Oral thrush is also known as oral candidiasis. It is a condition in which the fungus Candida albicans accumulates on the lining of your mouth. It is normal to have candida in your mouth, but sometimes it can overgrow and cause symptoms.
Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. Sometimes oral thrush may spread to the roof of your mouth, your gums or tonsils, or the back of your throat.
It is more likely to occur in babies and older adults because they have reduced immunity, however it can affect anyone, especially people with suppressed immune systems. In healthy individuals oral thrush is a minor problem but symptoms may be more severe and more difficult to control if you have a weakened immune system.
Symptoms
The following signs and symptoms may include:
- Creamy white lesions on your tongue, inner cheeks, and sometimes on the roof of your mouth, gums and tonsils
- Slightly raised lesions with a cottage cheese-like appearance
- Redness, burning or soreness that may be severe enough to cause difficulty eating or swallowing
- Slight bleeding if the lesions are rubbed or scraped
- Cracking and redness at the corners of your mouth
- A cottony feeling in your mouth
- Loss of taste
- Redness, irritation and pain under dentures (denture stomatitis)
- In addition to the distinctive white mouth lesions, infants may have trouble feeding or be fussy and irritable.
In severe cases, usually related to cancer or a weakened immune system from HIV/AIDS, the lesions may spread downward into your throat (oesophagus). If this occurs, you may experience pain and difficulty swallowing. It could feel as if food is getting stuck in your throat.
When to see a doctor
Thrush is uncommon in healthy older children, teenagers and adults but if you or your child develops white lesions inside the mouth, speak to a healthcare professional.
Causes
Harmful invading organisms, such as viruses, bacteria and fungi, are usually effectively controlled by your immune systems, but if the protective mechanisms fail, then a fungus such as candida will increase, causing oral thrush.
Therefore, a weakened immune system, can increase your risk of oral thrush.
Risk factors
You may have an increased risk of oral thrush infection if any of these issues apply:
- Weakened immunity. Oral thrush is more likely to occur in infants and older adults due to reduced immunity. Some medical conditions and treatments can suppress your immune system, such as cancer and its treatments, organ transplants and required drugs that suppress the immune system, and HIV/AIDS.
- Diabetes. If you have untreated diabetes or the disease isn’t well-controlled, your saliva may contain large amounts of sugar, which encourages the growth of candida.
- Vaginal yeast infections. Vaginal yeast infections are caused by the same fungus that causes oral thrush.
- Medications. Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the natural balance of microorganisms in your body can increase your risk of oral thrush.
- Other oral conditions. Wearing dentures, especially upper dentures, or having conditions that cause dry mouth can increase the risk of oral thrush.
Complications
Oral thrush is seldom a problem for healthy children and adults.
For people with lowered immunity, such as from cancer treatment or HIV/AIDS, thrush can be more serious. Untreated oral thrush can lead to more-serious systemic candida infections. If you have a weakened immune system, thrush may spread to your oesophagus or other parts of your body.
Prevention
These measures may help reduce your risk of developing candida infections:
- Rinse your mouth. If you need to use a corticosteroid inhaler, be sure to rinse your mouth with water or brush your teeth after taking your medication.
- Brush your teeth at least twice a day and floss daily or as often as your dentist recommends.
- Check your dentures. Remove your dentures at night. Make sure dentures fit properly and don’t cause irritation. Clean your dentures daily. Ask your dentist for the best way to clean your type of dentures.
- See your dentist regularly, especially if you have diabetes or wear dentures. Ask your dentist how often you need to be seen.
- Watch what you eat. Consider reducing your intake of sugary foods, as they can promote the growth of candida.
- Maintain good blood sugar control if you have diabetes. Well-controlled blood sugar can reduce the amount of sugar in your saliva, discouraging the growth of candida.
- Treat a vaginal yeast infection as soon as possible.
- Treat dry mouth. Ask your doctor about ways to avoid or treat your dry mouth.
Treatment
The goal of any oral thrush treatment is to stop the rapid spread of the fungus, but the best approach may depend on your age, your overall health and the cause of the infection. Eliminating underlying causes, when possible, can prevent recurrence.
- Healthy adults and children. Your doctor may recommend antifungal medication. These medications come in several forms, including lozenges, tablets, or a liquid that you swish in your mouth and then swallow. Speak to your doctor or pharmacist. If these topical medications are not effective, medication may be given that works throughout your body.
- Infants and nursing mothers. If you’re breastfeeding and your infant has oral thrush, you and your baby could pass the infection back and forth. Your doctor may prescribe a mild antifungal medication for your baby and an antifungal cream for your breasts.
- Adults with weakened immune systems. Most often your doctor will recommend antifungal medication.
Thrush may return even after it’s been treated if the underlying cause, such as poorly disinfected dentures or inhaled steroid use, isn’t addressed.
Lifestyle and home remedies
These suggestions may help during an outbreak of oral thrush:
- Practice good oral hygiene. Brush and floss regularly. Replace your toothbrush often until your infection clears up. Don’t share toothbrushes.
- Disinfect dentures. Ask your dentist for the best way to disinfect your dentures to avoid reinfection.
- Try warm saltwater rinses. Dissolve about 1/2 teaspoon (2,5 mL) of salt in 1 cup (237 mL) of warm water. Swish the rinse and then spit it out, but don’t swallow.
- Use nursing pads. If you’re breast-feeding and develop a fungal infection, use pads to help prevent the fungus from spreading to your clothes. Look for pads that don’t have a plastic barrier, which can encourage the growth of candida. Wear a clean bra every day. Ask your doctor about the best way to clean your breast nipples, bottle nipples, pacifiers and any detachable parts of a breast pump if you use one.
Reference:
https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533 – Accessed 16 January 2025
