Could probiotics help with oral thrush?
Most women are only too aware of the rather irritating symptoms of thrush, when it comes to their vaginal health, however few people realise that the same yeast (Candida albicans) that causes vaginal thrush, can also flourish in the warm, moist environment of the mouth, causing oral thrush? And, given that this pesky yeast is readily able to colonise the mouth, should it follow, that you could use the same treatment protocol with your clients that you would to manage a gut or vaginal infection of Candida? I have been looking at available research into the use of probiotics as a component of an oral thrush clearing protocol, along with anecdotal evidence of its helpfulness?
The symptoms of oral thrush are easy to recognise as the yeast gives rise to a thick white coating on the tongue, and/or white spots on the inside of the cheeks. Sufferers may also see areas of inflammation in the mouth, have red cracks at the corners of the lips or notice an unpleasant taste in the mouth, or odour to the breath.
Symptoms often arise after a course of antibiotics, as antibiotics deplete our levels of beneficial flora, and enable pathogens to over-grow. Infants are even more likely to develop oral thrush as a consequence of taking antibiotics, as they are often given their antibiotics in a liquid or syrup form, which coats the mouth and tongue as they swallow it. This affects the oral flora far more than taking a capsule or tablet would. (you may like to read more on the topic of antibiotics and their effect on our friendly bacteria here) Other medications such as steroids and especially steroid inhalers used to treat asthma can also cause an overgrowth of Candida in the mouth, as can the use of anti-bacterial mouthwashes that deplete the levels of good bacteria in the mouth as well as bad.
Additionally, other lifestyle factors such as poor diet (especially those high in sugars and refined carbohydrates), stress, ageing, inadequate dental hygiene and the wearing of dentures can also contribute to the development of oral thrush.
Can probiotics help?
It would make sense to me that you could treat an oral overgrowth of Candida, in the same way as you would any other Candida overgrowth. The standard natural Candida protocol used by many practitioners is based around eliminating sugars and other refined carbohydrates (as these are the favoured food sources for yeasts) and adding anti-fungal supplements such as oregano, garlic, grapefruit seed extract or caprylic acid. Probiotics are used as an important part of the treatment plan, as they take up the space on the gut wall, left by the elimination of the yeast, and prevent it from coming back.
However, supposition and educated ‘guesses’ are one thing, but is there any scientific research out there that supports the use of probiotics for oral thrush? Well, actually, yes there is.....
A 2007 study 1 published in the ‘Journal of Dental Research’ gave 276 elderly people either 50g of probiotic cheese, or 50g of a regular, or ‘control’ cheese every day for 16 weeks. Their saliva samples were analysed at the beginning and end of the trial, and total yeast cell counts were noted. The trial showed that those from the probiotic group had significantly lower yeast cell counts at the end of the study period. In fact, probiotic intervention reduced the risk of high yeast counts by 75%, and also reduced the risk of hyposalivation (low saliva levels) by 56%. The trial was summarised by saying that probiotic bacteria can be ‘effective in controlling oral candidiasis’.
Additionally a 2012, Brazilian study 2, published in the ‘Brazilian Dental Journal’ showed that the consumption of a specific probiotic yoghurt drink three times a week over a period of 30 days, led to decreased prevalence of Candida in the test subjects saliva samples, coupled with a statistically significant increase in specific anti-candida antibodies in the mouth. Whilst this was a relatively small study, with just 42 participants, the findings were very promising, and the researchers summarised that ‘ probiotic bacteria reduced Candida numbers in the oral cavity of the elderly and increased specific secretory immune responses against these yeasts, suggesting its possible use in controlling oral candidiasis.’
More scientific research still needs to be done to identify the best strains of probiotics to recommend as part of an oral Candida treatment protocol. However, preliminary studies do seem to support the general theory that probiotics at least have a part to play in the management of this condition.
I would suggest that all other elements of a natural anti-Candida plan should also be adhered to, in order to get the best results, rather than simply adding in a probiotic to target the oral flora. Elimination of sugars and refined carbs is especially important as sugar sticks to the teeth and encourages yeast overgrowth there, whilst also altering the pH of the mouth.
It would also seem sensible to take measures to cleanse the digestive tract of Candida albicans, since an overgrowth in the mouth would often indicate an overgrowth further down the digestive tract. Taking a high quality daily probiotic supplement, alongside a special strain such as Saccharomyces boulardii could offer essential support when looking to rebalance gut flora in this situation.
I would recommend one to two capsules of a high quality daily friendly bacteria supplement, preferably taken with breakfast each morning.
The dosage of Saccharomyces boulardii, should be built up gradually over a three week period. Two can be taken each day in week 1, followed by 4 capsules each day in week 2, and then finally the maximum dose of 6 capsules can be taken each day in week 3. Clients should be monitored for die-off type reactions in this time however. If excessive symptoms are encountered then the dose should be built up more gradually.
To tackle the local infection in the mouth, some people find relief from emptying a capsule of Saccharomyces boulardii into a glass of water, and gargling with the liquid. Or even tipping the contents of a capsule on to their toothbrush, and cleaning their teeth with it. It is important to note though that this suggestion only comes from feedback that we have had from customers or our own staff, and it has not been clinically trialled, so please be sure to make your own reasoned decision before you recommend this to your clients! Oh, and just as a quick ‘heads up’, I might mention that Saccharomyces boulardii doesn’t taste the nicest either....but, anything in the name of health right?!
To read more about Saccharomyces boulardii, click here, and learn why it is one of my favourite probiotics!References: 1. J Dent Res: 2007 Feb;86(2):125-30. Probiotics reduce the prevalence of oral candida in the elderly--a randomized controlled trial. Hatakka K1, Ahola AJ, Yli-Knuuttila H, Richardson M, Poussa T, Meurman JH, Korpela R.2. Braz. Dent. J. vol.23 no.5 Ribeirão Preto Sept./Oct. 2012. Effects of probiotic bacteria on Candida presence and IgA anti-Candida in the oral cavity of elderly. Fabio Henrique Boarini Pacheco MendonçaI; Silvana Soléo Ferreira dos SantosI; Ivan da Silva de FariaI; Célia Regina Gonçalves e SilvaI; Antônio Olavo Cardoso JorgeII; Mariella Vieira Pereira LeãoI.