Homoeopathic solution for aphthae (thrush): natural remedies and treatment

Kishan Kumar Brij¹ Megha¹, Haobam Vidyalaxmi Devi¹

ABSTARCT:
Aphthae, commonly known as thrush, is an oral condition caused by Candida species, particularly Candida albicans. It manifests as painful, white, ulcerative lesions in the mouth and is prevalent in immunocompromised individuals, infants, and the elderly. Diagnosis is primarily clinical, supplemented by culture tests. Treatment options include antifungals such as nystatin and fluconazole. Prevention strategies focus on maintaining oral hygiene and managing underlying health conditions. This overview covers its epidemiology, clinical features, diagnosis, and management.

KEYWORDS:  Aphthae, Homeopathy, Candida albicans

INTRODUCTION:

Aphthae, commonly known as thrush, is a prevalent oral condition characterized by multiple red spots or greyish areas in the mouth, often surrounded by a ring of erythema. These lesions inevitably progress to ulceration, causing significant discomfort. The condition frequently arises in association with candidiasis, a fungal infection caused by species of the genus Candida. Candida fungi are ubiquitous in nature and commonly inhabit the soft tissues of the mouth, throat, intestines, vagina, and skin. Infections such as oral candidiasis, or thrush, manifest in the mouth as aphthae, which can extend to the throat (aphthous throat) and affect other regions like the vulva and vagina (vulvo-vaginitis), and the glans penis and prepuce in men (balanoposthitis).

The development of aphthae is often linked to poor oral hygiene and systemic health issues, including constipation, indigestion, digestive disturbances, and eruptive fevers such as measles. Additional contributing factors include the consumption of very hot foods, excessive intake of sugar, lime, or mercury, the use of allopathic drugs, malnutrition, blood poisoning, and underlying conditions like syphilis. The resulting inflammation makes the soft tissues of the mouth red and sore, leading to considerable discomfort and impacting daily activities like eating and speaking.

Effective treatment of aphthae requires addressing both the local lesions and any underlying systemic conditions. Standard therapeutic approaches encompass antifungal medications to control Candida overgrowth, alongside measures to enhance oral hygiene and general health. Understanding the multifactorial etiology of aphthae is crucial for developing comprehensive management strategies aimed at alleviating symptoms and preventing recurrence. This introduction provides a foundation for exploring the epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for aphthae, highlighting the importance of an integrated approach to managing this common yet distressing condition.

1. KM3x, NM3x, KP3x: Administer 2-4 grains per dose. These remedies are beneficial for aphthae and can be alternated with any indicated homeopathic medicine, especially in cases with redness of the soft tissues of the mouth, vesicles, and blisters on the lips and tongue, accompanied by burning pains.

Biochemic Salts: KM3x, KP3x, NM3x, NP3x, NS3x – 2-4 grains per dose
Protocol: Thuja-30 should be given in combination with biochemic salts, ensuring that the biochemic salts are administered between Merc. Sol.-30 and Thuja-30 every time.
Indications: Most effective in treating aphthae with a recurring tendency or very painful stomatitis. It addresses hollow ditch formation in ulcerated spots with red indurated rings, which are very painful to touch. Symptoms include profuse salivation, a white-coated tongue with teeth imprints on its side, and an offensive smell from the mouth due to abscess formation in ulcerated spongy gums. The patient experiences a great thirst for cold water even when the mouth is moist.

2. Aethusa 30: Effective for aphthae with violent burning pain around red-swollen lesions, thrush on the tongue, inside lips, and inner throat, causing pain while eating and swallowing. Particularly useful for infants with painful mouth, crying during breastfeeding, vomiting milk soon after feeding, sweating, and weakness post-vomiting. It can be alternated with KM3x and NM3x, 1 grain dose every 1-2 hours for quick relief.
3. Argentum Nitricum 30: Indicated when the tip of the tongue is red and painful with elevated papillae, worsened by sugar and hot spices, and canker sores due to gastric derangements and acidity.
4. Baptisia 30: Suitable for ulcerated mouth, gums, tongue, throat, and tonsils with dark red color, profuse offensive saliva, and a white creamy coated tongue that is painful, sore, dry, and cracked. Useful in cases with gastric derangement, abuse of mercury, and phthisis origin. Symptoms include fever, offensive diarrhea, great thirst, extreme prostration, and debility, with a mouth full of ulcers.
5. Borax 6: Effective for aphthae in nursing children and elderly people, characterized by vesicles and blisters that bleed, profuse salivation, and violent pain. Aphthae present with a red ring, white spots, and inevitable ulceration. It can be administered every 2-4 hours for quick relief. Externally, Borax can be applied in honey or glycerin.
6. Capsicum 30, Nux Vomica 30, Sulphur 30: This trio is beneficial for obstinate cases of aphthae, thrush, and stomatitis in adults caused by gastric derangements, weak digestion, loss of appetite, alternating constipation and diarrhea, and abdominal distension. Symptoms worsen with eating seasoned or fried foods, walnuts, and dry dates, leading to redness and inflammation of mucous membranes, burning sensations, bad breath, dryness, and ulcerated spots on lips. Administer these remedies one after the other every 4 hours, or separately.
7. Hydrastis 30: Useful for aphthous mouth and throat with a heavily coated white tongue, teeth marks on the sides, and slimy thick mucus secretion in the mouth. It addresses weak digestion, constipation alternating with diarrhea, and causes stomatitis, aphthae, and thrush with painful, indurated, and elevated ulcerated spots on the soft tissue of the mouth.
8. Hydrastis Muriaticus 3x: Serves dual purposes; it can be applied externally over painful, indurated, swollen ulcerated spots in the mouth for immediate relief from burning pain, and also taken internally for curing aphthous mouth, throat, and tongue ulcers. A 2-grain dose can be applied and swallowed.
9. Kali Muriaticum 30 or 6x (biochemic): For aphthae, thrush, greyish-white patches, or sore, swollen, white-coated mouth and tongue due to indigestion from eating rich, fatty food. It can be used in alternation with KM3x, KP3x, NM3x, and NP3x, with a 4-grain dose.
10. Lachesis 30: Indicated for treating dry, aphthous throat, severe cases of aphthae, and stomatitis with swollen, spongy, bleeding gums. It is used for great burning and pain in the ulcerated spots on the tongue, at the side near the root of the tongue, and deeper in the throat. The pain extends to the ear on the respective side, worsening when touched or during swallowing. It is tried when other remedies fail to act.
11. Lycopodium 30, 200: Used in cases of aphthae, thrush, and stomatitis due to stomach or gastric disorders, liver affections, constipation, and nervous or flatulent dyspepsia. It is effective for recurring aphthae due to the aforementioned causes, or due to rheumatism, cancerous, or syphilitic miasm in the body or family history. It is helpful for ulceration of gums, lips, and soft tissue of the mouth after minor injury during tooth brushing. The patient prefers sweets and cool open air, prefers hot food and drinks, but cold water aggravates rheumatism and gastric affections.
12. Mercurius Solubilis (Merc. Sol.)-30 Appearance and Location of Merc Sol is often indicated when aphthae are present on the tongue, gums, or inside the cheeks. The ulcers are typically irregular in shape, have a greyish or yellowish base, and are surrounded by a red, inflamed margin. The ulcers are usually very painful, especially when eating or drinking. There may be increased sensitivity to hot, cold, and spicy foods. Excessive salivation is a key symptom that might point towards Merc Sol. The saliva may be thick and stringy. Patients might experience offensive breath along with the ulcers. General symptoms, other symptoms can include a metallic taste in the mouth, swollen gums, and general weakness or fatigue.
13. Natrum Muriaticum (Nat. M)-30
    Indications: Used for ulceration and stomatitis of the mouth with profuse salivation, sometimes dryness of the tongue with white frothy saliva, burning tip, sore throat, vesicles (blisters) on swollen gums, inside lips, and on the soft tissue of the buccal cavity. Symptoms include cracked corners of the mouth and vesicles that look like pearls on soft tissue with a fetid smell. Swollen gums or soft tissue are very sensitive to cold and hot drinks. The patient has a preference for more salt, experiences great hunger, and may have muscle atrophy even after eating well. It is effective in treating aphthae, thrush, and stomatitis in little children. Thuja-30 is very useful for aphthae or thrush with a recurring tendency, especially with the formation of white blisters on the sides near the root of the tongue, where the burning pain extends to the ears.
14. Nitric Acid (Nit-ac)-30
    Indications: Best remedy for curing stomatitis with redness of the mouth and tongue, scalded tongue, profuse fetid and acrid saliva causing redness of the soft tissue of the mouth, new sores on the lips, sides of the tongue, gums, or in the most violent cases of ulceration, stomatitis, and thrush due to syphilitic miasm or abuse of mercury in the body. It treats bleeding gums with painful vesicles on the sides of the tongue, offensive smell from the mouth, and ulceration of the soft palate with spongy and ulcerated gums.
15. Sulphur (Sul)-30 and Nux Vomica (Nux. V)-30
    Protocol: Sulphur-30 in the morning and Nux Vomica-30 after meals.
    Indications: A set treatment for common cases of aphthae, thrush, and stomatitis due to constipation, gastric disorders, or constipation alternating with diarrhea. It is used when psoric miasm affects the body, impacting the liver and nerves attached to the digestive system, causing nervous or atonic digestion, great distention of the abdomen due to weak digestion, and a white-coated tongue with mental depression and burning heat from the top of the head and feet. It also addresses frequent urging, tenesmus, and scanty stool. This set treatment not only cures aphthae but also alleviates chronic constipation.

 Precautions for Managing Aphthae

1. Maintain Oral Hygiene: Brush teeth twice daily and use antiseptic mouthwash to reduce bacterial load.
2. Avoid Irritants: Refrain from consuming spicy, acidic, or very hot foods that can aggravate lesions.
3. Balanced Diet: Eat a nutritious diet rich in vitamins and minerals to boost immune function.
4. Hydration: Drink plenty of water to keep the mouth moist and prevent dryness.
5. Limit Sugar Intake: Reduce consumption of sugary foods and drinks that can promote Candida overgrowth.
6. Stress Management: Practice stress-relief techniques like yoga or meditation to avoid triggering outbreaks.
7. Regular Dental Checkups: Visit the dentist regularly for professional cleaning and early detection of oral health issues.

Home Management for Aphthae (Thrush)

1. Maintain Oral Hygiene: Brush teeth twice daily and floss regularly to keep the mouth clean.
2. Use Antiseptic Mouthwash: Rinse with an antiseptic mouthwash to reduce oral bacteria.
3. Saltwater Rinse: Gargle with warm saltwater (1 teaspoon of salt in 1 cup of water) to soothe sores.
4. Avoid Irritants: Steer clear of spicy, acidic, or very hot foods that can aggravate lesions.
5. Stay Hydrated: Drink plenty of water to keep the mouth moist.
6. Balanced Diet: Consume a diet rich in fruits, vegetables, and whole grains to support overall health.
7. Topical Remedies: Apply over-the-counter topical anesthetics or homeopathic gels for pain relief.
8. Stress Management: Practice stress-reducing techniques like yoga or meditation, as stress can exacerbate symptoms.

Conclusion:

1. Aphthae, also known as thrush, presents a significant burden on individuals due to its discomfort and impact on daily activities like eating and speaking.
2. Understanding its multifactorial etiology, including poor oral hygiene, systemic health issues, and dietary habits, is crucial for effective management.
3. Treatment approaches, including antifungal medications and homeopathic remedies, aim to address both local lesions and underlying systemic conditions.
4. An integrated approach to managing aphthae is essential for alleviating symptoms and preventing recurrence.
5. Further research and clinical studies are warranted to explore novel therapeutic interventions and enhance our understanding of this common yet distressing oral condition.

ACKNOWLEDGE:
I extend my heartfelt gratitude to Prof. (Dr.) Meenakshi Ambwani, Head of the Department of Homoeopathic Pharmacy at Bakson Homoeopathic Medical College and Hospital, Greater Noida, U.P, 201310, for her invaluable support in bringing forth this work.

References:

1. Apthae: National Institute of Dental and Craniofacial Research. (n.d.). Retrieved from https://www.nidcr.nih.gov/health-info/mouth-bytes/more-info/canker-sores
2. Oral Candidiasis: Centers for Disease Control and Prevention. (2021, November 16). Retrieved from https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html
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4. Poor Oral Hygiene: American Dental Association. (n.d.). Retrieved from https://www.mouthhealthy.org/en/az-topics/p/oral-hygiene
5. Systemic Health Issues: Mayo Clinic. (2021, May 20). Retrieved from https://www.mayoclinic.org/symptoms/red-tongue/basics/causes/sym-20050624
6. Gastric Disorders: National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works
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Kishan Kumar Brij¹ Megha¹, Haobam Vidyalaxmi Devi^1
1PG Student (M.D part-2^nd) at Bakson Homoeopathic Medical College and Hospital, Greater Noida, UP, 201310.
Email : kk.brij@gmail.com