A few years ago, I realized that I was thinking about dental care all wrong. Instead of listening carefully to my dentist and making the necessary changes, I assumed that he was ultimately responsible for making sure that my teeth stayed healthy. Unfortunately, I developed a few serious cavities because I failed to properly brush and floss my teeth, and I knew that it was my fault. I decided to start taking notes at my dental checkups and carefully abiding by the dentist's orders. The difference was almost miraculous. This blog is all about working with your dentist to improve your result.
You're probably already aware of the many complications that lupus can cause throughout your body, but you may not know that the medications you take to control it can also cause issues. Lupus medications may lead to oral health complications like candidiasis, also called oral thrush or an oral yeast infection. Here are four things lupus sufferers need to know about candidiasis.
How does lupus cause candidiasis?
Lupus on its own isn't responsible for causing candidiasis; the problem is the medications that are often used to treat lupus. Corticosteroids are one of the main medications used to treat the inflammation associated with lupus, but unfortunately, corticosteroids also have some side effects. One of these side effects is immunosuppression.
When your immune system is suppressed due to corticosteroids, your body isn't able to fight off fungal infections as easily. This increases your chances of developing candidiasis and other fungal infections. Your risk of getting candidiasis is greater if you've been taking corticosteroids for a long time or if you're taking a high dose.
What are the signs of this condition?
The symptoms of candidiasis are easy to identify. You'll notice white lesions inside your mouth; these lesions have a lumpy texture and look like curds of cottage cheese. You may also notice pain or bleeding if you accidentally scrape the lesions while you're eating or cleaning your teeth. In addition, you may notice that you have a strange taste in your mouth. If you notice these symptoms, see your dentist, and make sure to tell them that you have lupus.
Why is it a concern?
Candidiasis is just a nuisance for people with healthy immune systems, but it's a serious concern for immunocompromised people. This is because your immune system may not be able to prevent the infection from spreading from your mouth to other areas. If it spreads to your esophagus, you'll develop what's known as esophageal candidiasis and have trouble swallowing and may lose weight.
Worse, the fungi can spread to your lungs, which leads to fungal pneumonia. Like other types of pneumonia, fungal pneumonia presents as a severe cough and fatigue. Fungal pneumonia has been reported to kill as many as 90% of immunocompromised people who develop it. This is why it's important to get treatment right away for the infection inside your mouth.
How is it treated?
Your dentist can give you a prescription for antifungals to get rid of the infection. However, the infection may come back in the future. The fungi responsible for candidiasis, Candida, is naturally found in the human mouth, so recurrence is a big concern.
The root cause of candidiasis needs to be addressed to prevent it from coming back. In lupus patients, candidiasis is caused by corticosteroid therapy, so if possible, your medications will need to be changed. Your rheumatologist may be able to lower your dose and still effectively treat your lupus symptoms, or may be able to switch you to a different medication with fewer side effects.
If you're not able to alter your corticosteroid regimen, your dentist may need to prescribe intermittent anti-fungal therapy to keep the fungi within your mouth under control. Your dentist may also recommend prophylactic anti-fungal therapy, meaning that you'll take the medication on an ongoing basis as a preventative measure. Since long-term anti-fungal therapy can interact with other medications, like some corticosteroids, make sure that your dentist is aware of the medications you are taking to treat your lupus.
If you have lupus and have developed lumpy, white lesions inside your mouth, make sure to tell your dentist (someone like Schererville Family Dentistry, PC). Your dentist can help you get rid of the infection and help you prevent a recurrence.