Infectious Dental Diseases

Infectious Dental Diseases

Infectious dental diseases are caused by bacteria or viruses and include common conditions like dental caries (cavities), gingivitis, periodontal disease, and oral herpes. Symptoms can range from pain, bad breath, and sensitivity to hot or cold, to swelling of the gums, jaw, or face, and fever. Untreated infections can lead to a dental abscess and potentially spread to other parts of the body, so prompt dental care, good oral hygiene, and sometimes antibiotics or other dental treatments are necessary. 

Common Infectious Dental Diseases

• Dental Caries (Cavities): Caused by bacteria that produce acids, destroying tooth enamel and dentin, leading to holes in the teeth. 
• Gingivitis: Inflammation of the gums caused by bacterial plaque, leading to bleeding and redness. 
• Periodontal Disease: A more severe form of gum disease that results from chronic gingivitis, causing loss of the bone structure that supports teeth. 
• Oral Herpes: A viral infection (HSV-1) that causes painful cold sores or blisters around and inside the mouth, spread through direct contact. 
• Oral Thrush: A fungal infection that can occur in the mouth. 

Symptoms to Watch For

• Pain: Intense and continuous toothache or gum pain. 
• Swelling: Gums, face, or jaw may become swollen or tender. 
• Bad Breath or Taste: A persistent foul odor or bitter taste in the mouth. 
• Sensitivity: Teeth may be sensitive to hot or cold food and drink. 
• Fever: A sign of a more serious, widespread infection. 
• Difficulty: Problems with opening or closing your mouth or chewing. 

When to Seek Help 

• See a dentist promptly: if you experience any symptoms of a dental infection.
• Go to the emergency room: if you have a fever and facial swelling, or difficulty breathing or swallowing, as this could indicate a serious infection that has spread.

Treatment and Prevention

• Good Oral Hygiene: Regular brushing, flossing, and mouthwash can prevent plaque buildup. 
• Fluoride: Effective in preventing dental caries. 
• Dental Visits: Frequent checkups help dentists monitor and treat oral health issues. 
• Antibiotics: Your dentist may prescribe antibiotics to target the bacteria causing the infection. 
• Root Canal Therapy or Extraction: May be necessary for severe infections, such as a dental abscess. 

সংক্রামক দাঁতের রোগ ব্যাকটেরিয়া বা ভাইরাস দ্বারা সৃষ্ট হয় এবং এর মধ্যে রয়েছে দাঁতের ক্ষয় (গহ্বর), মাড়ির প্রদাহ, পেরিওডন্টাল রোগ এবং মৌখিক হারপিসের মতো সাধারণ অবস্থা । লক্ষণগুলির মধ্যে ব্যথা, দুর্গন্ধ, গরম বা ঠান্ডার প্রতি সংবেদনশীলতা, মাড়ি, চোয়াল বা মুখ ফুলে যাওয়া এবং জ্বর অন্তর্ভুক্ত থাকতে পারে। চিকিৎসা না করা হলে সংক্রমণ দাঁতের ফোড়া তৈরি করতে পারে এবং শরীরের অন্যান্য অংশে ছড়িয়ে পড়ার সম্ভাবনা থাকে, তাই দ্রুত দাঁতের যত্ন, ভালো মুখের স্বাস্থ্যবিধি এবং কখনও কখনও অ্যান্টিবায়োটিক বা অন্যান্য দাঁতের চিকিৎসা প্রয়োজন।  

সাধারণ সংক্রামক দাঁতের রোগ

• দাঁতের ক্ষয় (গহ্বর) : ব্যাকটেরিয়া দ্বারা সৃষ্ট যা অ্যাসিড তৈরি করে, দাঁতের এনামেল এবং ডেন্টিন ধ্বংস করে, যার ফলে দাঁতে গর্ত হয়।  
• জিঞ্জিভাইটিস : ব্যাকটেরিয়াজনিত প্লাকের কারণে মাড়ির প্রদাহ, যার ফলে রক্তপাত এবং লালভাব দেখা দেয়।  
• পিরিয়ডন্টাল রোগ : মাড়ির রোগের আরও গুরুতর রূপ যা দীর্ঘস্থায়ী মাড়ির প্রদাহের ফলে হয়, যার ফলে দাঁতকে সমর্থনকারী হাড়ের গঠন নষ্ট হয়ে যায়।  
• ওরাল হারপিস : একটি ভাইরাল সংক্রমণ (HSV-1) যা মুখের চারপাশে এবং ভিতরে বেদনাদায়ক ঠান্ডা ঘা বা ফোসকা সৃষ্টি করে, সরাসরি সংস্পর্শের মাধ্যমে ছড়িয়ে পড়ে।  
• থ্রাশ : মুখের মধ্যে ছত্রাকের সংক্রমণ হতে পারে।  

যেসব লক্ষণ লক্ষ্য রাখতে হবে

• ব্যথা: তীব্র এবং অবিরাম দাঁত ব্যথা বা মাড়ির ব্যথা।  
• ফোলা: মাড়ি, মুখমণ্ডল, অথবা চোয়াল ফুলে যেতে পারে বা কোমল হতে পারে।  
• মুখের দুর্গন্ধ বা স্বাদ: মুখে একটানা দুর্গন্ধ বা তিক্ত স্বাদ।  
• সংবেদনশীলতা: দাঁত গরম বা ঠান্ডা খাবার এবং পানীয়ের প্রতি সংবেদনশীল হতে পারে।  
• জ্বর: আরও গুরুতর, ব্যাপক সংক্রমণের লক্ষণ।  
• অসুবিধা: মুখ খোলা বা বন্ধ করার বা চিবানোর সমস্যা।  

কখন সাহায্য চাইতে হবে  

• দ্রুত একজন দন্ত চিকিৎসকের সাথে দেখা করুন : যদি আপনার দাঁতের সংক্রমণের কোন লক্ষণ দেখা দেয়।
• জরুরি কক্ষে যান : যদি আপনার জ্বর এবং মুখ ফুলে যায়, অথবা শ্বাস নিতে বা গিলতে সমস্যা হয়, কারণ এটি একটি গুরুতর সংক্রমণের ইঙ্গিত দিতে পারে যা ছড়িয়ে পড়েছে।

চিকিৎসা এবং প্রতিরোধ

• ভালো মৌখিক স্বাস্থ্যবিধি: নিয়মিত ব্রাশ করা, ফ্লস করা এবং মাউথওয়াশ করলে প্লাক জমা হওয়া রোধ করা যায়।  
• ফ্লোরাইড: দাঁতের ক্ষয় প্রতিরোধে কার্যকর।  
• দাঁতের চিকিৎসা: ঘন ঘন চেকআপ দাঁতের ডাক্তারদের মৌখিক স্বাস্থ্য সমস্যাগুলি পর্যবেক্ষণ এবং চিকিৎসা করতে সাহায্য করে।  
• অ্যান্টিবায়োটিক: আপনার দন্তচিকিৎসক সংক্রমণ সৃষ্টিকারী ব্যাকটেরিয়াকে লক্ষ্য করে অ্যান্টিবায়োটিক লিখে দিতে পারেন।  
• রুট ক্যানেল থেরাপি বা নিষ্কাশন: দাঁতের ফোড়ার মতো গুরুতর সংক্রমণের জন্য এটি প্রয়োজনীয় হতে পারে।  

Dental Caries Definition

Dental caries, or tooth decay, is an infectious disease where bacteria produce acid from consuming sugars and food debris, leading to the demineralization and destruction of tooth enamel and other hard tissues, forming cavities. Key causes include insufficient oral hygiene, frequent consumption of sugary foods and drinks, and inadequate salivary flow or fluoride exposure.  

What is Dental Caries?

• A Chronic Disease: Dental caries is a prevalent chronic disease that causes cavities (holes) in the teeth. 
• Bacterial Process: It involves a complex interaction between acid-producing bacteria in plaque and fermentable carbohydrates from the diet. 
• Demineralization and Remineralization: The disease process involves the breakdown of minerals from tooth enamel (demineralization). If the rate of demineralization exceeds the tooth’s ability to remineralize, typically with the help of saliva and fluoride, decay occurs. 
• Progressive Destruction: Over time, the enamel breaks down, and the decay can progress into the softer dentin layer and eventually the tooth’s pulp, causing pain, sensitivity, and infection if left untreated. 

Causes of Dental Caries

• Bacteria: Cariogenic bacteria, such as Streptococcus mutans, metabolize sugars and food debris. 
• Sugars: The primary energy source for these bacteria is simple sugars, making a high-sugar diet a significant risk factor. 
• Acid Production: Bacteria produce acid as a byproduct of fermentation, which then dissolves the tooth’s hard tissues. 
• Poor Oral Hygiene: Infrequent brushing and flossing allow plaque to accumulate, providing a breeding ground for harmful bacteria and their acids. 
• Reduced Saliva Flow: Saliva helps protect teeth by neutralizing acids and remineralizing enamel. Conditions or medications that reduce salivary flow increase the risk of caries. 
• Fluoride Deficiency: Fluoride strengthens tooth enamel and helps it resist acid attacks and aids in remineralization. 
• Frequent Snacking: Frequent consumption of sugary foods and drinks, especially between meals, continuously exposes teeth to acids, increasing decay risk. 

Clinical Feature of Dental Caries

Clinical Features

• Sensitivity and Pain: Early stages may not cause symptoms, but as caries progresses to the dentin, it exposes nerve endings, leading to pain when consuming hot, cold, or sweet foods and beverages. 
• Changes in Tooth Appearance: You might notice white or brown spots or discoloration on the tooth surface, which can progress to brown or black stains. 
• Holes or Pits (Cavities): As the decay continues, it breaks down the tooth structure, creating cavities or holes in the tooth. 
• Pain on Chewing: Pain can worsen or become persistent, especially if the tooth’s inner pulp is involved. 
• Bleeding Gums: In severe cases, infection can occur, leading to painful, swollen, or bleeding gums around the affected tooth. 

Diagnosis of Dental Caries

Dentists use a combination of methods to accurately diagnose dental caries:

• Visual and Tactile Examination: A dentist will carefully examine the teeth and use a dental explorer to detect roughness or softness indicating a lesion. 
• Radiographs (X-rays): Dental X-rays are crucial for identifying caries that are not visible on the tooth surface, such as between teeth (interproximal caries) or in pits and fissures. 
• Laser Fluorescence Devices: Newer technologies use light to detect mineral loss in the enamel, aiding in the early diagnosis of incipient caries. 
• International Caries Detection and Assessment System (ICDAS): This classification system helps standardize the assessment of lesion severity and activity, providing a more comprehensive approach to diagnosis. 
• Risk Assessment: Dentists also consider individual risk factors, such as a history of decay, poor diet, or saliva flow issues, to inform diagnosis and treatment planning. 

Treatment of Dental Caries

Treatment for dental caries varies by severity, from fluoride treatments and dental fillings for early stages to dental crowns, root canal treatments, and tooth extractions for advanced decay. 

Complication of Untreated Dental Caries

Complications of untreated dental caries include tooth loss, infections, abscesses, and potentially more serious systemic conditions. Seeking prompt professional dental care is essential for accurate diagnosis and appropriate treatment.  

Definition of Gingivitis

Gingivitis is the early stage of gum disease, characterized by inflamed, swollen, and bleeding gums, most commonly caused by plaque, a buildup of bacteria and food debris. Other causes can include hormonal changes, certain medications, nutritional deficiencies, and ill-fitting dental appliances. If left untreated, gingivitis can progress to periodontitis, a more severe form of gum disease.  

Causes of Gingivitis

The primary cause of gingivitis is the accumulation of dental plaque. 

• Plaque Buildup: Bacteria in plaque produce toxins that irritate the gum tissue, leading to inflammation. 
• Poor Oral Hygiene: Inadequate brushing and flossing allow plaque to accumulate along the gum line. 
• Hormonal Changes: Fluctuations in hormones, such as those during pregnancy or puberty, can increase gum sensitivity. 
• Certain Medications: Some drugs can increase the risk of gingivitis. 
• Nutritional Deficiencies: A lack of essential vitamins, particularly Vitamin C, can lead to gum inflammation. 
• Other Medical Conditions: Systemic diseases like uncontrolled diabetes can also increase susceptibility to gingivitis. 
• Ill-Fitting Dental Appliances: Poorly fitting or unclean dentures, crowns, or braces can trap plaque and irritate the gums. 
• Smoking: Smoking is a risk factor that can contribute to the development of gingivitis. 

Clinical Features of Gingivitis

• Color changes: Gums may appear red (bright red or dark red) or darker than usual. 
• Swelling: The gums may be swollen or puffy. 
• Bleeding: Gums bleed easily, especially during tooth brushing or flossing. 
• Tenderness: The gums may feel tender to the touch or when chewing. 
• Changes in texture: Healthy gums have a firm, stippled appearance; with gingivitis, the surface may become rounded and shiny. 
• Bad breath: Persistent bad breath or a bad taste in the mouth can be a sign. 
• Gum recession: In some cases, the gums may recede, pulling away from the teeth. 

Diagnosis of Gingivitis

A dentist or oral hygienist typically performs the following during a periodontal examination:

• Visual inspection: The professional will examine the gums for redness, swelling, and other changes. 
• Palpation: Gently touching the gums to check for tenderness and firmness. 
• Periodontal probing: A special instrument, the periodontal probe, is used to measure the depth of the pockets between the teeth and gums. Deeper pockets are indicative of more severe disease. 
• Dental X-rays: X-rays can be used to check for bone loss, which is a sign of more advanced gum disease (periodontitis), not gingivitis, but can help determine the extent of the problem. 
• Assessment of plaque and calculus: The dentist will look for the presence of dental plaque and tartar (calculus), the primary cause of gingivitis. 

Treatment of Gingivitis

• Professional Dental Cleaning: A dentist or dental hygienist removes hardened plaque (tartar) from above and below the gum line, a process called scaling and root planing. 
• Improved Oral Hygiene:
  • Brushing: Brush twice a day for two minutes with a soft-bristled brush and fluoride toothpaste. 
  • Flossing: Floss daily to remove plaque from between teeth. 
  • Mouthwash: Your dentist may recommend an antiseptic mouthwash, such as one containing chlorhexidine, to help control plaque and bacteria. 
• Lifestyle Changes:
  • Quit Smoking: Smoking is a major risk factor for gum disease, and quitting can significantly improve oral hygiene. 
  • Balanced Diet: Eating a healthy, balanced diet and avoiding sugary foods can help. 
• Regular Dental Checkups: Visit your dentist for regular checkups and cleanings to monitor gum health and prevent recurrence. 

Complications of Untreated Gingivitis

• Periodontitis: Gingivitis can progress to periodontitis, a more severe form of gum disease that is often irreversible. 
• Gum Recession: The gums pull away from the teeth, exposing the tooth roots. 
• Bone Loss: The bones that support your teeth can be damaged and lost. 
• Tooth Loss: In advanced stages, the damage can be severe enough to cause teeth to become loose and fall out. 
• Abscesses: Infections can form, leading to painful dental abscesses. 

Infectious Periodontal Disease

Infectious periodontal disease is primarily caused by the accumulation of plaque, a sticky film of bacteria, due to poor oral hygiene. These bacteria trigger an immune response, leading to inflammation, gum tissue destruction, and bone loss. Risk factors that worsen the condition or increase susceptibility include smoking, diabetes, hormonal changes, genetic factors, and certain medications.  

Causes of Infectious Periodontal Disease

The Primary Cause: Plaque and Bacteria

• Bacterial Buildup: Poor brushing and flossing allow plaque, a sticky film of bacteria, to accumulate on teeth. 
• Hardening into Tartar: If plaque isn’t removed, it hardens into tartar (calculus), which cannot be removed by brushing and requires professional dental treatment. 
• Infection and Inflammation: Bacteria within the plaque and tartar infect the gum tissues and trigger the body’s immune response, causing inflammation and damage to the tissues that hold teeth in place. 

Key Contributing Factors for Infectious Periodontal Disease

• Poor Oral Hygiene: This is the leading cause, creating the environment for bacteria to thrive and attack gum tissue. 
• Smoking: The most significant modifiable risk factor, it increases the risk of periodontal disease and makes it more severe, diminishing the effectiveness of treatment. 
• Diabetes Mellitus: Impairs wound healing and exacerbates periodontal breakdown, making it a major contributing factor. 
• Hormonal Changes: Hormonal fluctuations, such as those during pregnancy, can increase the risk of gum disease. 
• Genetics: Some people are genetically predisposed to gum disease, influencing their immune system’s response to bacteria. 
• Certain Medications: Some medications can increase the risk of dry mouth, which can contribute to periodontal disease. 
• Autoimmune and Systemic Diseases: Conditions like HIV/AIDS can weaken the immune system, increasing susceptibility. 

How the Infection Progress for Infectious Periodontal Disease

1. Plaque Formation: Bacteria in plaque accumulate on the teeth. 
2. Inflammation (Gingivitis): If not removed, plaque can lead to inflamed, red, and bleeding gums. 
3. Tartar Buildup: Plaque hardens into tartar, which allows bacteria to colonize deeper below the gum line. 
4. Bone and Tissue Destruction (Periodontitis): Over time, the bacteria and the body’s immune response lead to the destruction of the gum tissues and the bone that supports the teeth. 

Clinical Feature of Infectious Periodontal Disease

Clinical Features (Signs and Symptoms)

• Gums: Redness, swelling, tenderness, and bleeding, especially during brushing or flossing. 
• Receding Gums: Gums may pull away from the teeth, making teeth appear longer. 
• Loose or Shifting Teeth: Teeth may become loose, or there might be a change in how they fit together. 
• Pus: Oozing of pus from between the teeth and gums can indicate an infection. 
• Bad Breath (Halitosis): Persistent bad breath that doesn’t go away. 
• Pain: Painful chewing or discomfort in the gum area. 
• Changes in Bite: A noticeable difference in the way your upper and lower teeth fit together. 

Diagnosis of Infectious Periodontal Disease

• Clinical Examination: A visual and tactile examination of the mouth, including checking the gums, to identify signs of inflammation or recession. 
• Probing: Using a dental probe to measure the depth of the periodontal pockets around the teeth. Deeper pockets suggest deeper involvement of the tissue and bone. 
• Radiographs (X-rays): X-rays are essential to visualize and assess the extent of alveolar bone loss, which is a key indicator of the severity of periodontal disease. 
• Bleeding on Probing (BOP): A dentist will check for bleeding when gently probing the gums, which is a sign of inflammation. 
• Mobility Assessment: Evaluating the degree to which teeth are loose or mobile. 
• Oral Hygiene and Calculus Assessment: Using indices to measure plaque buildup and the amount of calculus (hardened plaque) on the teeth. 

Early and comprehensive diagnosis is crucial for implementing effective treatment and preventing the disease from progressing and leading to tooth loss.  

Treatment of Infectious Periodontal Disease

Treatment for periodontal disease is stepwise and depends on its severity. 

• Nonsurgical Treatments:
  • Professional Cleaning: Removal of plaque and tartar from above and below the gum line. 
  • Scaling and Root Planing: A deep cleaning procedure to remove calculus and infected tissue from the tooth roots, helping the gums reattach. 
  • Antibiotics: Prescription of oral antibiotics or the local placement of topical antibiotics (like chlorhexidine or minocycline microspheres) in periodontal pockets. 
  • Antimicrobial Mouthwash: Used to help control bacteria. 
  • Oral Hygiene and Lifestyle Changes: Education on proper brushing and flossing, along with quitting smoking, can improve treatment outcomes. 
• Surgical Treatments: Reserved for advanced cases.
  • Pocket Reduction Surgery: Reshaping or removing infected tissue to reduce pocket depth. 
  • Bone Grafting: Using bone to rebuild areas of the jaw damaged by the disease. 
  • Soft Tissue Grafts: Replacing gum tissue that has been lost. 
  • Regeneration Procedures: Techniques that use growth factors to help regenerate lost bone and tissue. 

Complications of Infectious Periodontal Disease

Untreated periodontal disease can lead to serious complications: 

• Dental Abscesses: A pocket of pus that requires prompt treatment. 
• Tooth Loss: As the disease progresses, the infected tissue can damage the tooth’s root, leading to complete loss of the tooth. 
• Bone and Jaw Damage: The infection can spread from the gums to the jawbone, causing tissue damage. 
• Systemic Links: The bacteria from periodontal infections may enter the bloodstream and are linked to other health issues, including cardiovascular disease, diabetes, respiratory issues like COPD, and complications during pregnancy. 
• Tissue Death (Gangrene): In some acute infections, tissue can become necrotic and waste away, requiring removal, according to HSE.ie. 

Oral Herpes Definition

Oral herpes is a common, contagious viral infection of the mouth area caused by the herpes simplex virus (HSV-1). It is spread through close contact and causes symptoms like tingling, burning, and fluid-filled blisters (cold sores) on or around the mouth, which can also include a fever, swollen glands, and a sore throat. After the initial infection, the virus becomes dormant in the nerve tissue and can reactivate later due to triggers like stress, illness, or a weakened immune system.  

Causes of Oral Herpes

• Herpes Simplex Virus (HSV): The most common cause is the herpes simplex virus type 1 (HSV-1). Less commonly, herpes simplex virus type 2 (HSV-2), which usually causes genital herpes, can also spread to the mouth through oral sex and cause oral herpes. 
• Transmission: The virus spreads through intimate or personal contact with an infected person. This can happen through direct contact with a herpes sore or even indirectly by sharing items that have come into contact with the virus, such as utensils, towels, or lip balm. 
• Reactivation: After the first infection, the virus lies dormant in nerve tissues. It can then reactivate, leading to recurring symptoms. Common triggers for reactivation include stress, illness (like a fever), hormonal changes, and a weakened immune system. 

Clinical Features of Oral Herpes

The symptoms of oral herpes can vary in severity. 

• Prodromal Symptoms: Before an outbreak, some people experience symptoms like tingling, itching, burning, or pain in the affected area. 
• Blisters and Sores: The hallmark of oral herpes is the formation of small, fluid-filled blisters that often appear on the lips or around the mouth. These blisters can eventually rupture, forming painful, crusty sores. 
• Systemic Symptoms: In some cases, particularly during the primary infection, systemic symptoms can occur, such as:
  • Fever 
  • Headache 
  • Swollen glands in the face or neck 
  • Sore throat and painful swallowing 
  • Malaise (a general feeling of discomfort) 
• Location: Sores may appear on the gums, tongue, roof of the mouth, or inside the cheeks, though they are most commonly seen on the lips. 
• Duration: The initial outbreak can last for about 10 to 14 days. Recurrent infections are often shorter, lasting around 5 days. 

Diagnosis of Oral Herpes

A healthcare provider can often diagnose oral herpes by examining the painful, fluid-filled blisters or sores that appear around the mouth and lips. To confirm the diagnosis, they may: 

• Take a sample of the sore: This can be sent to a lab to look for the virus’s DNA. 
• Perform a viral culture: The virus is grown from a sample of the lesion. 
• Use a PCR test: This test detects viral DNA and can distinguish between HSV-1 and HSV-2. 
• Perform a blood test: This checks for antibodies to the virus, indicating an immune response. 

Treatment of Oral Herpes

While oral herpes infections often resolve within a couple of weeks, treatments can help manage symptoms and shorten the outbreak. 

• Antiviral medications: Acyclovir, famciclovir, and valacyclovir are common antiviral drugs prescribed for oral herpes. 
• Systemic (oral) antivirals: These are taken by mouth and are particularly effective if started during the prodrome (the tingling or itching sensation before blisters appear). 
• Topical antiviral medications: Creams like docosanol or penciclovir can be applied directly to the sores. 
• Over-the-counter remedies: Topical anesthetics can help numb the area and ease discomfort, making it easier to eat or drink. 

Complications of Oral Herpes

Most outbreaks are mild, but complications can occur, especially in children or those with weakened immune systems. 

• Dehydration: Especially in children who are uncomfortable eating or drinking. 
• Secondary bacterial infections: Bacteria can infect the sores, leading to impetigo. 
• Eczema herpeticum: A severe, disseminated infection that can occur in people with eczema. 
• Herpes encephalitis: A rare but serious infection of the brain. 
• Ocular herpes: A serious eye infection that can cause damage to the cornea. 

Oral Thrush

Oral thrush is a mouth infection by the yeast fungus Candida, characterized by creamy-white lesions that resemble cottage cheese, causing pain, a cottony feeling, or altered taste. It arises when the immune system is weakened, often due to conditions like diabetes, cancer, or HIV, or by the use of antibiotics or inhaled steroids, which disrupt the balance of microbes in the mouth. Risk factors include poor overall health, infant or elderly age, and ill-fitting dentures. 

Definition of Oral Thrush

• Oral thrush, also known as oral candidiasis, is an overgrowth of the fungus Candida albicans in the mouth and throat. 
• While Candida is normally present in the body, it can cause an infection when its growth becomes excessive. 

Causes of Oral Thrush

Oral thrush results from an imbalance in the body’s natural microbial environment, leading to increased yeast growth. Common causes and risk factors include: 

• Weakened Immune System: Conditions like HIV/AIDS, cancer, or taking immunosuppressive drugs can reduce the body’s ability to control fungal growth. 
• Antibiotics: These medications can kill beneficial bacteria that normally keep Candida in check, allowing the yeast to multiply. 
• Diabetes: High sugar levels in saliva from poorly controlled diabetes can feed the yeast. 
• Inhaled Steroids: Steroids used in asthma inhalers can increase the risk of thrush. 
• Dentures: Poorly fitting dentures can create an environment where Candida thrives. 
• Extremes of Age: Newborns and older adults are more susceptible due to their developing or weakened immune systems. 

Clinical Features (Signs and Symptoms)

Symptoms of oral thrush can include:

• White Lesions: Creamy-white patches on the tongue, inner cheeks, roof of the mouth, or tonsils, resembling cottage cheese. 
• Pain and Soreness: The mouth may feel sore, burning, or have a fuzzy texture. 
• Altered Taste: A reduced or altered sense of taste. 
• Difficulty Swallowing: Pain or discomfort when eating or drinking. 
• Redness: Redness or cracking of the skin at the corners of the mouth, especially in denture wearers. 
• Bleeding: The white patches may bleed slightly if scraped. 

Diagnosis of Oral Thrush

• Visual Examination: A doctor will look for white, cottage cheese-like patches on the tongue, inner cheeks, and roof of the mouth that may bleed when scraped off. 
• Medical History: They will inquire about recent antibiotic use, medical conditions like diabetes or HIV, and corticosteroid use, which are known risk factors for thrush. 
• Swab Test: A sample may be taken from the affected area and sent to a lab to confirm the presence of the yeast (Candida). 
• Endoscopy: In severe or complicated cases, especially to check for esophageal spread, an endoscope (a lighted, flexible tube) may be used to examine the esophagus and stomach. 

Treatment of Oral Thrush

• Antifungal Medications: This is the primary treatment and can include:
  • Topical Treatments: Gels, liquids, lozenges, or mouthwashes that are applied directly to the mouth. 
  • Oral Medications: Tablets or capsules for moderate to severe cases. 
• Addressing Underlying Causes: If antibiotics or corticosteroids are contributing to the thrush, the doctor may adjust the medication or dosage. 
• Oral Hygiene: Maintaining good oral hygiene is also important for management and prevention. 
• Duration of Treatment: Treatment usually lasts for at least one week, but your doctor will provide specific instructions. 

Complications of Oral Thrush

• Spread to the Esophagus: The infection can spread to the esophagus, causing pain when swallowing. 
• Systemic Infection: In people with weakened immune systems (e.g., due to HIV/AIDS or cancer), the Candida fungus can spread to other parts of the body, potentially causing a life-threatening systemic infection. 
• Difficulty Eating: Symptoms like pain and inflammation can make eating and drinking difficult. 
• Nutritional Deficiencies: Difficulty with eating can lead to nutritional problems.