Thrush of the oral cavity (oropharyngeal candidiasis) is a superficial yeast infection of the mouth, which may include the tongue, inner cheek (mucous membrane of the cheek), the area of the inner lip, and sometimes the gums.
Although this is most often observed in young children, thrush can affect to a lesser extent, older children and sometimes adults. Oral thrush will also proceed to a scan for the underlying condition (immunosuppressive treatment, diabetes, etc.) identified in older children, teens, and adults.(1)
Is Oral Thrush Brought On By Stress?
Often a fungal overgrowth occurs in your mouth & is called oral thrush. When medications, stress, hormonal changes, or a weak immune system cause imbalance, Candida albicans can grow freely, causing thrush. So, excessive stress, physical or emotional can cause oral thrush.
When you experience any form of stress, whether physical or emotional, the adrenal glands start to work quickly. They release a group of stress hormones, especially cortisol. Cortisol is highly inflammatory. The purpose is to activate your immune system so that you can deal with a wound or injury because this is the type of pressure you are gradually facing.
However, after this initial increase in the immune system, cortisol can suppress your immune system. This is because your body knows that high levels of inflammation are not sustainable (it increases pressure on the immune system and can cause autoimmune diseases). To compensate for the initial peak of inflammation, cortisol can restore your immune system to a level 40% to 70% lower than your baseline, thereby suppressing your immune system.
The second effect of stress is that it temporarily stops the function of the digestive system. This can also be attributed to the pressures you are repeatedly facing as the body starts focusing on the stress and saving energy from other essential metabolisms such as digestion.(2)
Gives Candida The Opportunity
Usually, your body can control Candida. The immune system and healthy intestinal bacteria work actively to prevent them from reproducing too quickly. But when your immune system is suppressed and the digestive system is constantly closed, Candida has the opportunity to reproduce uncontrollably. Soon, it becomes overspread and out of control.(3)
Can Oral Thrush Be Mistaken For Something Else?
Some diseases are having similar manifestations of oral thrush. Some of these common diseases are:(4)
White Tongue: In this disease, the surface of your tongue is colonized by dead cells & bacteria. These are trapped between small nodules on your tongue, giving the tongue a white coating appearance.
Hairy Leukoplakia: Hairy leukoplakia can cause foggy white spots, similar to folds or ridges, usually on both sides of your tongue. It is frequently mistaken for thrush, and this infection is characterized by removable milky spots, which are also common in people with weakened immune systems.(5)
Oral Leukoplakia: Oral leukoplakia is a white plaque or patch formed in the mouth. This is usually formed on the tongue, but it may also appear on the cheeks, lower lips, gums, and inside the back of the mouth.(6)
Geographic Tongue: In this case, white spots appear with a map-like appearance on the tongue and are often confused with thrush.(7)
Aphthous Mouth Ulcers: These are sores in the mouth. It’s painful, but it’s usually harmless and disappears on its own, you probably have one of them before. If your stomach ulcer lasts for more than two to three weeks or becomes more painful or inflammatory, consult your doctor.(7)
Oral Lichen Planus: is a chronic illness that can cause a pale mouth, almost like a ligament, streaks, and plaques. The cause is unclear, but it is not considered contagious. However, it lasts much longer than thrush, & for few people, this is a lifelong condition.
So, oral thrush should not be underestimated as it can be a sign of serious underlying illness. Moreover, it can cause severe complications if left untreated. Consult your doctor and take the suggested therapy to arrest the condition at the earliest.(8)
- Taylor M, Raja A. Oral Candidiasis (Thrush). StatPearls [Internet]: StatPearls Publishing; 2019.
- Jena A, Patnaik S. Stress and Oral Health: A Literature Review. Indian Journal of Public Health Research & Development. 2019;10(11).
- Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. Journal of Fungi. 2020;6(1):15.
- Porter S, Mercadante V, Fedele S. Oral manifestations of systemic disease. British dental journal. 2017;223(9):683.
- Vijay S, Srivastava S. Oral Hairy Leukoplakia-A Comprehensive Review. International Journal Of Drug Research And Dental Science. 2019;1(2):1-12.
- Dilhari A, Weerasekera MM, Siriwardhana A, et al. Candida infection in oral leukoplakia: an unperceived public health problem. Acta Odontologica Scandinavica. 2016;74(7):565-569.
- Hernawati S. Management of Geographic Tongue, Fissure Tongue, and Oral Candidiasis on Dorsum of an Elderly Smoking Patient’s Tongue. Health Notions. 2019;3(4):182-186.
- Marable D, Bowers L, Stout T, et al. Oral candidiasis following steroid therapy for oral lichen planus. Oral diseases. 2016;22(2):140-147.
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