Oral Thrush; PART I

Manila Bulletin, October 17, 2007 | Go to article overview
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Oral Thrush; PART I


Byline: Dr. Gary S. Sy

Oral thrush is a condition in which the fungus Candida albicans accumulates on the lining of your mouth.

Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. The lesions can be painful and may bleed slightly when you scrape them or brush your teeth. Sometimes oral thrush may spread to the roof of your mouth, your gums, tonsils or the back of your throat.

Although oral thrush can affect anyone, it occurs most often in babies and toddlers, older adults, and in people with compromised immune systems. Oral thrush is a minor problem for healthy children and adults, but for those with weakened immune systems, symptoms of oral thrush may be more severe, widespread and difficult to control.

Causes

Microorganisms such as viruses, bacteria and fungi are everywhere, including in and on your own body. In general, the relationship between you and the microorganisms in your body is mutually beneficial. You provide nutrition, protection and transportation for them, while they stimulate your immune system, synthesize essential vitamins, and help protect against harmful viruses and bacteria.

But your relationship to microorganisms in the world at large is more complex. Some microbes are highly beneficial, whereas others -- such as those that cause malaria and meningitis -- can be deadly. For that reason, your immune system works to repel harmful invading organisms while maintaining a balance between "good" and "bad" microbes that normally inhabit your body.

But sometimes these protective mechanisms fail. Oral thrush and other candida infections occur when your immune system is weakened by disease or drugs such as prednisone, or when antibiotics disturb the natural balance of microorganisms in your body.

These illnesses may make you more susceptible to oral thrush infection:

* Chronic mucocutaneous candidiasis. This group of rare disorders is marked by a chronic candida infection of your mouth and fingernails and of the skin on your scalp, trunk, hands and feet. Scaly, crusted lumps known as granulomas also may develop in your mouth or on your nails and skin.

* HIV/AIDS. The human immunodeficiency virus (HIV) -- the virus that causes AIDS -- damages or destroys the cells of your immune system, making you more susceptible to opportunistic infections your body would normally resist. One of the most common opportunistic infections is oral thrush. Thrush is rare in the early stage of AIDS. It usually only appears if levels of the virus-fighting cells known as CD4 fall below 300.

* Cancer. If you're dealing with cancer, your immune system is likely to be weakened both from the disease and from treatments such as chemotherapy and radiation, increasing your risk of candida infections such as oral thrush.

* Diabetes mellitus. If you don't know you have diabetes or the disease isn't well controlled, your saliva may contain large amounts of sugar, which encourages the growth of candida.

* Vaginal yeast infections. Many women experience at least one vaginal yeast infection (Candida vulvovaginitis) before menopause. Vaginal yeast infections are caused by the same fungus that causes oral thrush. Although a yeast infection isn't dangerous, if you're pregnant you can pass the fungus to your baby during delivery.

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