With candidiasis of the oral cavity in adults, severe visceral forms of candidiasis and candidacepsis often begin, therefore special attention is paid to the diagnosis and treatment of fungal diseases of the oral mucosa today.
Factors causing infection with candidiasis and its form:
Call Candidias yeast-like Candida fungus anaerobes, which easily adapt and grow well in conditions of limited nutrition, perfectly tolerate x-ray and laser radiation, freezing and drying.
There are more than 80 species of Candida fungi. Most of them are safe and only a few cause a candida infection . The most pathogenic species are C. Albicans and S. Tropicalis. If a defect occurs in the body's protective system, the fungi begin to multiply actively and invade the epithelial cells.
Factors inducing candidiasis of the oral cavity are:
- Mechanical and chemical microtrauma (carious teeth, dentures, irrational therapeutic tactics during sanitation);
- The ingestion of antibiotics and some other substances used in the production of canned food and food products on mucous membranes and skin;
- Metabolic disorders (iron deficiency, hypovitaminosis, endocrine pathology, ovarian hypofunction, hypothyroidism);
- Somatic diseases that reduce the body's resistance (immunity disorders, digestive tract diseases, gynecological pathology, etc.);
- Candidateship ;
- Secondary immunodeficiency states;
- Unscientific antibiotic treatment.
The main symptoms of damage to the oral cavity and the red border of the lips (they are observed in 41.7% of patients with candidal pathology) - hyperemia of the mucosa, plaque, desquamation and swelling. These symptoms are observed in any form of candidiasis: acute pseudomembranous candidiasis, acute atrophic candidiasis, chronic hyperplastic candidiasis, chronic atrophic candidiasis.
These forms are distinguished from the clinical course. According to the localization of candidiasis, oral cavity is divided into stomatitis , glossitis and cheilitis, seizures, gingivitis, etc.
Acute pseudomembranous candidiasis
The most common form of candidiasis, which occurs even in newborns, infants, weakened by bronchitis and infectious diseases. In adulthood, the so-called "thrush" is found in cancers.
The affected area: tongue, sky, cheeks.
Complaints of patients: dry mouth, pain when eating, burning.
Clinical manifestations: plaque in the form of curdled film, which is easily removed if the disease is easy. Under the plaque, there is a swollen, hyperemic surface. If candidiasis is started, bleeding erosions are revealed under a hard-to-remove film.
Stages of the disease:
- Desquamative (desquamation sites on the back of the tongue, plaque is difficult to remove);
- Erythematous (tongue edematous, viscous, foamy);
- Infiltrative (it is difficult to remove plaque covered the lateral surfaces of the tongue);
- Erosive (plaque plaque, gray-white, after removal, erosion is detected).
Click on the spoiler below to see how the candidiasis looks in the mouth:
Acute atrophic candidiasis
It occurs both alone and after an acute pseudomembranous form.
The main cause is a side effect of taking antibacterial drugs, inhaled corticosteroids.
Complaints of patients: dryness and burning sensation in the oral cavity, the inability to move the tongue, the sensitivity of the mucosa to any stimuli.
Clinical manifestations: spots of erythema without plaque or plaque in the large folds of the tongue, a fiery red color of the mucous membrane, the back of the tongue (when it is involved in the infection) is dark red, shiny, mucous cheeks and a rim of the lips thin, sometimes on the lips appear crusts.
Chronic hyperplastic candidiasis
It occurs in 75% of patients. The main contingent is people taking cytotoxic drugs, antibiotics, those who have a history of tuberculosis and blood diseases. Sometimes it is diagnosed in smokers and patients using dentures.
Complaints of patients: perversion of taste, pain when taking acute and sour food, dry mouth.
Clinical manifestations: the mucosa is hyperemic, white plaques of different sizes can appear on the tongue and cheeks. In neglected cases, a coarse whitish-gray deposit appears, which can be removed with difficulty. Under the blister, bleeding erosions are found. If the tongue is affected, then there may be a proliferation of papillae.
Chronic atrophic candidiasis
Diagnosed in patients with dentures, elderly people who have concomitant diseases: atrophic gastritis, diabetes mellitus, etc.
Complaints of patients: dryness and burning of the mucous membrane, redness, the release of viscous visceral saliva.
Candidiasis of this form often affects the skin of the prosthetic bed, and in most cases it is the prosthesis of the upper jaw. A long-term disease can cause atrophy of the papillary apparatus of the tongue.
Each of the above forms can be accompanied (or may occur independently) by mycotic galling, candidal cheilitis and candidal gingivitis.
Mycotic zaeda, or candidiasis of the corners of the mouth - a disease that is diagnosed in children who are in the habit of sucking a finger or licking their lips, in adults with an understated bite. The main signs of seizures are cracks in the corners of the mouth, erythema and easily removable whitish coating.
Candidiasis cheilitis is a disease in which the red border of the lips is affected. Often, cheilitis affects the lower lip: first it appears as separate vesicles, eventually merging into a white film. Heilith is characterized by severe itching, worse at night and a feeling of contraction.
If you do not treat the candidiasis of the oral mucosa and the corners of the mouth, discomfort in the abdomen appears, the headache and bad breath begin to worry, nausea and irritability arise. The pathological effect of fungi on the organism is explained by the development of a number of toxic substances by microorganisms, the prolonged cumulation of which disrupts the autonomic nervous system.
The fundamental point in the treatment is drug antifungal therapy , which can be systemic and local. Preparations for local treatment are divided into antimycotics and antiseptics.
In Western Europe and CIS countries, experts most often designate miramistin , cetylpyridinium chloride, triclosan, chlorhexidine bigluconate , hexetidine, sanguirithrin. Some of these antiseptics, in addition to weakening the pathogenic properties of fungi and helping to reduce the contamination of the oral cavity with fungi, still suppress inflammatory phenomena.
Table "Medicinal preparations for the treatment of fungal infections of the oral cavity and the corners of the mouth":
|A drug||The scheme of appointment|
|Tantum Verde (spray, solution, resorption tablets)|| Spray: 4-8 times a day for adults, every 1.5-3 hours, children 6-12 years 4 times a day, up to 6 years - at a rate of 1 dose for every 4 kg of body weight.
Solution: 1 tablespoon (15 ml) of mouthwash or throat every 1.5-3 hours.
Tablets: one 3-4 times a day.
|Novosept forte (spray, lozenges)||1 lozenge for resorption every 2-3 hours, spray spray the mucous 3-4 times a day|
|Lugol's solution||Irrigation 3-4 times a day, applications on the mucous membrane|
|Chlorhexidine Bigluconate||6-8 rinses for 1 minute (10 ml.)|
|Sanguirithrin||2-3 irrigation per day|
|Oralcept||The drug is sprayed into the oral cavity every 4-6 hours|
|Aqueous solutions of aniline dyes||3-4 times a day, the duration of 1-2 weeks (you can swallow and simultaneously sanitize the esophagus from fungi )|
|Fukorcin , brilliant green and magenta||Applied for the treatment of mycotic zaed.|
|Antimycotics for local use|
|Kanesten (cream)||Application 2-3 times a day|
|Nystatin (ointment or aqueous suspension)||4 applications per day for 30 minutes, rinses for 1 min. (At once 5-10 ml.)|
|Amphotericin||Rinse and apply 4 times a day for 1 ml.|
|Clotrimazole (spray)||Irrigation of the mucosa|
|Candide or Clotrimazole 1% solution for the oral cavity||Specify in the pharmacy before buying - special solutions are produced, which you can rinse your mouth.|
|Antimycotics for systemic therapy|
|Fluconazole||50-100 mg. Per day (duration - 10 days)|
|Itraconazole||100-200 mg. Per day (duration 7-10 days)|
|Ketoconazole||200-400 mg. Per day (duration - maximum 10 days)|
|Nizoral||10-14 days once a day in the morning during a meal at a dose of 200 mg. (The control on functions of a liver and kidneys is necessary)|
|Diflucan||10-14 days in a dose of 50 to 200 mg. Morning|
|Orungal||15 days per capsule a day after a full meal|
During the treatment of oral candidiasis, therapy of concomitant diseases is mandatory. In addition, it is important to take:
- Preparations normalizing the microbial flora of the intestine ;
- Preparations with immunocorrecting action;
- Common restorative means;
- Medications that stop inflammation and contribute to the recovery of the epithelium.
Medicamentous therapy of candidiasis of the oral cavity and the corners of the mouth should be combined with electrophoresis, phonophoresis, quartz therapy. It alleviates the course of candidiasis and relieves inflammatory reactions of phytotherapy (oral cavity is irrigated with herbal medicinal herbs - yarrow , sage, chamomile, St. John's wort ).
As you can see, the arsenal of antifungal agents is quite impressive. However, candidiasis is an insidious disease, and the therapeutic effect of treatment is not always observed. In addition, a relapse of yeast infection often occurs.
Therefore, do not self-medicate. A specialist (dentist, ENT, or at the most extreme therapist) will prescribe a treatment, take into account the general pathology and select the drugs that are rational in your particular case.