ORAL YEAST INFECTIONS
by Seymour L. Gottlieb, BS, BDS, DDS, member of NOHA’s Professional Advisory Board, with a private practice in Dentistry in Northbrook, Illinois; former Research Assistant and Instructor, College of Dentistry, University of Illinois and Researcher in Microbiology, United States Public Health Service, Center for Disease Control.
The most common oral fungal infection is caused by the yeast Candida, which is a normal constituent of the digestive and vaginal tracts. Candida, also called Monilia, is the name for a large group of yeastlike fungi commonly found in nature. A particular yeast organism in this group, Monilia albicans, causes candidiasis (sometimes known as moniliasis). The organism infects the mouth and throat, especially of babies and the very elderly. In this form, it is called thrush. Candida species are assumed to cause disease by tissue invasion, by inducing a hypersensitive state, or by producing potent toxins. In individuals with compromised immune systems, Candida can cause a variety of opportunistic infections.
The four clinical forms of oral candidiasis are:
Oral candidiasis may cause burning or painful sensations but most often is asymptomatic. Other symptoms that may be yeast connected include a craving for sugar, alcohol, or bread; digestive problems; fatigue; depression; and muscle or joint pains.
Oral candidiasis is initiated along with decreased host defense by a variety of different drug therapies, systemic diseases, or conditions that result in changes in the oral cavity. At one time oral fungal infections were rare in the dental office until broad-spectrum antibiotics, glucocorticosteroid preparations, birth control pills, and tricyclic antidepressants were developed.
There are systemic diseases in which oral Candida infections are more prevalent. These include diabetes mellitus, hypothyroidism, hypoadrenalism, and Sjogren’s syndrome (reduced saliva).
Dietary folate or iron deficiencies as well as radiation of the head and neck region may also predispose to candidiasis development. Reports indicate that iron-deficient subjects with candidal infections have a decrease in lymphocytes, the cells in the blood that are involved in immunity. Other studies show that the immune response can be restored when iron levels are normalized.
Most of these predisposing conditions cause decreased salivary flow and/or decreased excretion of immunoglobulins in the saliva. The latter decrease lowers the efficiency of the B-lymphocyte immunologic defense mechanism that should help control Candida infections. In addition, Candida growth in saliva is enhanced and the adhesive property of the yeast to oral tissue is increased by a high carbohydrate diet.
I often see denture stomatitis, which is a chronic inflammatory condition under dentures or removable partials. The inflammation can be caused by irritation or from an allergic response to the acrylic denture base material or candidal infection. The relatively acidic and anaerobic environment under the denture is ideal for yeast growth. The denture or partial must be soaked in a nystatin solution during treatment. Deeper infections in tissue are signs that the yeast organism has become systemic and the patient should be referred to a medical specialist. A biopsy can determine if such a deep fungal infection is present.
The oral signs that most commonly occur in my years of practice are heavily coated, discolored tongues or cracking at the corners of the lips. Vitamins and acidophilus are immediately prescribed plus a therapeutic diet and effective drug therapy, along with a diary taken of everything they eat or take in by mouth for five days.
Following are the drugs used in treatment:
Other remedies include: grapefruit seed extract, capricin tea, homeopathic Candida silicea, artemisia, grape seed oil, and gentian. FOS (fructo-oligosaccharide) is an insoluble fiber that acts as a food source for the healthful bifidus bacteria in the intestine. These bacteria ferment this carbohydrate resulting in fatty acids that are used for the intestinal epithelial cells, which enhance water and mineral absorption.
A prescribed therapeutic diet is necessary during treatment to prevent the invasive re-growth of the yeast organism. The diet should include avoiding alcohol, sugar, white flour, and refined or processed carbohydrates. In addition, in order to provide optimal treatment results, fruit and milk, as well as any foods that have been dried, fermented, or that contain yeasts or molds, must be excluded. Also, sterilizing your tooth brush in household hydrogen peroxide or 70 percent alcohol for a few minutes will prevent its re-contamination of the mouth with organisms that survive on the brush.
Taking lacto bacillus acidophilus is safe and inexpensive. It in itself is not a cure but can help provide a healthier and better recovery from a yeast infection. Each use of antibiotics can alter the balance of bacteria. A diet adequate in important nutrients aids this balance for health.
Article from NOHA NEWS, Vol. XX, No. 3, Summer 1995, pages 4-5.