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Oral mucosa – Important diseases

by Josephine Andrews
Published: Last Updated on 152 views

The most common diseases of the oral mucosa include aphthae and oral thrush. Here you can find out how these diseases develop, how to recognize them and what can be done about them!

balance of microorganisms

The oral cavity is not a sterile place. Fungi, viruses and bacteria are found on the mucous membranes, tooth surfaces and in the saliva . Most of these microorganisms are part of a healthy oral flora and are responsible for certain metabolic processes. They also prevent colonization by pathogens:

In a healthy body there is a balance between “good” and “bad” germs. Cold, other pathogens, antibiotics, stress, serious illnesses and poor eating habits can shift this balance in favor of the pathogens.

Possible changes

Not all diseases of the oral mucosa are recognizable to the layperson. Some, however, make themselves felt with significant changes. Then you should definitely see your dentist! Because every thorough examination at the dentist includes not only the examination of the teeth but also that of the soft tissues and mucous membranes.

The most common inflammations of the oral mucosa are aphthous ulcers and oral thrush . There are also forms of cancer that occur in the oral cavity. Early detection is important here. Regular check-ups can reveal malignant changes at an early stage.

aphthous ulcers

Aphthae are round (as if punched out), yellowish-white colored mucosal ulcers with a reddish inflamed area. They cause pain when touched or in contact with acidic foods, such as vinegar or acidic fruits. There are three forms:

  • The most common is the minor type with a few mucosal ulcers measuring two to five millimeters in size, which mainly occur in the front third of the oral cavity.
  • The major type with a few ulcers larger than one centimeter is rarer . They reach much deeper into the tissue and cause more severe symptoms. They are often accompanied by enlarged, tender lymph nodes.
  • The rarest is the herpetiform type with many very small aphthae arranged like herpes. 

Individual aphthous ulcers can merge into larger foci of inflammation. If a large part of the oral mucosa is affected, experts speak of aphthous stomatitis . It makes chewing and swallowing very painful and takes well over a week to heal.

Why do aphthous ulcers develop?

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

Supporting the infection theory is that disinfectants and antibiotics sometimes accelerate healing. Otherwise, the old ENT and dentist saying applies to aphthous ulcers: “With a disinfectant it takes a week to improve, without treatment eight days”. This applies primarily to the minor type, which is the most widespread.

What to do against aphthous ulcers?

So in most cases it means: protect the sore spot and otherwise wait. Special pain-relieving mouthwashes, for example, can be used to alleviate the symptoms. In the case of a proven vitamin or mineral deficiency (such as iron or folic acid deficiency ), appropriate preparations can be useful.

Aphthous ulcers can occur again and again or more severely if the immune system is weakened by chronic diseases (such as diabetes ). In the case of chronically recurring aphthous ulcers, the doctor may recommend local treatment with a corticosteroid gel (“cortisone”) alternating with antiseptic mouthwash.

oral thrush

Oral thrush is a fungal infection of the lining of the mouth. Candida yeasts are responsible for this. They are found in the saliva of almost everyone. However, if their growth gets out of hand, a whitish coating forms on the mucous membrane. It can usually be scraped off relatively easily with a toothbrush or a scraper – except in the case of more severe cases with thicker thrush plaques or large, thick deposits.

The fungi multiply best on the rough surface of the tongue, in gum pockets and under ill-fitting dentures . However, the fungal lawn can also spread over the entire oral cavity. It is often accompanied by bad breath.

Who is prone to oral thrush?

Children and the elderly are at greatest risk of oral fungal infections – especially if they have chronic diseases that affect the immune system (such as leukemia , HIV, diabetes). Certain medications also promote thrush, especially antibiotics, cytostatics (cancer drugs) and agents that suppress the immune system (immunosuppressants).

How is oral thrush treated?

Thrush can be treated with antifungal agents ( antimycotics ) such as nystatin : The agents are applied locally (e.g. as a gel or lozenge) and act directly on site. Treatment with drugs that act throughout the body (systemically) is only necessary in severe exceptional cases and in the case of additional fungal infestation in other parts of the body.

The therapy requires patience: it can take a few weeks for the fungi to disappear from the oral cavity.

If there is an increased risk of a pronounced fungal infestation in the oral cavity, antimycotics are also taken as a preventive measure. This applies to long-term antibiotic therapy or local radiation therapy in the mouth and throat area (e.g. in the case of tumors of the tongue, throat or larynx ).

brush your teeth, rinse your mouth

Anyone who is prone to recurring mouth infections or mouth ulcers should brush their teeth extra thoroughly and gargle with an antibacterial solution before going to sleep. Ask your dentist for specific suggestions.

The best way to protect yourself from fungal infestation on the tongue is to regularly clean the rear parts of the tongue with a special tongue scraper. It is very flat and less likely to trigger a gag reflex than a toothbrush.

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