Antifungal and Antiviral Drugs for Oral or Dental Lesions

Most common Fungal infection of the Oral cavity is Candidiasis, other non-candidial fungal infections seen in the Oral cavity are mycoses, aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, paracoccidioidomycosis, oral geotrichosis, zygomycosis or mucormycosis, fusariosis and Phodotorula infection. Patients with impaired immune competence (HIV, tumors, leuemia, transplants etc) are most prone to Fungal infections.

Viral infections of the Oral cavity are most commonly related to the Human herpes virus and Human papillomavirus, viral infections in humans can affect either with local oral symptoms are show systemic symptoms as well. The other Viral infections which are seen in humans are – rubella, mumps, coxsackievirus infection, HPV infection, measels or rubeola and HIV (Oral Lesions in HIV or AIDS).

angular chelitis treatment, features differential diagnosis

Note: The medicines mentioned here are just for informative purposes and should not be used for self medication. Please consult the Dentist or Physician before taking any medication.

Antifungal Medication for Oral lesions:

Oral Rinse:

  • Nystatin 1,00,000 U/mL – Gargle or swish and spit out 5 ml of liquid 3 to 4 times a day for 1 week.
  • Amphotericin B suspension 100mg/ml: Swish and spit out 5ml, 3-4 times per day for 1 week.

Lozenge:

  • Nystatin lozenge 200,000 u/lozenge– Dissolve -2 pastilles in mouth 3-4 times a day for 1 week.
  • Amphotericin 10 mg lozenges: Dissolve 1-2 tablets in mouth 3-4 times per day for 1 week to 10 days.
  • Clotrimazole 10 mg troches: Dissolve 1 troche for 3-5 times per day for 1 week

Gels:

  • Mycostating or Triamcinolone cream, Clotrimazole . betamethasone cream, lodoquinol or hydrocortisone 1% cream, Mixonazole 2% gel – Used in cases of Angular cheilitis caused due to either viral or fungal infections. Apply the creams on the corners of the mouth 3-4 times a day. Can also be used in patients with Dentures, apply the gel onto the denture base and wear it.

Tablets:

  • Ketoconaole 200-400 mg per day: Take 1-2 tablets bid for 1 week.
  • Fluconazole 100-200 mg daily: Use for 3-4 days
  • Itraconazole 100-200 mg per day: 1-2 times a week for long term treatment
  • Voriconazole 200 mg twice a day: 1-2 times a week for long term treatment
  • Posaconazole 100 mg daily: 1-2 times a week taken in immunosupressive therapy.
  • Miconazole 50mg dissolving tabs: OD for 1 week to 10 days.

Denture Cleaner:

  • Nystatin 100,000 U/ml, Chlorhexidine digluconate 0.12-2%, 3% Sodium hypochlorite diluted in water (1:10), 2% sodium bnzoate: Remove denture and Soak it in any one of the liquids overnight and wash it thoroughly in the morning before wearing them.

Antiviral Medication for Viral Lesions of Oral Cavity:

Viral lesions of the oral cavity are usually seen due to systemic Viral infection and in most cases Antiviral medication is given to treat the systemic condition which is useful for the Oral lesions as well. But Oral Gels are prescribed to relieve symptoms.

  • 50:50 suspension of diphenhydramine and bismuth subsalicylate or lidocaine viscous: Used in Acute herpetic gingivostomatitis
  • Acyclovir 400 mg: qid for one to two weeks, Used in Acute herpetic gingivostomatitis and Herpes Labialis
  • Topical Acyclovir 5% cream, ointment: Topical application for Lesion on the lips,
  • Abreva 10% cream: Topical application
  • Famciclovir: As directed by your Dr
  • Valacyclovir: As directed y your Dr

Both Antiviral and Antifungal medications should not be used without consulting your Doctor, self prescription is a strict no. If the symptoms do not subside within the said dosage it is best to visit your Doctor and do not continue the medication on your own.

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