Black Fungus and the Oral Cavity

What is Black Fungus?

Black fungus, also known as ‘Mucormycosis’ is a disease belonging to the fungal family ‘Mucorales’. Mucormycosis is a very rare infection which is caused by exposure to mucor mould commonly found in soil, plants, manure, and decaying fruits and vegetables.

This fungus infects people who have impaired immune systems. We are all breathing in, fungal spores constantly viz… when we walk by a construction site or compost piles. Healthy people clear them easily without experiencing illness, however those with compromised immunity tend to get adversely affected; so much so it can prove fatal.

This fungus primarily affects facial sinuses, brain and lungs of severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS.

Healthcare Professionals observed that black fungus infection majorly occurs in the COVID-19 recovered patients after a long time of hospitalisation and medication. If it lands in the sinuses or brain, it can cause facial swelling, nasal congestion, and headache.

 

Who is more likely to get this Infection?

Black Fungus is commonly being observed in patients:

• who were suffering from COVID-19 and treated with steroids for a long time (as steroids causes increase in blood sugar levels and provide a favourable environment for the growth of this virus)
• who have uncontrolled diabetes. Escalated blood sugar levels is one of the main reasons for the fungus to multiply
• who have been hospitalised for a long time (making them more prone to getting exposed to the fungal spores)
• who were on oxygen support or ventilator (People undergoing oxygen therapy in the ICU, where a humidifier is used, are more at risk due to exposure to moisture as it has favourable condition for fungal growth)
• poor hospital hygiene (increases the chances of getting infected)
• with a weakened immune system due to overuse of antibiotics and/or steroids
• with cuts on skin from surgeries, transplants and burns that have been left unattended
  

Black Fungus Symptoms

The prime symptoms of the black fungus include: 

• discolouration of the oral tissues, tongue and gums
• loosening of the teeth
• stuffy nose
• sinusitis
• severe pain in the teeth, check and eyes
• swelling of face
• heaviness below the eyes
• discomfort
• fever
• headache
• pulmonary mucormycosis: Fever, cough, chest pain, pleural effusion (collection of fluid in the lungs), haemoptysis (coughing of blood), worsening of respiratory symptoms.

Oral Symptoms of Black fungus

1) Loose Teeth 

If you notice loose teeth beyond its actual physiological boundaries around the gum area after recovering from corona infection, it can be a sign of black fungus in the jawbones. When mucormycosis attacks our bone, the bone turns black and eventually dies. Then the infected bone should be extracted surgically. Black fungus infection weakens the jawbone and is followed by loosening of the teeth as they lose support of the jaw. So visit any dental clinic in Delhi or whichever city you are in immediately, as soon you get these signs.

2) Pain in the jawbone

Black fungus is an aggressive infectious condition and it will spread throughout your body if it is not treated in time. Pain in the jawbone is a warning sign indicating the transmission of infection in the sinus region.

We recommend you to consult your dentist in Delhi immediately when you have a toothache, painful sensation in the jawbone and reddish eyes after recovering from covid 19 infections.

3) Gum Abscess

Gum abscess is one of the most noticeable signs of black fungus. In general, it happens when the infection occurs in spaces between the teeth and the gums. This is followed by pus development which leads to gum recession. Dentists in Delhi are taking extra care to check post covid/black fungus symptoms in the patients’ oral cavity.

 4) Discoloration in Oral tissue

Discoloration in oral tissues is a serious problem you should be concerned about. It may occur with the accumulation of microbes especially after recovering from COVID-19.

If you see discoloration or color changes in regions around your mouth like lips, cheeks, gums, tongue, visit your cosmetic dentist in Delhi immediately.

5) Numbness in the mouth

Numbness in the mouth and cheeks is the main symptom indicating the spread of black fungus infection to the facial muscles. When muscles around the orofacial region get infected, it triggers numbness inside our mouth.

Possible Treatments of Black Fungus

If not treated on time, the black fungus infection can turn fatal. The medical treatment for mucormycosis ranges from 6 to 12 weeks and is a debridement treatment, which means that it has to be treated medically as well as surgically.

• A Multi-Disciplinary Team approach is required: Primary Team MUST comprise of – Internal Medicine specialist/ Pulmonologist, ENT, Endocrinologist & Ophthalmologist.
• Other specialists which may need to be involved: Microbiologist, Dentist, Intensivist, Neurologist, Neurosurgeon as needed.

Anti-fungal therapy majorly includes (amphotericin B) preparations which are administered by the specialist.

The fungus has to be removed surgically so that the penetration of anti-fungal drugs is much better into these areas. Surgery is very important in severe cases because the black fungus has to be completely scraped off and healthy tissue should be seen.

How can Black Fungus be Prevented?

Prevention is always better than cure. According to dentists, one can reduce their chance of getting infected by various viral and fungal infections including COVID and black fungus, by following some simple dental hygiene rules:

1. Maintain Oral Hygiene: After COVID recovery, the intake of steroids and other medication enables the bacteria or fungus in the mouth to grow and cause a problem in the sinus, lungs and even brain. Taking care of your mouth by brushing twice a day. Visiting dentists in Delhi for a professional scaling/cleaning of your mouth done can help.
2. Oral Rinsing: Maintaining good oral hygiene post-COVID-19 recovery is a must for patients to protect themselves from the effect of the disease. Change your toothbrush once you test yourself negative after covid. Regular oral hygiene care by rinsing with mouthwash and povidone-iodine gargles must be done.
3. Disinfecting toothbrush and tongue cleaner: A COVID recovered patient should have a separate brush holder from rest of the family members. Clean your brush and tongue cleaner regularly using an antiseptic mouthwash.

Other Preventive Measures of Black Fungus

Avoid fungal infection by taking certain other precautions like:

• Wearing a mask even after testing negative
• Strictly monitoring the sugar levels and keeping it in check.
• While administering oxygen to COVID patients, water for humidification/ oxygen therapy must be sterile and there should be no leakage from the humidifier.
• Maintenance of good hygiene and cleanliness is a must.
• Limit steroid usage. Strictly monitor sugar levels and keep it in check.
• Unnecessary use of broad-spectrum antibiotics, anti-fungals should not be done as this removes the normal commensal flora resulting in the growth of unwanted organisms due to lack of competition.

Key take-home messages about Black Fungus

• that COVID-19 patients are more susceptible to this opportunistic fungal infection
• hence awareness about this deadly disease among health care providers and the public is important
• early diagnosis and timely treatment are paramount for improving outcomes in an otherwise dismal disease
• preventive methods can protect us from these microbes

SYNOPSIS

Black fungus is a destructive fungal infection that should be treated in time. Currently, it is found that covid survivors are getting infected with this infectious condition. As certain post covid complications mimic the symptoms of black fungus, many people neglect and become victims.

Keep in mind if you or your loved ones who recovered from acute covid-19 witness any atypical signs similar to the ones we described here, they may be the signals of black fungus.

To book an appointment with us in, ‘Smile Delhi- The Dental Clinic’– call us on +91- 9811106871 or whatsapp Dr. Suprriya B Bhatia on +91-9811106377. You can also mail us on [email protected]

We Care To Make You Smile.

Posted by: Dr Hema