Black Fungus and the Oral Cavity

What is Black Fungus?

Black fungus, also known as 'Mucormycosis', is a rare fungal infection caused by a type of mold from the Mucorales family. This fungus is commonly found in soil, plants, manure, and decaying fruits and vegetables. It affects people with weakened immune systems, as they are less able to fight off the fungal spores in the air, such as near construction sites or compost piles.

While healthy individuals can typically clear these spores without becoming ill, those with compromised immunity are at greater risk. In severe cases, this infection can be fatal.

Black fungus usually affects the facial sinuses, brain, and lungs, particularly in individuals with weakened immune systems, like cancer patients or those with HIV/AIDS. Healthcare professionals have observed that Mucormycosis tends to occur more frequently in patients who have recovered from COVID-19, especially after prolonged hospitalization and medication. If the infection reaches the sinuses or brain, it can cause symptoms like facial swelling, nasal congestion, and headaches.

Who is More Likely to Get This Infection? 

Black fungus is commonly seen in patients who: 

1. Have recovered from COVID-19 and were treated with steroids for a prolonged period. Steroids can increase blood sugar levels, creating a favorable environment for the fungus to grow. 
2. Have uncontrolled diabetes, as high blood sugar levels help the fungus multiply. 
3. Have been hospitalized for extended periods, making them more likely to be exposed to fungal spores. 
4. Have you received oxygen support or been on a ventilator? People in the ICU, especially those using a humidifier, are at higher risk due to increased moisture, which promotes fungal growth. 
5. They are in hospitals with poor hygiene practices, which can increase the risk of infection.
6. Have a weakened immune system, often due to the overuse of antibiotics and steroids. 
7. Have cuts or wounds from surgeries, transplants, or burns that were not adequately treated, providing an entry point for the fungus. 

Symptoms of Black Fungus

The main symptoms of black fungus include:

1. Discoloration of the oral tissues, tongue, and gums
2. Loosening of teeth
3. Stuffy nose
4. Sinusitis (inflammation of the sinuses)
5. Severe pain in the teeth, cheeks, and eyes
6. Facial swelling
7. Heaviness or pressure below the eyes
8. General discomfort
9. Fever
10. Headache

For pulmonary Mucormycosis, symptoms may also include:

1. Fever
2. Cough
3. Chest pain
4. Pleural effusion (fluid build-up in the lungs)
5. Haemoptysis (coughing up blood)
6. Worsening respiratory symptoms

Oral Symptoms of Black Fungus

1) Loose Teeth 

If you notice that your teeth are loosening beyond their normal range after recovering from a COVID-19 infection, it could be a sign of black fungus affecting the jawbones. When Mucormycosis infects the bone, the tissue turns black and eventually dies, requiring surgical removal. The infection weakens the jawbone, causing teeth to lose their support and become loose. If you experience these symptoms, you must visit our dental clinic in Chennai immediately for evaluation and treatment.

2) Pain in the Jawbone

Black fungus is an aggressive infection that can spread throughout the body if left untreated. Pain in the jawbone is a warning sign that the disease may affect the sinus region. 

Suppose you experience toothache, jawbone discomfort, or eye redness after recovering from COVID-19. In that case, it is important to consult our dentist in Chennai immediately for proper evaluation and treatment.

3) Gum Abscess

A gum abscess is a crucial sign of black fungus. It typically occurs when the infection affects the spaces between the teeth and gums. This leads to the formation of pus and gum recession. Our dentist in Chennai is paying extra attention to check for post-COVID and black fungus symptoms in patients' oral cavities.

4) Discoloration in Oral Tissues

Discoloration in the oral tissues is a serious concern, often caused by the build-up of microbes, especially after recovering from COVID-19. 

If you notice any colour changes or discoloration around your mouth - such as on your lips, cheeks, gums, or tongue - it's essential to visit your cosmetic dentist in Chennai immediately.

5) Numbness in the Mouth

Numbness in the mouth and cheeks is a crucial symptom of black fungus spreading to the facial muscles. When the muscles in the orofacial region become infected, it can cause numbness inside the mouth.

Possible Treatments for Black Fungus

If not treated promptly, black fungus infection can become life-threatening. Treatment for Mucormycosis typically lasts 6 to 12 weeks and involves medical and surgical interventions, including debridement (removal of infected tissue).

Multi-Disciplinary Team Approach:

The primary team should include:

1. Internal Medicine specialist or Pulmonologist
2. ENT specialist
3. Endocrinologist
4. Ophthalmologist

Other specialists who may be involved:

1. Microbiologist
2. Dentist
3. Intensivist
4. Neurologist
5. Neurosurgeon (if needed)

Antifungal therapy, usually consisting of amphotericin B, is administered by a specialist. In addition, surgical removal of the infected tissue is crucial for better penetration of the antifungal drugs. Surgery is critical in severe cases to ensure the complete removal of the fungus and the restoration of healthy tissue.

How Can Black Fungus Be Prevented?

Prevention is always better than cure. Dentists recommend following basic dental hygiene practices to reduce the risk of viral and fungal infections, including COVID-19 and black fungus:

1. Maintain Oral Hygiene: After recovering from COVID-19, medications like steroids can promote the growth of bacteria or fungi in the mouth, which may lead to infections in the sinuses, lungs, or brain. To protect yourself, brush your teeth twice daily and visit a Chennai dentist for professional scaling and cleaning.
2. Oral Rinsing: Good oral hygiene after COVID recovery is essential. Replace your toothbrush once you've tested negative for COVID. Regularly rinse your mouth with mouthwash and perform povidone-iodine gargles to maintain oral health.
3. Disinfect Toothbrush and Tongue Cleaner: A COVID-recovered patient should use a separate toothbrush holder from other family members. Clean your toothbrush and tongue cleaner regularly with an antiseptic mouthwash.

Other Preventive Measures for Black Fungus

To reduce the risk of fungal infections, consider the following precautions:

1. Wear a mask even after testing negative.
2. Monitor and control blood sugar levels.
3. Ensure that the water used for humidification in oxygen therapy is sterile, and check for leaks in the humidifier.
4. Maintain good hygiene and cleanliness.
5. Limit steroid use and closely monitor blood sugar levels.
6. Avoid unnecessary use of broad-spectrum antibiotics and antifungals, as they can disrupt the normal bacterial flora, allowing harmful organisms to grow unchecked.

Key Takeaways About Black Fungus

1. COVID-19 patients are more vulnerable to this opportunistic fungal infection.
2. Awareness of this dangerous disease is crucial for healthcare providers and the public.
3. Early diagnosis and prompt treatment are essential for better outcomes in a severe condition.
4. Preventive measures can help protect us from these harmful microbes.

SYNOPSIS

Black fungus is a severe fungal infection that requires timely treatment. Currently, many COVID-19 survivors are developing this infection. As some post-COVID complications share symptoms with black fungus, many people ignore these signs, putting themselves at risk. 

If you or a loved one who has recovered from acute COVID-19 notices any unusual symptoms similar to those described here, it could be an early sign of black fungus. 

To book an appointment at 'Smile Solutions Family Dentistry', call us at +91-9384877610. You can also email us at [email protected].    

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