Oral mucosa - important diseases

The oral cavity is not a sterile place, but full of fungi, viruses and bacteria. Most of these microorganisms are components of a healthy oral flora. In cold weather, antibiotics, stress, serious illnesses or wrong eating habits but can spread pathogens. The most common diseases of the oral mucosa include aphthae and oral thrush.

Oral mucosa - important diseases

Balance of microorganisms

The oral cavity is not a sterile place. The mucous membranes, tooth surfaces and saliva contain fungi, viruses and bacteria. Most of these microorganisms are components of a healthy oral flora. They are responsible for certain metabolic processes or prevent the colonization with pathogens.

But not all microorganisms are harmless. In the healthy body there is a balance between the "good" and "bad" germs. Cold, other pathogens, antibiotics, stress, serious illnesses or wrong eating habits shift the balance in favor of the pathogens.

Frequent changes

Not all diseases of the oral mucosa are recognizable to the layman. In case of significant changes you should definitely visit your dentist. Every thorough examination by the dentist includes the assessment of teeth, soft tissue and mucous membranes. The most common inflammations of the oral mucosa are aphthous and oral thrush. However, there are also forms of cancer that occur in the oral cavity. Here an early detection is important. Regular check-ups reveal malignant changes at an early stage.

aphthous ulcers

Aphthae are round (as punched out), yellowish-white colored mucosal ulcers with a reddish inflamed courtyard. In contact with acidic foods such as vinegar or sour fruits they cause pain. There are three forms:

The most common is the Minor type with a few, two and five millimeters large mucosal ulcers, which occur predominantly in the anterior third of the oral cavity. Rarer is that Major type with a few, more than one centimeter large ulcers. They reach deeper into the tissue and cause more discomfort. Often they are accompanied by enlarged, tender lymph nodes. The rarest is the herpetiform type with many, very small, herpes-like arranged aphthae.

Individual aphthous ulcers may fuse into larger centers of inflammation. If a large part of the oral mucosa is affected, experts speak of a stomatitis aphthosa. It makes chewing and swallowing very painful and takes much longer than a week to heal.

The cause of the aphthae is unknown. Minerals and vitamin deficiencies, allergic factors, infections or hormonal fluctuations are discussed as triggers.

For the infection theory suggests that disinfectants and antibiotics sometimes accelerate healing. Otherwise, the old ENT and dentists' saying applies to aphthae: "With a disinfectant, it takes one week to get better, eight days without treatment". This applies primarily to the type of minor that is most widespread. Thus, it means in most cases: protect the sore spot and wait. To relieve the symptoms, for example, special analgesic mouthwashes can be used. In the case of proven vitamin or mineral deficiency (such as deficiency of iron or folic acid), appropriate preparations may be useful.

Aphthae can occur more often or more pronounced if the immune system is weakened by chronic diseases (such as diabetes). In the case of chronic recurring aphthous ulcers, the doctor may recommend a local treatment with a corticosteroid gel ("cortisone") alternating with antiseptic mouth rinses.

Oral thrush

The cause of thrush is a fungus. In almost every saliva sample can be detected Candida yeast. As their growth increases, a whitish coating forms on the mucous membrane. With the toothbrush or a scraper, it is usually relatively easy to scrape off, except in the case of thicker thrush plaques or large thick coverings. The mushrooms multiply best on the rough tongue surface, in gum pockets and under badly fitting prostheses. The mushroom turf can spread over the entire oral cavity. Often he goes along with a bad bad breath.

Children and the elderly are at the highest risk of fungal oral disease - especially if they have chronic diseases that affect the immune system (such as leukemia, HIV, diabetes). Certain medications also favor soorbeing, especially antibiotics, cytostatics (anticancer drugs) and immune suppressants (immunosuppressants).

Thrush can be treated with anti-fungal agents (antifungals) such as Nystatin: they are applied locally (for example as a gel or lozenge) and work directly on site. A treatment with drugs that act throughout the body (systemic), is only necessary in extreme cases and with additional fungal infestation of other places in the body. Despite therapy, it may take several weeks for the fungus to disappear from the oral cavity.

If there is an increased risk of pronounced fungal infection in the oral cavity, antimycotics are also taken preventively. This applies to prolonged antibiotic therapy or local radiation therapy in the oral and cervical region (such as tumors of the tongue, throat or larynx).

Brush your teeth, rinse your mouth

All people prone to recurrent mouth infections or aphthous ulcers should brush their teeth thoroughly and gargle with an antibacterial solution before falling asleep. Ask your dentist for specific suggestions.

It is best to protect yourself against fungal attack of the tongue by cleaning the back of the tongue with a special tongue scraper. It is very shallow and less likely to trigger a gag reflex compared to the toothbrush.


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