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Oral candidiasis: causes, symptoms and treatment of the disease

Candidiasis of the oral mucosa, in medicine is called fungal stomatitis. It occurs as acute or chronic inflammation, leading to frequent relapses. Normally, candida is constantly present on the mucous membrane of the digestive system, incl. oral cavity.

Especially a lot of them in the cavities of carious teeth, pockets between the gum and the tooth, in the depressions of the tonsils. However, this number can significantly increase in various pathological conditions, causing the development of candidal stomatitis.


Causes of oral candidiasis

The causative factors of oral thrush are yeast from the genus Candida. They are parasitic in cells of the squamous epithelium, consisting of several layers. This is due to the high content of glycogen in these cells, which these fungi “love” very much.

Causes of oral candidiasis

These pathogens do not always lead to the development of inflammation. Their pathogenicity varies widely and depends largely on the state of the human body (general and local), the number of living fungi and the state of the microbiocenosis in the oral cavity.

Primary infection with candida occurs in different ways:

  • During pregnancy (intrauterine mode);
  • During labor, if the female genital tract is infected. Moreover, it does not depend on whether or not there are clinical manifestations of urogenital candidiasis;
  • During the contact of the mother with the child or the medical staff with the baby.

However, not every infection of the child leads to the subsequent development of stomatitis. This largely depends on the violation of the microbiocenotic relationship in the oral cavity.

Normal microbiocenosis is a reliable factor of protection against various infectious and inflammatory complications. Normally, the corresponding microorganisms should dwell in certain quantities in the oral cavity:

  • Streptococci;
  • Lactobacillus;
  • Staphylococcus;
  • Candida.

At the same time, bacteria from the group of E. coli should never be detected in the oral cavity.

They always talk about an imbalance in the microbial landscape and an increased risk of developing inflammatory conditions, including and candida.

Common causes predisposing to candidal stomatitis are:

  • Irrational use of antibacterial drugs;
  • Pathological course of the neonatal period, incl. and due to prematurity or durability;
  • Conducted radiation treatment, incl. and frequent repetitions of x-ray examination of the dental system;
  • Operations;
  • Intestinal infections;
  • Impaired absorption due to pathology of the digestive system;
  • Allergies;
  • Reduced immunity;
  • Disturbed metabolism.

An important role is played by local factors:

  • Violation of the rules of hygienic oral care;
  • Immaturity of the mucous in children;
  • Traumatic mucosal injury of a different nature;
  • The multiplicity of the carious process;
  • Wearing orthodontic appliances;
  • Carbohydrate abuse (various sweets and pastries);
  • Inflammatory diseases of the dental system.

Symptoms of oral candidiasis in adults

Oral candidosis is clinically manifested in various forms:

  • Stomatitis (the most frequent form) - the entire mucous membrane of the oral cavity is affected;
  • Gingivitis is only gum;
  • Cheilitis - lip mucosa is involved. With angular cheilitis, only the corners of the lips (popularly, this condition is called zaedy);
  • Glossitis - isolated lesion of the tongue.
Symptoms of oral candidiasis in adults

Symptoms of oral candidiasis in adults

The classic variant of the development of thrush in the mouth in adults is plaque, which is defined on the mucous membrane. Outwardly, it looks like a cheesy grain of yellow or white.

In some patients it can easily be removed, while in others it can be tightly welded to the underlying epithelium. Under bloom, an eroded surface is exposed, touching it leads to slight bleeding.

In addition to the classic form of candidal stomatitis, there are atypical options. These include:

  1. Acute atrophic - the tongue becomes varnished by smoothing the papillae. Usually this condition is associated with antibiotics and corticosteroid drugs that suppress immunity.
  2. Chronic oral - intermittent dryness and redness of the mucous membranes, an increase in the tongue in size, leading to difficulty swallowing.
  3. Chronic atrophic, due to the wearing of orthodontic structures.
  4. Chronic hyperplastic - the appearance of white spots of large and small size on the mucous membrane, combined with the formation of very thick and viscous saliva.

Candida inflammation of the tongue leads to the following symptoms:

  • Redness and swelling of the back of the tongue;
  • The appearance of raids on it (easily removed at the beginning, and later tightly welded to the underlying layers);
  • The nipples of the tongue can atrophy, and in case of a chronic course, the filiform papillae increases, causing the appearance of a “black hairy tongue”.

When heylite appear:

  • Redness and infiltration of lips, their pain;
  • Many small cracks on them, covered with gray-white scales and films;
  • Under the films is erosion.

Symptoms in children

Candidiasis of the mouth in infants

Candidiasis of the mouth in infants

Thrush in the mouth in children is manifested not only by local symptoms, but also by common ones:

  • The child becomes restless;
  • Refuses to eat;
  • Not sleeping;
  • An unpleasant taste in the mouth appears;
  • Burning and pain when eating;
  • The nearest lymph nodes become enlarged and painful.

Diagnosis of the disease

Thrush in the mouth in adults and children is diagnosed only with a combination of characteristic clinical manifestations and positive additional examination results.

It involves specific tests:

  • Microscopic examination of scrapings from the oral mucosa. It identifies cells with pseudocellular filaments.
  • Mycological examination, with which you can determine the level of contamination with fungi (more than 1,000 CFU is regarded as a positive value).
  • Serological reactions - the definition of antibodies to Candida, based on which the form of the disease is diagnosed (acute or chronic)
    Polymerase chain reaction.
  • Allergy with antigen (Candida proteins).

Treatment of oral candidiasis

Treatment of oral candidiasis is carried out in several directions:

  • Identification of possible risk factors and their elimination (treatment of background diseases);
  • Antifungal therapy prescribed only during the presence of clinical signs of candidiasis;
  • Desensitization therapy, especially indicated for chronic course;
  • Restoration of the oral microbiocenosis;
  • Strengthening of local immunity, which allows to prevent the recurrence of the disease.

в лечении больных с кандидозным стоматитом. Antifungal therapy is the first step in the treatment of patients with candidal stomatitis. Local forms are most often used - solutions, gels, aerosols, creams, etc.

The duration of their use ranges from 2 to 4 weeks. It depends on the time of the disappearance of clinical manifestations. After this, therapy is continued for one more week.

является пробиотикотерапия — она направленна на восстановление нормального микробного состава ротовой полости (Бифидумбактерин, Бифиформ, Бифинорм и др.). The second direction is probiotic therapy - it is aimed at restoring the normal microbial composition of the oral cavity (Bifidumbacterin, Bifiform, Bifinorm, etc.).

At the same time, it is recommended to change the diet:

  1. Exclusion of a large amount of carbohydrates (sweets should be completely abandoned).
  2. Regular consumption of fermented milk products, which are enriched with live bacteria.

лечения – иммунокоррекция. The third stage of treatment is immunocorrection.

It can be carried out with vitamin aids and non-specific immunostimulants (tincture of Ginseng, Eleutherococcus, etc.). In patients with pronounced disorders of the immune system, treatment is selected based on the results of an immunogram (a specific blood test).

In chronic course of oral candidiasis, vaccination is recommended.

Prevention of oral candidiasis

Prevention of oral candidiasis in adults and children is possible with the observance of certain preventive measures:

  1. Regular cleaning of teeth, tongue in the framework of oral care.
  2. Timely treatment of dental diseases and ENT organs.
  3. The exclusion of self-prescribing antibiotics and corticosteroids - these drugs should be used only as directed by a physician.
  4. Strengthening immunity by various tempering procedures.
  5. Treatment of diseases of the digestive system.

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