Antifungal Treatment – Dental Treatment

Introduction –Antifungal Treatment

The most common fungal infection in the mouth is called as thrush. It is a yeast infection developing in the mouth and throat and on the tongue. Thrush is most common in newborns and infants, but it can occur at any age.

Infants are always treated with topical antifungal medicines. But, they are not very effective in adults as surface area of the oral cavity is larger and difficult to cover with topical medicines.

People with weakened immune systems should take an antifungal medicine on a routine basis to prevent fungal infections.
Oral antifungal medicines should never be used during pregnancy, because they can harm the growing fetus except in a rare, severe oral infection. The risk of harm to mother and fetus is more by the infection rather than by the use of antifungal medicines in such cases.

Fungal infection should be prevented from spreading. Prescribed antifungal medicines slow down the growth of yeast and they are the standard treatment for thrush. Thrush is treated with medicines that can either be applied directly to the affected area (topical) or swallowed (oral). In rare cases, an antifungal medicine needs to be injected into a vein (intravenous, or IV).

Depending on the severity, there are three types of fungal infection:

  1. Mild infection:

In adults, mild cases can be cured bysimple home treatment. The home treatment includes use of an antifungal mouth rinse or lozenges. Treatment period should be about 14 days.

Mild thrush in infants is usually treated with topical medicines. The end point of treatment is at least 48 hours of symptom-free period.

  1. Moderate to severe infection:

More severe infections that have spread to the food pipe are treated with oral antifungal medicines along with topical therapy.

For some severe infections, a treatment period is usually longer than 14 days.

  1. Persistent or recurrent infection:

It needs to be treated for a period about twice as long as the symptoms last. Both oral and topical antifungal medicines are required in this case.

People with weakened immune systems should take an antifungal medicine on a routine basis to prevent fungal infections. Diabetes, cancer, HIV infection and steroid therapy are the common causes of deranged immunity.

In children, it is important to get rid of the source of infection to treat persistent thrush.Cleaning the toys, pacifiers, bottles, and other items which are regularly put in mouth by a child is useful.

Medications

Prescription medicines inhibit the growth of the yeast (antifungals) and control the thrush.

In adults, the treatment period is usually about 14 days. In infants, treatment is continued till there is at least 48 hours of symptom-free period.

Topical antifungal medicines:

  1.   These are applied to the affected area and are available in several forms like rinses and lozenges.
  2. Topical medicines need to be in contact with the infected area for sufficient time to stop the growth of the yeast. Lozenges are preferred to rinses as they take longer time to dissolve. Sipping water along with the lozenges is advised because the lozenges need moisture to dissolve.
  3. Most of the topical antifungals contain sugar; therefore there is an increased risk of formation of cavities when the medicines are used for longer periods. Using a topical fluoride rinse or gel during treatment may help to prevent the cavities. In children, excess fluoride is toxic and can stain their teeth. Make sure to talk to the doctor or dentist before giving fluoride products to children.

Oral antifungal medicines (pills)

Oral antifungal medicines affect the whole body. Oral medicines can be used alone to treat mild thrush infections. They can also be combined with topical antifungal medicines to treat severe thrush infections. Another use of oral antifungals is to prevent thrush in certain people with conditions that weaken the body’s immune system.

Choice of medication

There are different classes of medicines with different modes of action-

  1. Polyenes: such as nystatin
  2. Azoles: such as clotrimazole, fluconazole, and itraconazole
  3. Chlorhexidine

It contains Gentian violet (1%), an over-the counter dye and it kills bacteria and fungi, including the yeast that causes thrush.

Some important points

Both polyenes and azoles cure thrush most of the time. These medications are usually first to be used in children with fungal infection. If the infection does not respond to medicines, the doctor can order a culture test to find out whether drug-resistant strains of yeast are causing the infection. Then, specific treatment is given according to the results.

- Link of interest: Twitter Antifungal Treatment – Dental Treatment.

 

This article is not medical advice nor a substitute to professional health advice. Always consult a doctor.

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