Candidal Stomatitis - What Is It? How Is It Treated? Symptoms And Effects

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Candidal stomatitis

Candidal stomatitis is a fungal disease that is accompanied by an inflammatory process in the oral cavity. It can be caused by such microorganisms as: Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Candida parapsilosis.

Candidal stomatitis is often diagnosed, as the impetus for the disease is a decrease in immunity. Even the slightest failure can cause illness. Candida stomatitis is rarely complicated, but treatment should not be delayed.

Content:

• What it is
• Causes of occurrence
• Symptoms of candidal stomatitis
• Types of candidal stomatitis and stages of disease development
• Which specialist should you contact
• Diagnosis of the disease
• How is candidal stomatitis treated?
• Treatment of candidal stomatitis in adults
• Treatment of candidal stomatitis in children
• Features of manifestation and treatment in infants
• Consequences if not treated
• Prevention

What it is?

Candidal stomatitis is called fungal stomatitis or thrush. The main manifestation of the disease is a white coating on the tongue and on the mucous membrane of the oral cavity on the inside of the cheeks. It can be easily removed with a medical spatula.

Fungi of the genus Candida are always present in the human oral cavity, but normally they do not lead to disease. Therefore, many people are not even aware of such a neighborhood. Certain microbes, which also live in the human oral cavity, prevent the growth of the fungus. If the balance of microflora is disturbed and harmful bacteria become more than useful, Candida begins to actively grow and increase its number. Thus, candidal stomatitis develops.

The disease can be diagnosed in people of different ages and gender. It is noticed that Candida glabrata more often affects the elderly, and Candida parapsilosis prefers to multiply in the oral cavity of infants. People with severe illnesses (HIV, cancer, diabetes mellitus) are more likely to have candidal stomatitis caused by Candida rugosa or Candida sake.

In the international classification of diseases 10 revision, candidal stomatitis is assigned the code B37.0.

Causes of occurrence

The reasons why fungi of the genus Candida begin to increase their numbers in the oral cavity and lead to the development of fungal stomatitis:

• Weak immune system. If the body's defenses are not weakened, then the likelihood of developing the disease is minimal. When the immune system fails, the fungus grows rapidly, causing characteristic symptoms.
• Poor oral hygiene. People who use dentures and braces need to carefully monitor their teeth. For such persons, special rules have been developed that must be impeccably followed.
• Xerostomia (dry mouth). This problem occurs in people who too often use balms to freshen the breath or brush their teeth with a toothpaste containing sodium lauryl sulfate. Another cause of dry mucous membranes in the mouth is Sjogren's syndrome.
• Hormonal imbalance. Hormones affect the microflora of the oral cavity. If there is a malfunction in their natural balance, a person may develop candidiasis. This reason is especially true for pregnant and lactating women who are prone to fluctuating hormones.
• Treatment with antibacterial drugs or steroid hormones. People who use these medicines for topical oral cavity treatment are more likely to develop candidal stomatitis. They destroy not only harmful, but also useful flora. Therefore, when taking antibiotics, you need to receive drugs that are aimed at maintaining the natural biocenosis in the oral cavity.
• Early childhood. In a child who has just been born, the microflora in the oral cavity is not sufficiently formed, since his body has just begun to exist in the external environment. Therefore, it is not surprising that candidal stomatitis often develops in infants. Also, infection can occur during the passage of the child through the birth canal, if during the period of childbirth the woman suffered from thrush.
• Elderly age. The older the person, the weaker his immunity.

• Diabetes. Patients with such a diagnosis often face candidal stomatitis, since there are all the prerequisites for the development of the disease.
• HIV. This disease lowers the human immune system, so fungi will multiply in conditions that are comfortable for them.

Risk factors for the development of candidal stomatitis:

• Allergy to food;
• Deficiency of B vitamins, vitamin a, c, e;
• Diseases of the oral cavity (gingivitis, stomatitis, caries, etc.);
• The presence of bad habits;
• Hereditary predisposition.

Symptoms of candidal stomatitis

Candidal stomatitis has different manifestations in children and adults. Symptoms depend not only on age, but also on the patient's health. The brighter the clinical manifestations of the disease, the worse the state of the patient's immune system.

Symptoms of candidal stomatitis in children:

• The appearance of plaques in the mouth, which are covered with a curdled bloom. They form on the tongue, on the inner surface of the cheeks. Plaque is removed easily, and bleeding ulcers are found under it.
• The child is capricious, refuses to eat, he will lose weight.
• The fungus can spread to the digestive system and cause pain.

Symptoms of candidal stomatitis in adults:

• Pain and burning sensation in the mouth.
• Hyperemia of the mucous membranes.
• White coating on the tongue, on the gums. A bleeding surface is visible under it.
• Deterioration of taste, the appearance of a metal taste in the mouth.
• Dry mouth.
• Pain when swallowing food.

Types of candidal stomatitis and stages of disease development

Depending on the clinical picture and morphological changes in the oral cavity, the following forms of candidal stomatitis are distinguished:

• Atrophic form. This form of the disease is most often diagnosed in adults who have been treated with hormonal or antibacterial drugs for a long time.
• Pseudomembranous form. This type of stomatitis develops mainly in children, since it is caused by the transferred infectious diseases and bronchitis.
• Erosive form. Such stomatitis is not often diagnosed. The disease can affect people with diabetes mellitus, with autoimmune polyendocrinopathy. In addition to a large number of plaques covered with plaque, multiple eroded areas form in the mouth.
• Hyperplastic form. The disease affects people with severe pathologies in the body, for example, with blood cancer or tuberculosis, as well as patients who have been taking antibacterial drugs for a long time. The symptoms of this form of the disease are more pronounced than the symptoms of pseudomembranous candidal stomatitis. In addition to plaque in the oral cavity, a person complains of burning and pain. The tongue becomes inflamed, the mucous membranes turn red and swell due to the rush of blood to them.

Depending on the nature of the course of candidal stomatitis, there are:

• Acute candidal stomatitis. Only the language is involved in the pathological process. It becomes dry and red, it is difficult for the patient to move it. The disease is preceded by such signs as: general deterioration of health, increased weakness, increased body temperature. A hyperthermic reaction is not always observed.
• Chronic candidal stomatitis. The chronic form of the disease develops due to the fact that an acute infection has not been treated. A person complains of pain and burning sensation in the mouth, it is difficult for him to eat, as it causes discomfort. When examining the mucous membranes, you can see that they are thin and excessively dry. Even the color of the mucous membrane changes, it acquires an unnaturally bright color, plaques form on its surface, covered with a curdled bloom.

Pseudomembranous and atrophic candidal stomatitis are varieties of the acute form of the disease.

Candidal stomatitis develops in several stages:

1. First stage. Small patches of redness appear in the mouth. It is difficult to understand that they indicate candidal stomatitis, since many diseases begin in this way.
2. Second phase. In the place where there were previously ulcerative defects, a plaque appears, resembling cottage cheese in appearance.
3. Stage three. If you try to remove plaque, then bleeding mucous membranes will be visible under it. At this time, the oral cavity is especially vulnerable to pathogenic flora, as the risk of infection of open wounds increases.
4. Fourth stage. An increase in body temperature is possible. If the disease is severe, it is complicated by infection of the respiratory tract.

Which specialist should you contact

If the disease develops in a child, then you need to visit a pediatrician. When the need arises, the doctor directs the baby to an immunologist. If there are carious teeth in the mouth, a consultation with a pediatric dentist is required.

If candidal stomatitis develops in an adult, then you need to visit the dentist's office. To find out the cause of the disease, you need to go to an appointment with an immunologist and therapist.

Diagnosis of the disease

As a rule, making a diagnosis does not cause any difficulties for a specialist. The doctor will examine the oral cavity and assess the nature of the plaque.

If in doubt, diagnostic measures such as:

• Examination of a smear from a candidal plaque under multiple magnification. The fungus is clearly visible under a microscope. Additional tests can also be carried out to determine the sensitivity of pathogenic flora to drugs.
• Blood donation for clinical analysis. If an increase in the level of leukocytes is found, then this indicates an inflammatory response.
• Serological studies. Testing is carried out for the detection of diseases such as HIV, tuberculosis, etc. The analysis allows you to detect antibodies to the corresponding infections.

How is candidal stomatitis treated?

Treatment of candidal stomatitis depends on what form of the disease develops in a person, as well as how intense its manifestations are. There is no single therapy regimen, since the infection proceeds differently in different people.

However, quite specific tasks are set for the doctor:

• Suppress the activity of the fungal flora. For this, antifungal agents are used.
• Increase the body's resistance.
• Relieve pain and inflammation, stop allergy phenomena, if any.
• To save the patient from concomitant diseases.
• Normalize the microflora of the oral cavity.

In addition to the listed activities, the patient will need to follow a diet. It is shown to people of any age. The diet is designed in such a way that it helps to increase immunity and help fight infections. The basic principles of dietary nutrition for candidal stomatitis:

• Reducing the amount of simple carbohydrates in the menu.
• Refusal from fast food, semi-finished products, alcoholic beverages, preservation.
• Avoiding foods that contain yeast. This applies not only to baked goods, but also to beer.
• Sour milk drinks are included in the daily menu.
• Eating fresh vegetables and fruits.

In addition to the diet, the patient will be prescribed medications, including:

• Preparations for combating fungal infection. Their use is mandatory, since it is they that make it possible to eliminate the disease (destroy the fungal flora). Antimycotics destroy fungal cells and prevent them from multiplying. These can be preparations based on miconazole, fluconazole, clotrimazole, nystatin, natamycin. To begin with, they are used for local therapy, that is, in the form of a solution, gel or ointment. If the treatment has not brought the desired success, then a tablet form of antifungal drugs is required.
• Antihistamines. Stomatitis caused by Candida is often accompanied by allergic symptoms. This is due to the body's reaction to enzymes that the fungus secretes. Antihistamines can reduce the severity of tissue edema and relieve redness from the mucous membrane. The drugs that are used more often than others: Suprastin, Tavegil, Claritin, Loratadin.
• Antiseptic drugs that are prescribed in liquid form, since it is more convenient to treat the oral cavity with such means. Their use allows you to get rid of curdled plaque. It can be such means as: Yoks, Miramistin, Rotokan.
• Pain relievers. Their use allows you to stop painful sensations, because a person can eat again. The following drugs have such an effect: Anestezin tablets or Hexoral Tabs, Kamistad gel, Lidocaine Asept spray.
• Preparations for relieving inflammation. These can be medicines such as: Camenton spray, Eucalyptus M tablets, Actovegin gel or Cholisan.
• Preparations that accelerate tissue regeneration. After removing plaque, ulcerative defects remain in the mouth, which are very painful. To make them heal faster, you can use tools such as: Solcoseryl paste, Propolis spray or Carotolin. They are prescribed after the inflammation has been arrested.

Treatment of candidal stomatitis in adults

Therapy for adult patients is selected depending on the severity of the pathological process. At an early stage of the development of the disease, it is possible to cope with it on an outpatient basis. The mainstay of treatment is drugs for local treatment of the oral cavity. Patients are advised to use absorbable lozenges and mouthwashes.

• Mouthwash from the Listerine series. These products are designed to provide quality oral care. They help reduce inflammation and kill bacterial flora. The use of mouth rinses prevents germs from attaching to the oral mucosa, so recovery occurs faster. To feel the effect of their use, you need to rinse your mouth 2 times a day. For one approach, take 20 ml of solution. Treatment continues until a full recovery occurs.
• Eludril. It is an antifungal solution that also has the ability to kill bacteria. They rinse their mouth 3 times a day for the first week. Starting from the second week, the mouth must be processed 2 times a day. At one time, you will need about 10 ml of solution and 100 ml of water.
• Itracon. This drug is prescribed at the initial stage of the development of the disease. It comes in tablet form. The daily dose is 100 mg. The therapy should last 2 weeks. If you combine the intake of the drug with the use of mouthwash, the effect will come faster and will be more pronounced.

When the disease is severe, patients are prescribed serious medications. They can also be used topically and orally.

These include:

• Dactarin gel. It is harmful not only to fungi, but also to bacteria. The drug does not allow them to increase in number. Do you take a day? tablespoons of the drug 4 times. After a week of treatment, the dose is reduced by 2 times and taken for another 2 weeks.
• Nizoral. This medication is prescribed as a tablet. It aims to destroy fungal cells. The daily dose is 200 mg. The course must last 21 days.
• Flucostat. This remedy is used for both mild and severe stomatitis by varying the dosage. The maximum daily dose is 50-100 mg. The course of therapy can last from 2 weeks to a month. If an HIV patient develops stomatitis, then he is prescribed 150 mg of the drug for up to 2-3 months. This is the only way to cope with the disease.

Treatment of candidal stomatitis in children

If the child develops candidal stomatitis, then the oral cavity should be treated after each feeding episode.

When the meal ends, the baby is given a little boiled water, and then antiseptic agents are used:

• Soda solution. A teaspoon of soda is dissolved in a glass of water.
• Solutions Orasept, Livanol, Miramistin, Pimafucin ointment or Clotrimazole.
• Creams and gels Kamistad, Kalgel, Candide, They anesthetize the oral cavity well, so that the child can eat.

Do not apply hydrogen peroxide or brilliant green to the mucous membrane of the oral cavity, as well as honey. Any sweet food is a breeding ground for fungi.

For additional disinfection of the child's mucous membranes, you can use the Dactarin spray. It is used 3 times a day for a week. Children over 3 years old are offered Imudon or Faringosept in lozenges for resorption.

Principles to be followed when treating candidal stomatitis in children:

• If the child's illness is severe, then oral medication is required. Children can be given Pimafucin (1 tablet a day). The course of treatment should last a week.
• When candidiasis develops against the background of antibacterial therapy, children are prescribed funds to restore the microflora in the oral cavity. It can be drugs such as: Linex, Bifiform, Biogaya.
• The child should be getting enough fluids. In addition to plain water, he can be offered orange juice, herbal tea, lingonberry juice, cranberry juice.
• Food should be soft or liquid. Various soups, mashed potatoes, omelets are allowed.
• To increase immunity, the child is prescribed drugs such as: Immunal, Imunoriks, Imupret. Immunal for children 1-6 years old is offered in a dosage of 1 ml 3 times a day, and for children 6-12 years old in a dosage of 1.5 ml. Treatment continues after completion of the main therapy for another month.

Features of manifestation and treatment in infants

In infants, candidal stomatitis is diagnosed often and is acute. In premature babies, the likelihood of developing the disease increases 2 times. They develop candidiasis quickly. Within a few hours, areas of redness in the mouth can become covered with a white coating. It affects the cheeks, palate, tongue, gums, larynx. The inflamed areas crack, and blood oozes from them.

Sometimes children have a fever. The kid refuses to eat, cannot sleep. In such a situation, hospitalization is required. Through ulcerative defects, an infection can enter the body, which threatens to become infected.

Treatment in infants. Babies must be examined by a doctor. Most often, stomatitis has an uncomplicated course in them, so hospitalization is not required. The mother of the child should also receive therapy, since it is often she who becomes the spread of the infection.

To treat the oral cavity, use a soda solution and Candide. If systemic therapy is required, then Nystatin is prescribed. The tablet is pounded to a powdery state, the finished powder is divided into 2 parts, one part is moistened with water and the baby's oral cavity is wiped with this composition 3-4 times a day. Folk remedies in the treatment of candidal stomatitis are unacceptable, unless the doctor recommended them.

Treatment lasts 30 days, until the symptoms of the disease are completely stopped. During this time, the mother must carefully look after the nipples to prevent re-infection.

Consequences if not treated

If the disease was diagnosed at a later date and there was no treatment, the likelihood of severe complications increases. First, a person stops eating, begins to lose weight. Then immunity decreases. There is a risk of spreading the disease to the larynx, esophagus and further, to the intestines.

Complications of candidal stomatitis can be as follows:

• Endocarditis, accompanied by inflammation of the lining of the heart.
• Meningitis, which affects the brain. The person either dies or becomes disabled.
• Nephritis, which affects the kidneys.
• Dermatitis, that is, damage to the skin.

If the treatment was not chosen correctly, then the disease becomes chronic and often worsens. Relapses occur with every decrease in immunity.

Prevention

In order to prevent the development of candidal stomatitis, the following recommendations must be observed:

• Carefully take care of the oral cavity, treat all diseases on time and visit the dentist regularly.
• Wash hands with soap and water before eating.
• In the chronic form of the disease, antifungal medications should be taken to prevent the development of the disease. However, this should be done only after visiting a doctor.
• If a person is being treated with antibacterial drugs or steroid hormones, rinse your mouth after taking them.
• Pregnant women need to get rid of vaginal candidiasis. This must be done before childbirth.
• The mucous membrane should not be overdried.
• It is necessary to eat as many vegetables and fruits as possible, but the consumption of sweets should be limited, since fungi feed on sugars.
• To increase immunity, you need to take vitamin complexes.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".