Candida

You are here: Home > Dental > Candida

Candida, (Candida albicans) is a fungal disease. Yeasts have become

increasingly significant as pathogens in all fields of medicine. This is
particularly true of those which are saprophytes (they live by eating dead
tissue instead of living tissue), because of their opportunistic behavior towards
the altered/compromised condition of their host. Fungi are part of the world of
plants, not bacteria, and there are about 100,000 distinct types of them. 50
types cause disease in humans. In people they are common, and usually
harmless companions of our skin tissues, and live as inhabitants of our
mucous membranes in our mouth, vaginal tract etc. as symbiotic saprophytes.
The outbreaks of acute episodes where these fungi "bloom and take over" are
not due to a change in the fungi, (they are with us all the time in limited
numbers) but due to a change in the hosts' immunologic defense
mechanisms. Someone who is compromised by radiation treatments,
antibiotic therapy, AIDS/HIV, corticosteroid treatment etc. has a lowered ability
to keep them in check, and is a prime candidate to have an outbreak of
Candida.
Yeast infections such as Candida were recognized centuries ago as an
indicator of much larger underlying diseases such as diabetes mellitus,
malignant tumors, and chronic infections. (Sort of the miners canary.) When
antibiotics are used, there is a flip-flop in the balance of the natural occurring
flora in the mouth (and elsewhere) where the normal flora is damaged by the
antibiotic therapy to the advantage of the fungus, which then blooms. Damage
to the mucus membranes and to the salivary glands also allow for Candida
colonization. Dry mouth (xerostomia), upsets the balance of microorganisms
in the oral cavity. When the delicate balance of normal and abnormal bacteria
is disturbed, an overgrowth of this fungus may occur.
Using an extreme example, such as a person with HIV/AIDS, Candidiasis
begins in the oral cavity, then has escalating symptoms in the esophagus and
descending into the gastrointestinal tract, finally into organ mycosis and when
in the blood system, it is finally called Candida sepsis. At this late stage it can
be deadly. The clinical picture of Candida appears as white raised spots/areas
which have underneath an infected red base. Left unchecked by antifungal
drugs it can actually ecome several millimeters thick. The whitish portion is not
firmly attached to the underlying tissue, and can actually be wiped or brushed

off. Candida is commonly called thrush, and if left unchecked for a period in
the mouth, it can spread to the pharynx and the esophagus and cause severe
symptoms such as erosions and ulcerations of the tissues.

Doctors can typically diagnose Candidiasis simply by looking in the mouth or

the back of the throat, but a sampling of the white overgrowth may be scraped
easily from the surface and sent to a lab for positive identification. Classic
symptoms of oral Candidiasis include the appearance of whitish, velvety
plaques on the mucous membranes of the mouth and tongue. If the whitish
material is scraped away, the base may be red (erythematous) with pinpoint
bleeding. More general symptoms of candida infection include burning pain in
the mouth or throat, altered taste (especially when eating spicy or sweet
foods), and difficulty swallowing. The corners of the mouth may also become
chapped, cracked, and sore (angular cheilitis). If the immune system has been
severely compromised, the infection may cover much of the surface of the
mouth and tongue, and it may spread to the esophagus. Esophageal
candidiasis, which is much more common in people with suppressed immune
systems, occurs deep in the throat, and cannot always be seen during an oral
examination. An endoscope is commonly used to identify this type of
Candidiasis. In its esophageal form, Candidiasis can cause chest pain, as well
as pain and difficulty in swallowing. Once the Candida fungus migrates past
the gastrointestinal tract, it can become established in other major organs
such as the lungs and kidneys. Left untreated, it can even cause death. When
Candida progresses to the point where it is in the bloodstream, it is referred to
as Candida sepsis. At this stage it is hard to treat and recovery is extremely
difficult. The death rate from late stage disseminated Candidiasis may reach

seventy percent. The importance of treating it in its early stages cannot be

overstated.
Candida overgrowth may also cause a condition called Intestinal HyperPermeability, more commonly know as Leaky Gut Syndrome (LGS). This
condition occurs when the wall of the gastrointestinal tract is damaged. The
Candida change form, creating rhizoids, root like structures that break the
intestinal walls. A healthy intestinal wall will allow only nutrients to enter
bloodstream, but when it is damaged, larger molecules such as incompletely
digested fats, proteins, and toxins may also slip through. The body recognizes
these substances as foreign and forms antibodies to them, causing the patient
to suddenly become allergic to foods they would previously been able to eat
without a problem. LGS may also lead to environmental allergies, causing the
patient to respond to inhalants in their general environment. The patient may
also form antibodies to proteins similar to, or the same as, human proteins
This can lead the immune system to attack parts of the patient's own body.
With LGS, vitamin and mineral deficiencies are common because the patient
lacks the ability to move minerals and vitamins from the gut to the blood.
When the Candida becomes controlled and the gut has healed, food allergies
will remain until antibodies to that food have been eliminated.
Antifungal agents are vital to the control of candidiasis. These can be either
systemic or topical. In selecting a topical oral antifungal agent, the patient's
degree of xerostomia and possible inability to dissolve a lozenge must be
considered, as well as the level of oral hygiene and the risk associated with
the high levels of sucrose in topical preparations. Topical antifungal agents
include nystatin and clotrimazole (or other closely related agents), either of
which may be applied directly to the oral lesions as a dissolving lozenge or in
a liquid wash. Infections that are resistant to those agents, or that have
already disseminated, are treated with IV medications such as Amphotericin
B, Ketoconazole, Itraconazole, and some oral antifungal agents such as
Fluconazole (Diflucan). These are more potent drugs, and are more likely to
cause side effects, including stomach upset, diarrhea, nausea, and elevated
liver enzymes.
While "natural" or homeopathic remedies exist which may alleviate Candida
outbreaks, never self treat Candida infections with a health store remedy
without consulting your doctor first. These health store remedies are not as
potent as prescription medication, and may not be as effective for those who
have had radiation therapy or chemotherapy. One of these types of treatments
is gentian violet, a dye made from coal tar that may be purchased from some

pharmacies, health food stores, and other places where alternative therapies
are sold. The dye is applied by using a cotton swab to coat the Candida
blotches. It is best to avoid swallowing the dye, as it can cause upset
stomach. Gentian violet can also stain the inside of the mouth, but this fades
over time.
Your doctor should always be consulted, as a delay in complete control of the
Candida "bloom" can allow it to spread to further areas of the body. Though
potentially serious, prescription antifungal agents can quickly eradicate a
Candida infection.