Oral Thrush

Oral Thrush is an infection of the skin tissue lining the mouth (mucous membrane) with a yeast organism known as candida. There are eight types of candida known to cause infection in humans and candida albicans is by far the most common.

Thrush is a very common fungal infection affecting areas of the body where mucous membrane is present i.e., the soft, moist, pink skin found inside the cheeks, covering the palate and inside the vagina and anus. Candida is normally considered to be a harmless parasite that exists within the human body along with other similar microorganisms. Together, these make-up what is known as the body's 'normal flora'. Illness, medications and lifestyle factors can contribute to an imbalance in the body, which allows a previously harmless organism to multiply and change. This imbalance, which adversely affects the immune response, causes the organism to change, enabling it to attach itself to cells on the surface of Mucous membrane then to grow and invade the surrounding and deeper skin layers.
When candida is the organism that is rapidly multiplying and changing in this fashion, the infection is known as 'Thrush'. Not all people have candida colonies in the mouth and these people are unlikely to ever develop Oral Thrush. Between 40 to 65% of the population, however, do have harmless candida albicans colonies in the mouth. Certain people within this group are at greater risk of developing Oral Thrush. These people include those with dry mouth, dentures, poor immunity, those who take medication, those who smoke and infants.

SIGNS AND SYMPTOMS
Oral Thrush appears as creamy white patches on the tongue, roof of the mouth, back of the throat and inside the cheeks. In some cases the white patches may not be visible and the patient may have an irritated and tender mouth with reddened, inflamed areas. Some adults complain of a sore throat. If the infection is severe, ulcers may form in the mouth. Occasionally the corners of the mouth will become red and split due to Oral Thrush. This condition is called perleche and may cause erosion and fissuring.
Adults may complain of a bad taste in the mouth and discomfort in eating, especially if they wear dentures.

TREATMENT OPTIONS
Ask your Doctor for advice. Your Doctor will diagnose and treat this ailment. In most cases your Doctor will be able to make a diagnosis based upon your symptoms. In some cases the Doctor may recommend a simple test to analyse the organism, which is causing the problem. Your Doctor may prescribe some anti-fungal medication in the form of lozenges, drops or gel to treat the infection.

DIET HINTS
• It is important to always have a healthy diet which is high in wholesome foods such as fruits, vegetables, wholegrains, lean protein etc., and low in fatty, sugary foods which are generally high in calories and low in nutritional value.
• Some dietary measures can be taken to minimise the growth of yeast in the bowel, which in turn, reduces the likelihood of Oral Thrush.
• Sugar provides the right environment in the bowel for Candida albicans to thrive. If a person has Oral Thrush it is advisable to avoid sugary foods including honey, soft drinks, lollies, chocolates, sweet desserts, cakes, biscuits etc.
• Eat acidophilus yoghurt regularly and take a course of acidophilus capsules after a course of antibiotics to help re-establish a healthy balance of organisms in the bowel.
• The diet should be high in foods, which are good sources of fibre such as wholegrain cereals, fruits and vegetables. Only 2-3 pieces of fruit daily due to the high sugar content.
• Garlic is a natural antibiotic and can be included in the diet every day. It is best to have garlic at a separate time to acidophilus as the antibiotic activity of garlic may interfere with the acidophilus organism.

VITAMINS/MINERALS/HERBS
Zinc supplementation has been found to improve the body's resistance to infection by candida albicans. Dissolving a zinc lozenge in the mouth may be more beneficial than swallowing a tablet or capsule.
• Probiotic supplements containing acidophilus and bifidus cultures help to restore the normal, healthy flora in the bowel that form a barrier to harmful bacteria. A probiotic supplement may help to prevent infection or reduce the severity of candidiasis.
• In cases of low immune function, an oversupply of harmful molecules (free radicals) may be present. Antioxidants such as vitamins A, C, E, zinc, grape seed extract, coenzyme Q10 and selenium help to reduce the number of free radicals in the body.
• Echinacea and Golden seal are herbs, which help to boost the immune system and prevent infection. An effective gargle and mouthwash against Oral Thrush may be made from a combination of these herbs and propolis liquid. Propolis, a natural bee product, has antimicrobial properties, which may help to eliminate the candida organism.
• Astragalus is a herb with a long history of traditional use in Chinese herbal medicine. Clinical trials have shown Astragalus to have immune enhancing properties. This herb may be especially beneficial in cases of chronic, recurring Oral Thrush.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints.
2. If you suffer from a dry mouth, which can increase the risk of Oral Thrush, ask your Pharmacist for advice about saliva substitutes such as carboxymethylcellulose gels, salivary peroxidase products and mouthwashes.
3. Ask your Pharmacist about nystatin drops. The usual dose is 1ml for infants, children and adults four times a day. The medicine is dropped into the mouth or under the tongue and then swallowed. Older children and adults can hold the medication in the mouth before swallowing. Another preparation, which can be used in cases of oral thrush, contains miconazole and is marketed in a gel.
4. It is important for dentures to be cleaned and fitted properly as this helps to reduce the risk of Oral Thrush. Ask your Dentist for advice if your dentures need to be adjusted. Denture cleaning products are available from your Pharmacy.
5. If breastfeeding is painful this may indicate a thrush infection of the nipples, which could be passed onto the baby. An antifungal cream applied to the nipples may help to eliminate the Candida organisms. Ask your Pharmacist for advice.
6. Proper sterilization of teats, bottles and soothers ensures that the baby does not suffer from recurring Oral Thrush infections. Ask your Pharmacist for advice about sterilizing techniques.
7. If the dietary intake is inadequate, consider some nutritional supplements.