I'd like to give that doc a good thrushing.
November 30, 2012 12:55 PM   Subscribe

I went to the doc because I thought I might have oral thrush. His diagnosis was so far in a different direction that I'm kind of baffled. Hope me?

So I just spent 8 days on an antibiotic (Clindamycin) because of a dental issue. Right at the beginning of those days I started to have a terrible taste in my mouth, and over the course of those days I developed a sort of white film covering my tongue. I couldn't discontinue the antibiotics, so I waited until the end, then another day or two to see if it would clear up. It didn't.

Googling around I see that thrush is a not-infrequent side effect of some antibiotics, and while the interior of my mouth does not -- thankfully! -- look as bad as some of the photos I've seen, it does look like this. Brushing doesn't help, and the terrible taste persists 24/7. My tongue also appears pitted or cracked -- though perhaps that is just the regular surface of my tongue being highlighted by the whiteness. It doesn't hurt.

I couldn't get ahold of my dentist so I popped into my general practitioner -- and though I couldn't see him I saw a different doc in the practice. He heard my story, took a look deep into my mouth, then here are his questions and my answers:

Are you having sinus pain? No.
Do you get many sinus infections? No, never had one in my life.
Do you clear your throat a lot? I don't think so.
Have you been coughing a lot? Definitely no.

Then he told me that this is all caused by post-nasal drip. And he told me to:
-- gargle with salt water
-- do warm compresses on my cheeks & nose
-- pick up a prescription of saline -- basically a neti pot situation.

Does this sound right to you guys? I am most definitely not a doctor, and I certainly don't expect a doc to just rubber stamp whatever I've learned on the internet. But for some reason this is feels like a real disconnect, given my "no" answers to his questions, and the fact that I'm just coming off the antibiotics.

Also, if you have any suggestions for my own self-treatment, I'd love to hear them. At this point I haven't picked up the saline prescription, and I was thinking of just doing the salt-water gargle all weekend to see if that helps. I'm confused about why I would be doing the neti pot-style of treatment when my nose seems entirely clear and unstuffed and I'm not experiencing any sinus issues that I can perceive.

Lastly, I'll just add that at Mr. BlahLaLa's insistence i had been having some of those live culture yogurt drinks during the antibiotics to help my gut recover. Don't know if that makes any difference.

posted by BlahLaLa to Health & Fitness (25 answers total)
A second opinion would seem to be indicated.
posted by computech_apolloniajames at 12:59 PM on November 30, 2012 [7 favorites]

Seconding the call for a second opinion. I had post-nasal drip and it was never like this.
posted by tommasz at 1:06 PM on November 30, 2012 [1 favorite]

Based on the photo you posted, it doesn't look very impressive. I can't comment on your case specifically (and am not your doctor) but I can tell you that I've had cases where people come in to me saying they are sure they have oral thrush (or worse, they Googled "white tongue" and found a million very unlikely worse things it could be), and really the thing is that they became convinced something was wrong with their tongue and the fact was they just never really noticed what their tongue looks like or that it has a certain degree of whiteness to it normally. That photo you linked to looked a lot closer to a normal tongue than thrush. Maybe your tongue looks pretty normal too. I don't know. But certainly a second opinion and using some home remedies are not going to be harmful.

the other question is.... is your tongue painful?
posted by treehorn+bunny at 1:07 PM on November 30, 2012 [2 favorites]

Response by poster: No, no pain, treehorn+bunny. Though it is awfully red after I brush.
posted by BlahLaLa at 1:09 PM on November 30, 2012

Response by poster: And just as further data: the #1 symptom is this terrible, terrible taste in my mouth. Like I'm licking raw metal.
posted by BlahLaLa at 1:10 PM on November 30, 2012

Having had thrush, I will tell you that the salt-water gargle and neti irrigation did WONDERS for clearing that crap out. And I hear you about it making everything taste awful... After switching to the salt rinse it started clearing up inside a day. Granted, I was gargling like 5-6 times a day at least, because the taste was that horrible otherwise.
posted by FatherDagon at 1:11 PM on November 30, 2012 [2 favorites]

IANAD. But I've always had periods of having white stuff on my tongue (which may or may not be the same case as yours). Never thought much about it. My partner does too sometimes, and it bothers him. So he uses a tongue scraper. After several weeks, he claimed that he can taste things a lot better now. *shrug*.
posted by ethidda at 1:11 PM on November 30, 2012

the #1 symptom is this terrible, terrible taste in my mouth. Like I'm licking raw metal.

That kind of metallic taste is itself a side effect of some antibiotics. Do check with another doctor if you're concerned, of course, but that is also another cause.
posted by EmpressCallipygos at 1:14 PM on November 30, 2012 [9 favorites]

Have you possibly eaten pine nuts recently?
posted by something something at 1:15 PM on November 30, 2012 [1 favorite]

I've experienced the metallic taste as a side effect of antibiotics. But get a second opinion.
posted by fake at 1:22 PM on November 30, 2012

Do you have a temporary crown? Do you have sensitivities to metals (like aluminum in anti-perspirants or nickel in jewelry)? When I had the same nasty metallic taste after dental work, I thought it was the Clindamycin but it turned out to be the temporary crown. As soon as that came out the problem went away. Plus, shiny pretty new tooth, woo.
posted by acorncup at 1:28 PM on November 30, 2012

Response by poster: No temporary crown, no pine nuts, no known metal sensitivities.
posted by BlahLaLa at 1:36 PM on November 30, 2012

I'd follow the doc's recommendations for now, just because they fall into the category of "can't hurt, might help" (which, when it comes to medical advice, is as good as it gets!). Anecdata: I get gunk like that on my tongue if I eat sugary/starchy stuff. The best way to remove it, if it doesn't hurt/bleed, is with a credit card bent into the approximate curvature of a Pringle.
posted by julthumbscrew at 1:44 PM on November 30, 2012

Try again with the dentist for a second opinion, and meanwhile try the salt rinses. That metallic taste sounds very much like the oral thrush I developed as the result of using too many Ricola cough drops when I had a cold, though I had pain, too. Prescription oral antifungal lozenges cleared it up in about three days. Coconut oil supposedly has antifungal properties and cleared up the cracks that appeared at the corners of my mouth at the same time.
posted by artistic verisimilitude at 1:46 PM on November 30, 2012

Clindamycin sucks. I had the same thing happen-right down to the doctor insisting it couldn't be thrush because it wasn't bad enough. Luckily, I had some diflucan sitting around, which cleared it right up. I am VERY yeast prone when on antibiotics and have bought diflucan from foreign pharmacies in the past to avoid constant doctor visits.
posted by PhoBWanKenobi at 2:34 PM on November 30, 2012 [2 favorites]

What was the dental work? One time when I had some work done, it loosened a filling, which allowed saliva to get in between the filling and the tooth, which led to a terrible taste because stuff was festering in there.
posted by cosmicbandito at 3:00 PM on November 30, 2012

Metallic taste is a known side effect of this antibiotic. When I have taken antibiotics which caused metallic taste, it lasted a while after the drug course was finished.

Since the mouth and sinuses are directly connected, it helps to treat both if you have a persistent problem in either area. Thrush can be killed by salt, so even if it isn't post nasal drip and is thrush, this treatment might help.

I also find that killing a known infection often causes me to have that "tastes like something died" taste in my mouth, sometimes pretty persistently, especially if the infection was in or near my mouth.
posted by Michele in California at 3:39 PM on November 30, 2012

I've had post-nasal drip diagnoses for everything from strep throat to mono to a sinus infection. My advice for anyone who gets that diagnosis is now forevermore: second opinion, asap.
posted by zinful at 3:40 PM on November 30, 2012

I have regular sinus infections and I got oral thrush pretty often. Every single doctor I went to for a while refused to believe that I had the thrush because it didn't fit THEIR definition of thrush even though I had pain, a white coating, a terrible taste in my mouth, etc. Sometimes the antibiotics they gave me for my sinus infections took care of the issue; but all the other times it made the whole thing worse. I finally persuaded a nice urgent care doctor to give me Nystatin just in case he was wrong and lo and behold, all the symptoms went away.

Do the salt rinses, but also get a second opinion. Sometimes doctors are dumb.
posted by These Birds of a Feather at 4:53 PM on November 30, 2012

These Birds, if antibiotics cleared it up, it wasn't a fungal infection (thrush is fungal).
posted by treehorn+bunny at 6:06 PM on November 30, 2012

I went to a doctor and a dentist with very similar symptoms. The doctor didn't know what it was. The dentist immediately saw that it was the result of my flonase nasal spray dripping down into my mouth and irritating my tongue.
posted by umbĂș at 8:10 PM on November 30, 2012

For future reference, if you think you have thrush and you want to abate some of the symptoms before you can get to a doctor, gargling with hydrogen peroxide will help. Just be careful not to swallow. And yeah, it tastes terrible.

Diflucan, an oral med given for traditional yeast infections, will clear up thrush too. Just in case you've had yeast infections before and your doctor will give you Diflucan without a pelvic exam.
posted by IndigoRain at 8:59 AM on December 1, 2012

I've found it effective, too, to just tell doctors that I need a diflucan scrip every time I'm given an antibiotic. Once or twice, it hasn't been necessary but the vast majority of the time it is.
posted by PhoBWanKenobi at 9:32 AM on December 1, 2012 [1 favorite]

A diagnosis that rules out thrush, without a culture of your throat/mucus, is a guess.

Seek a second diagnosis. You risk nothing but money (a fixed amount), and the upside potential is weeks off of your problem, if your doc is wrong.
posted by IAmBroom at 6:15 PM on December 1, 2012

Response by poster: It's not very dramatic, but here's the resolution: I got very, very busy and didn't do anything. And it went away by itself in about five days. Ta da.
posted by BlahLaLa at 4:55 PM on December 31, 2012 [2 favorites]

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