Mouth fungus needs further investigation

Q: I have been dealing with a fungus in my mouth off and on for almost a year. I have been to my doctor and she sent me to an oral surgeon. He said there are many things that can cause it. I know cinnamon does. He said I might have to deal with it off and on the rest of my life. He said cigarettes are one cause but I quit over 18 months ago. They were treating me with Mycelex 10 mg trochee 5 times a day. It was working but not any longer. Any help would be greatly appreciated to clear this up permanently.

A: There are many types and causes for fungus to appear. For example, thrush is caused by the candida fungus, an infection that generally appears in the mouth but can also occur as a diaper rash in infants and as a yeast infection in women. Small amounts of the candida fungus are present even in healthy people throughout the body – from the mouth, through the digestive tract, and skin – and are kept in check by microorganisms and other bacteria in the body. When that balance is knocked out of whack, the fungus grows out of control, causing thrush. Thrush can be exacerbated by the habit of smoking, having the herpes simplex virus types 1 or 2, uncontrolled diabetes, a weakened immune system, poor oral hygiene, dry mouth, stress, birth control pills, antibiotics, acidic foods, cinnamon flavorings, and the use of corticosteroids.

Symptoms may appear suddenly and unfortunately, as you have discovered, can last a long time. There may be raised lesions on the roof of the mouth, tonsils, gums, back of the throat, tongue or inner cheeks that are creamy white in color and slightly raised. The lesions may bleed when the teeth are brushed and they may be painful. Severe cases may spread to the esophagus, the muscular canal that connects the mouth to the stomach. When this occurs, the individual may experience pain, fever and dysphagia (difficulty swallowing).

Diagnosis can generally be made by visual examination of the inside of the mouth, or sometimes with the help of a simple scraping of the material examined under a microscope. When the lesions extend to the esophagus, a culture may be performed or endoscopy may be ordered.

Treatment is generally initiated with anti-fungal medications available in tablet or liquid form, or as lozenges taken for about two weeks. While the ingestion of yogurt or taking acidophilus capsules might not rid your body of oral thrush, these products may work toward restoring the normal flow of bacteria within the body.

Prevention entails seeing a dentist on a regular basis, limiting the consumption of sugary foods and those that contain yeast, discontinuing smoking if appropriate, brushing twice daily and flossing at least once each day. We don’t always take into account the yeasts we consume on an almost daily basis but bread, beer and wine may contribute or be solely to blame. Speak with your primary care physician or oral surgeon about your diet to determine if this could cause your long-standing problem.

Without knowing your history, I cannot determine if you have other medical problems that should be addressed or even when you last visited a health care professional for a full examination. I stress this because the problem could be the result of an underlying medical condition in another part of the body (such as Sjogren’s syndrome or an immunodeficiency) that has yet to be diagnosed. Have you had lab and other testing within the last year or so? If not, you are overdue and the results just might give some insight into your fungal infection.