Fungal Infection in the Mouth: Causes, Symptoms, and Treatments

Causes of Fungal Infection in the Mouth

The most common cause of fungal infection in the mouth is Candida albicans, a fungus. It is a type of yeast that naturally resides in our mouths, digestive tracts, and on our skin. Under normal circumstances, a healthy immune system and the beneficial bacteria in our bodies keep Candida growth in check. However, certain risk factors cause this fungus to grow uncontrollably in the mouth: 

• Compromised immunity: Individuals with medical conditions like HIV/AIDS, undergoing chemotherapy or radiation, or taking immunosuppressants (especially organ transplant recipients) have weaker immune systems. 

• Unchecked diabetes: Uncontrolled diabetes increases sugar levels, which enables the fungus to thrive.

• Antibiotic use: Certain antibiotics can indiscriminately kill both harmful and beneficial bacteria, disrupting the natural microbial balance in the mouth.

• Corticosteroids: The side effects of long-term use of inhaled corticosteroids for asthma or COPD can suppress immunity and increase fungal growth.

Other contributing factors include:

• Denture use: Wearing dentures can create warm, moist environments ideal for fungal growth.

• Dry mouth: Saliva plays a crucial role in washing away microbes and maintaining oral hygiene. Reduced saliva flow can increase the risk.

• Smoking: Smoking can alter the oral environment and compromise local immunity.

• Nutritional deficiencies: Deficiencies in iron, vitamin B12, or folate can impact overall immune function.

• Infancy and old age: Infants have underdeveloped immune systems, and the elderly often have weakened immunity, which may be exacerbated by multiple medications.

Symptoms of Fungal Infection in Mouth

Fungal infection in the mouth symptoms can vary in intensity. Some common symptoms of oral thrush include:

• Creamy white lesions: Maybe present on the tongue, inner cheeks, roof of the mouth, gums, and tonsils, these painful patches often resemble cottage cheese. Attempting to scrape them off usually reveals red, inflamed, and sometimes bleeding tissue underneath.

• Pain or burning sensation: This can make eating and swallowing uncomfortable.

• Loss of taste or an unpleasant taste: Food may taste bland or metallic.

• Redness and soreness inside the mouth: The affected areas may appear visibly inflamed.

• Cracking and redness at the corners of the mouth (angular cheilitis): This is a common co-occurrence, particularly in denture wearers or those with frequently chapped lips.

• Trouble swallowing (dysphagia): If the infection spreads to the throat or oesophagus, swallowing can become painful and challenging.

• A feeling of cotton in the mouth: This often accompanies dryness and discomfort.

In severe cases or individuals with severely compromised immune systems, the infection can spread beyond the mouth to other parts of the body. This leads to systemic candidiasis, which is a much more serious condition.
 

Fungal Infection in Babies' Mouth

Oral thrush is particularly common in infants and young babies due to underdeveloped immune systems.

Symptoms in babies may include:

• White patches: On the tongue, gums, or inside the cheeks. These usually don't wipe away easily.

• Reluctance to feed: Due to pain or discomfort in the mouth.

• Irritability and fussiness: Especially during feeding times.

• Diaper rash: If the Candida infection spreads through the digestive tract.

• Transmission to breastfeeding mothers: If the baby has thrush, the infection can be passed to the mother's nipples, causing pain and redness.

While usually not serious in otherwise healthy babies, it is important to consult a paediatrician for diagnosis and treatment.

Treating Fungal Infection in the Mouth

Most oral fungal infections are treatable. The approach to how to cure fungal infections in the mouth depends on the severity of the infection, the underlying cause, and the individual's overall health.

• Antifungal Medications: The preferred route of treating oral thrush is antifungal medications, which can arrest the growth of the Candida yeast. These can either be topical antifungals or oral pills if the infection has spread beyond the mouth.

• Addressing Underlying Causes: Another route of treatment also involves managing the underlying factors contributing to the infection:

• Diabetes management: For individuals with diabetes, achieving better blood sugar control is crucial.

• Denture care: Proper cleaning and fit of dentures are essential. Removing and thoroughly cleaning dentures and also soaking them in an antifungal solution can help reduce oral thrush.

• Medication review: If certain medications, such as corticosteroids, are causing the problem, consult with your doctor, who will adjust dosages or recommend alternative delivery methods.

• Immune system support: For individuals with compromised immune systems, addressing the underlying condition is paramount.

Home Remedies and Preventive Measures:

While not a substitute for medical treatment, some home remedies can help alleviate symptoms and prevent recurrence:

• Good oral hygiene: Brushing your teeth with a soft toothbrush, rinsing your mouth and flossing can help maintain a healthy oral environment.

• Saltwater rinses: Rinsing with warm salt water several times a day can help soothe irritation and reduce discomfort.

• Baking soda rinse: A mixture of baking soda and water can help neutralise acidity and may inhibit fungal growth.

• Probiotics: Consuming probiotic-rich foods (like yogurt with live cultures) or supplements may help restore the balance of beneficial bacteria in the gut and mouth.

• Avoid irritants: Steer clear of harsh mouthwashes, acidic foods, sugary drinks, and alcohol, which can further irritate the mouth.

• Breastfeeding mothers: If a baby has thrush, both the baby and the mother should be treated to prevent reinfection.

Conclusion

A fungal infection in the mouth is a common yet often uncomfortable condition. Regular dental check-ups are important for early detection and advice. If you are taking medications that increase your risk, discuss preventive measures with your doctor.

If you suspect you have a fungal infection in the mouth, consider visiting our experts at the Department of Internal Medicine at Manipal Hospital, Siliguri. They will help with understanding what is causing oral thrush and, accordingly, help with the necessary referral and treatment course.