Mundsoor – Fungal infection in Mund

Mundsoor – Fungal infection in Mund

Oral thrush is one of the most common forms of thrush, a fungal disease that can affect the skin and mucous membranes and is caused by the yeast Candida. The umbrella term for all infections caused by this fungus is candidiasis. Oral thrush is, therefore, also known as oral candidiasis. The fungal infection can appear on or in the mouth or throat. Babies are often affected, but the infection can also often be observed in adults with a weak immune system . Read how to recognize and treat oral thrush here.

Forms of candidiasis in the mouth

Oral thrush is defined as a thrush infection in or around the mouth. Mouth fungus typically occurs on the inside of the cheeks or lips. But the throat, the tongue (tongue fungus) or the palate can also be affected.

Oral thrush can come in different forms, and one form can develop from another. These are the different types of thrush in the mouth and their signs:

  • Pseudomembranous candidiasis: white, wipeable covering on red, inflamed mucosa
  • Acute erythematous candidiasis:  burning, very reddened mucous membrane without coating, especially on the tongue
  • hyperplastic candidiasis: fixed white coating with red edges on the mucous membrane and tongue

 

Pseudomembranous candidiasis is the most common form.

In the most common form of oral thrush, pseudomembranous candidiasis, isolated white speckles initially form in the oral cavity, which can be easily detached. Underneath, the oral mucosa usually appears shiny, dry and reddened. In addition to the tongue, the mucous membranes of the cheeks, lips and palate are often affected.

As the fungal infection progresses, more extensive white, creamy-looking patches form, leading to mucous membrane bleeding when they come off. If left untreated, oral thrush can spread to the throat, oesophagus (thrush esophagitis), or gastrointestinal tract.

Other symptoms of oral thrush

In addition to the plaque and reddening of the mucous membrane described, oral thrush can cause other symptoms, especially in the advanced stage. This includes:

  • furry or burning sensation in the mouth
  • dry mouth
  • increased thirst
  • bad breath
  • unpleasant or metallic taste in the mouth
  • swollen lymph nodes
  • Difficulty swallowing or pain when eating or drinking (especially in babies or if it spreads to the throat and oesophagus)

If oral thrush is left untreated, vomiting or heartburn can also occur.

In contrast to the mouth sores caused by the herpes simplex virus, oral thrush in children is accompanied at most by a slight fever.

Causes and risk factors

Ursache von Mundsoor sind immer die zu den Hefepilzen gehörenden Candida-Pilze, meist Candida albicans. Bei vielen gesunden Menschen kommen die Pilze im Mundraum, im Darm oder auf der Haut vor und richten dort üblicherweise keinen Schaden an, solange sie vom Immunsystem und den anderen Mikroorganismen in Schach gehalten werden. Finden sie jedoch eine Lücke in dieser körpereigenen Abwehr, können sie sich schnell vermehren und zu Beschwerden führen.

Daher sind von Mundsoor häufig Personen mit einem geschwächten Immunsystem betroffen. Dazu gehören insbesondere Babys, alte Menschen oder Personen, die an Erkrankungen wie Krebs, HIV oder Diabetes leiden.

Häufige Auslöser von Mundsoor

Bei Babys hat Mundsoor häufig eine Ansteckung bei der Mutter zur Ursache – oft infizieren sie sich bereits bei der Geburt mit einem unbemerkten Scheidenpilz der Mutter oder später über den Schnuller. Oftmals tritt Mundsoor bei Babys zusammen mit Windelsoor, einer Soorinfektion im Windelbereich auf.

Bei Erwachsen verursachen fehlende Zähne, Zahnspangen oder eine schlechtsitzende Zahnprothese oft Reizungen der Mundschleimhaut. Die Pilze nisten sich dann beispielsweise unter der Prothese ein oder dringen durch Verletzungen in die Mundschleimhaut ein. Auch Rauchen und ein trockener Mund können die Entstehung von Mundsoor begünstigen.

Außerdem zählt die langfristige Einnahme bestimmter Medikamente zu den möglichen Auslösern von Mundsoor. AntibiotikaKortison (beispielsweise in Form von Kortison-Spray bei Asthma) sowie Zytostatika (während einer Chemotherapie) können das Immunsystem oder die Mundflora aus dem Gleichgewicht bringen und der Entstehung der Pilzinfektion den Weg ebnen.

Diagnose anhand charakteristischer Symptome

The diagnosis of oral thrush is usually based – especially in small children – on the characteristic, usually clearly visible symptoms. In addition, there is usually a questioning of the person affected (or the parents) about the symptoms, accompanying circumstances and previous illnesses. The diagnosis can be made by a dentist or dermatologist just as easily as by a pediatrician or general practitioner.

For a clear diagnosis, a  swab is usually  taken from the oral mucosa and examined under a microscope. In addition, fungal cultures can be prepared to determine the exact type of Candida fungus. This may be particularly necessary if the thrush infection does not respond to drug treatment as expected and a change in medication is being considered.

Ideally, the doctor will also clarify where the entry point for the fungi is and, if necessary, treat the corresponding injury in the mouth. If illnesses are responsible for weakening the immune system, these should also be treated.

 

Treat oral thrush

To treat oral thrush, the doctor usually prescribes antifungal medications (antimycotics) specifically for the oral area. These often contain the active ingredients  nystatin , miconazole or amphotericin B. The medications are often in the form of lozenges, gel, mouthwashes or suspensions. The product should remain in the mouth for as long as possible.

When treating oral thrush, it is important to strictly adhere to the dosage of medication prescribed by the doctor and the duration of therapy. Even if there is no longer any plaque to be seen, the therapy must be completed as planned. Aborting it can cause the fungus to return or even spread to other areas.

Experts strongly advise against treating mouth fungus on your own. Home remedies like gargling with chamomile tea can make the infection worse by further drying out the lining of your mouth.

Be careful, contagious!

Good oral hygiene is essential to combat oral thrush. Since Candida fungi like to hide in teeth affected by tooth decay, brushing your teeth should be done particularly carefully during the treatment of oral thrush. Dentures, pacifiers, teats, toothbrushes or braces should be thoroughly  sterilized  or replaced if possible.

Also be careful not to infect other people around you. Just  a kiss or sharing dishes  can be enough to transmit the Candida fungus.

Although oral thrush is often stubborn, it can usually be treated within eight to ten days using the measures mentioned. If the fungal disease does not go away for a long time, stronger medication is usually used.

Prevention: Hygiene is the be-all and end-all

At-risk groups can take various measures to prevent a thrush infection in the mouth. Above all, hygiene is crucial. Specifically, the following measures help to prevent mouth fungus:

  • Wearers of dentures should clean them thoroughly after every meal and ensure that the dentures fit properly. It is also recommended to clean them two to three times a week with cleaning tablets provided for this purpose.
  • In people with weakened immune systems (for example during chemotherapy), an antifungal drug is often prescribed to prevent oral thrush.
  • If people are fed artificially or their salivation is severely reduced for other reasons, nursing staff usually carry out so-called thrush and parotitis prophylaxis. This includes, for example, regularly moistening the affected person’s mucous membranes.
  • Babies’ pacifiers, teats and toys that are placed in their mouths should be cleaned regularly and thoroughly. Remember that parental saliva can also be a possible source of infection for the child. “Cleaning” a dropped pacifier with your own saliva can actually promote the infection.
  • Since babies often become infected with Candida fungi at birth due to an undetected vaginal yeast infection in the mother, it may be advisable to treat the mother accordingly before birth.
  • Breastfeeding mothers often suffer from thrush infection of the nipples (thoracic thrush). So that affected women do not infect their children, they should temporarily stop breastfeeding and, if necessary, also include the baby in the treatment of thrush. Remember that contagion can go both ways.

In principle, it is advisable to consult a doctor immediately if oral thrush is suspected to prevent the fungus from spreading to the throat and oesophagus or infecting other people

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