Pain Relief – Part 6 – More, more Lesions / Medications – Fungal
This is an interesting lesion as it comes in under different names such as denture sore mouth, angular cheilitis, furry tongue and thrush.
It can be quite insidious and difficult to diagnose at first.
The mouth contains various organisms, including many types of bacteria, parasites, viruses, and many types of fungi and yeast.
They are all competing with each other for survival. Most of the time the body tolerates these “freeloaders” as sometimes there are benefits to the body.
However, the terms and conditions of them not to behave badly are as follows:
Human
- Immune system not compromised
- Not taking medication that upsets the balance
- Not having a dry mouth – due to medications, smoking, sinusitis, sleep apnoea
- Providing an environment that favours one organism over another
- Diet (or lack of it)
- Hygiene (or lack of it)
Organisms
Any opportunity to thrive, out compete the other orgasms and they don’t care about the host. Sorry no love lost here.
This brings us to Fungal infections.
Bacteria and Fungi and the two main groups of organisms in the mouth and they are severe competitors with each.
There are different types of fungi:
- Candida: Is the most prevalent type of fungi and Candida albicans being the most common cause of oral thrush and other candidal infections.
- Aspergillus: Can cause oral infections, especially in the immunocompromised.
- Mucor: Less common cause of oral fungal infections.
- Cryptococcus: Like Aspergillus, affects those with weakened immune systems.
Fungal overgrowth/infection – Causes
Thrush
- Taking antibiotics affects the bacteria but not fungi. Hence less competition and the fungi overgrow.
- High starch diet favours fungi growth.
- Diabetes affects the immune response by weaken the energy of the immune cells.
- Not Cleaning the tongue to remove furry fungi growth
- Dry mouth causes a more mucous production and a “stickier” mouth.
Angular Cheilitis
- In people with fold skin at the corners of the lips and a dry mouth, mucous saliva and collect there. This leads to a sore corner of the lip running along the skin furrow as the fungal extends out the mouth.
AIDS – Black Furry Tongue
- which is a severe immunosuppressed state causing an exaggerated black furry tongue.
- Fungi love a continuous warm moist starchy environment as found when dentures are not removed at night.
We now come to Pain Relief.
- Fungal infections are not obvious at first but as time moves on the mouth becomes inflamed and sore.
- Lozenges are prescribed to leave and dissolve in the mouth that is anti-fungal such as Nilsat. The medication may take 2 weeks to resolve it.
- DO NOT take antibiotics as will only make it worse!
- Wipe the tongue with gauze as the fungi grows on the surface.
- Reduce starch that feeds the fungi.
- Hydrate and wipe the corners of your lips of residual mucus and apply anti-fungal creams.
- Initially when it is inflamed – a numbing fluid mouth such as Cepacaine can be helpful.
Leave your dentures out at night and clean the dentures.
You will to the above to take the inflammation and pain away at a surface level.
Need an Appointment?
If you’d like to book an appointment with the dentist at Seymour Dental then call us in Dulwich Hill, Sydney on (02) 9564 2397 or
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Next week
Pain Relief - Part 7 – More, more Lesions / Medications - Viral