Hello, As per my clinical experience, as all conventional measures in form of nystatin gargles, gel and anti fungal medications are being taken care of nicely, there should be different issue with the condition. There can be atypical fungal infection, severely compromised immune system, which may be provoking such condition. My guidelines at present: - Drink more liquids - Mouth gargles with salted lukewarm water added peppermint oil - Tulsi and turmeric powder in skimmed milk raise the immunity - Multi vitamin and mineral tablets with anti oxidant - Control of blood sugar - If any of the corticosteroids are being used in current drug therapy, should be stopped immediately Discuss the need of culture report or biopsy of the scrapping of the oral lesion area for further management guidelines and curative steps. You should refrain from smoking if consuming. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon