What is thrush?
Thrush is a common fungal infection in the mouth. Medically, it is referred to as oropharyngeal candidiasis. The causative agent of thrush is the yeast fungus Candida albicans. Thrush is characterized by yellow or white bumps or spots in the mouth, which can occur on the tongue, cheeks, and gums [1].
Thrush commonly occurs when someone has a weak immune system [1]. This weakening can be temporary or permanent.
What can cause thrush?
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Among the factors that increase the risk for thrush are smoking, steroid therapy, chemotherapy, and anthological treatment [2, 3].
Also, diseases like diabetes and immunodeficiencies increase the risk of getting thrush [2, 3].
What are the symptoms of thrush?
The most characteristic sign of thrush is a white or yellow patch in the mouth. It can occur on the cheek, gum, tongue, bellow the tongue, hard palate, and throat [1].
Additionally, you may have a feeling of having cotton in your mouth. It can cause problems with tasting food or having a bad smell in the mouth [1, 2].
Another symptom is a dry or cotton-like feeling in your mouth, which can be accompanied by a loss of ability to taste food and a bad taste in your mouth [1, 2]. You may also experience redness in your mouth and pain, especially when swallowing food or liquids [1, 2].
In some cases, thrush can cause redness and dry or cracking skin at the corners of your lips [1, 4]. If the infection spreads to your esophagus, it can cause a sore throat and additional difficulty swallowing [1].
What are the diagnosis and treatment of thrush?
The diagnosis of thrush is based on symptoms and physical examination. In complex cases, the physician can also examine a patch sample under a microscope [5].
The treatment of oropharyngeal candidiasis starts with antifungal medication. It can be taken as pills, but most commonly, it is gel, pastilles, or oral suspensions [5, 6].
Medication used to treat thrush includes:
- nystatin,
- miconazole,
- clotrimazole [6].
With accurate and regular treatment, the oral thrush should heal within 14 days [7].
If you eat a lot of simple sugar, you should consider limiting it during the treatment. This will promote the healing process, as the Candida will have less food available to thrive [5].
What is leukoplakia?
Leukoplakia means white patches. It is a condition characterized by the formation of thick, white/grayish patches or plaques, commonly in the mouth [8, 9]. However, leukoplakia can also occur in the esophagus and urinary tracts [10, 11]. Usually, it does not cause any symptoms [12].
This condition is not fully understood. However, factors that are known to increase the risk of its development include smoking, chronic reflux, and other chronic irritations of the mouth [9, 10].
Leukoplakia is the most common precancerous lesion of the mouth [13]. It has the potential to transform into squamous cell carcinoma [14].
What can cause leukoplakia?
The causes of leukoplakia are the same as the factors that can contribute to its development. They include smoking and chewing tobacco [9], injuries in the mouth [9], chronic alcohol consumption [15],
Diseases like diabetes and inflammatory disease also increase the risk of leukoplakia [15, 16].
People with HIV and other immune deficiencies can get a subtype of leukoplakia (hairy leukoplakia) after Epstein-Barr virus infection [9].
Some research also indicates that human papillomavirus (HPV) could be linked to leukoplakia [9, 17].
What are symptoms of leukoplakia?
The most common symptom of leukoplakia is the formation of white, garish patches. Typically, they are hard and thick and form in the mouth [9].
In the subtype of hairy leukoplakia, the patches have a fuzzy or hairy look [9].
In rare cases, the patches can have red spots, which can be a sign of cancer [9].
Diagnosis and treatment of leukoplakia
The diagnosis of leukoplakia is based on the oral or patch examination. When leukoplakia has suspicious changes, the assessment can include a biopsy [9].
Visual examination of the thick white patches is often enough to make a diagnosis. They have the characteristic of being hard, thick, and not removable.
Treatment of leukoplakia is not always needed, and only monitoring the change can be enough. Sometimes, the patches can improve without any intervention [9]. When therapy is required, an efficient way to get rid of leukoplakia is surgical removal or a CO2 laser treatment [18, 19]. As an alternative, cryosurgery can also be considered [20].