to diagnose perform serological examination of blood.
A comparative analysis is performed with lichen planus, allergic stomatitis and drug Genesis, syphilis in the stage of papules.
How to do the treatment
If symptoms of oral candidiasis detected visually and cause discomfort in daily life, you ought to go to the doctor. Attending physician, orthopedist, orthodontist, internist and infectious disease physician. How to treat this disease?
Treatment of oral candidiasis in adults should be directed to the following points:
- The elimination of the causes;
- treatment of somatic abnormalities in the body;
- immunostimulatory therapy;
- the redevelopment of the teeth and the lining of the mouth;
- power correction.
If the patient noted a prolonged oral candidiasis, the treatment is performed under the control of the therapist. In the presence of systemic lesions and fungi, as well as deviations in the state of the mucosa of internal organs, the treatment performed by medical mycologists. In order, amid signs of candidiasis in the mouth treatment effect it is important to conduct a full examination in order to exclude pathology of the digestive, endocrine and other body systems. If Candida Zayed difficult to treat and often recurs, it is necessary to evaluate also the height of the bite. During the celebration of pathology of the occlusion should be adjusted.
Treatment of candidiasis in the mouth is divided into the implementation of General and local events. General treatment is the recommendation to receive the fungicidal means: «Nystatin», «Levorin», «Declin», «Amphoglucaminum», «Diflucan». Certain antifungal effect gives a 2-3% solution of potassium iodide. Complete the course of antimicrobial therapy, use of vitamin complexes, RR, S. Correction in the diet candidiasis is to limit the intake of easily digestible carbohydrates.
Local interference is in the form of applications and spreading of the mucous fungicidal ointments and solutions. Used: 0,5% «Dekumanova ointment» cream «Amphotericin b» (30000 U/g), «Clotrimazole» (1% ointment or solution). To align the pH of the mucous membranes in the mouth and red border of the lips (CCG) handle aniline dye (2% methylene blue solution fukortsin).
To align environment also apply alkaline solutions: irrigation 2-5% solution of borax in glycerin, soda, 2% boric acid solution. Treatment of thrush mouth in adults such solutions for 1 admission perform 1 Cup, wherein the frequency of repetition per day is 5-6 times. Mucosal lesions also smeared with solution of borax in glycerol (20%), Lugol’s iodine solution in glycerin.
If there is Zayed and violations of kkg and lips, for treatment using nystatin (100,000 IU/g), 5% levorinovuyu, 0.5% of dekumanova ointment; 1% ointment or cream of clotrimazole. To improve the effect of the treatment to produce the combination of several groups of drugs, alternating combination during the course. It is essential to create conditions for the elimination of candidiasis in the form of readjustment of foci of infection in the mouth. Begin treatment the teeth and other pathology in the mouth after 2-3 days of starting treatment of candidiasis. In any form of the course of candidiasis and the patients wearing removable dentures, it is important to treat the structures with antifungal drugs (solutions).
Given the marked for thrush mouth in adults symptoms and treatment, it is necessary to observe a number of measures to prevent re-infection by pathogenic fungi. You must carefully carry out hygiene mouth, to monitor the condition of removable dentures. Clean your teeth 2 times a day. It is better to apply toothpaste on the basis of rastor borax in glycerin («Bollicina», «Berry»).
It is desirable to complement the implementation of hygiene and additional equipment, such as: chewing gum, mouthwashes, dental floss, foam, and others. Removable dentures for the night shoot and put in a special solution. Before lowering it is also necessary to perform mechanical cleaning of the structure. If the prosthesis will not be in the solution, it may lead to shrinkage of the plastic which will lead to difficulties in the process of dressing design.
With a long reception of antimicrobials, antibiotics, corticosteroids and other drugs that promote the emergence of dysbiosis, with the aim of prevention have recommended the use of «Nystatin», «Levorin» (1500000 UNITS per day), alkaline rinsing. To enhance the regenerative and barrier capabilities of the mucous fulfill the purpose of the b vitamins (B1, B2, B6), S.
In General, when maintaining a healthy immune status can reduce the risk of candidiasis. It is therefore recommended to lead a healthy lifestyle, eliminate bad habits. It is recommended to eat right. The food should be useful. The balanced diet contained micronutrients. The amount of carbohydrate is minimal.