Oral thrush is a condition in which the fungus Candida albicans accumulates on the lining of your mouth.
Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. The lesions can be painful and may bleed slightly when you scrape them. Sometimes oral thrush may spread to the roof of your mouth, your gums, your tonsils or the back of your throat.
Although it can affect anyone, it's more likely to occur in babies and in people who wear dentures, use inhaled corticosteroids or have compromised immune systems. This condition is a minor problem if you are healthy, but if you have a weakened immune system, symptoms of oral thrush may be more severe and difficult to control.
Initially, you may not even notice symptoms of oral thrush. Depending on the underlying cause, signs and symptoms may develop suddenly and persist for a long time. They include:
In severe cases, the lesions may spread downward into your esophagus — the long, muscular tube stretching from the back of your mouth to your stomach (Candida esophagitis). If this occurs, you may experience difficulty swallowing or feel as if food is getting stuck in your throat.
In addition to the distinctive white mouth lesions, infants may have trouble feeding or be fussy and irritable. They can pass the infection to their mothers during breast-feeding. The infection may then pass back and forth between mother's breasts and baby's mouth. Women whose breasts are infected with candida may experience the following signs and symptoms:
If you or your baby develops painful white lesions inside the mouth, see your doctor or dentist. If it develops in older children or adolescents, seek medical care as an underlying condition such as diabetes may be the cause.
Oral thrush and other Candida infections can occur when your immune system is weakened by disease or drugs such as prednisone, or when antibiotics disturb the natural balance of microorganisms in your body.
Normally your immune system works to repel harmful invading organisms, such as viruses, bacteria and fungi, while maintaining a balance between "good" and "bad" microbes that normally inhabit your body. But sometimes these protective mechanisms fail, which can allow the infection to take hold.
These illnesses may make you more susceptible to infection:
Anyone can develop oral thrush, but the infection is more common in some. Risk factors include:
Candida infections are seldom a problem for healthy children and adults, although the infection may return even after it has been treated. For people with compromised immune systems, such as from HIV or cancer, however, thrush can be more serious.
If you have a compromised immune system:
You are likely to start by seeing your family doctor, pediatrician or a general practitioner. However, if you have an underlying condition that is contributing to the problem, you may then be referred to a specialist for treatment.
Here is some information to help you get ready for your initial appointment, and to know what to expect from your doctor.
Preparing a list of questions can help you make the most of your appointment. For Candida infections specifically, some basic questions to ask your doctor include:
Do not hesitate to ask any other questions that occur to you.
Your doctor is likely to ask you a number of questions, such as:
If you or your child has thrush, you may need treatment with an antifungal medication. While you are waiting for your appointment, however, you can try eating unsweetened yogurt to reintroduce beneficial bacteria to your mouth and throat. Rinsing with salt water may provide some symptomatic relief. If you wear dentures, thoroughly clean your dentures daily.
Oral thrush can usually be diagnosed simply by looking at the lesions, but sometimes a small sample is examined under a microscope to confirm the diagnosis.
In older children or adolescents who have no previously identified risk factors, an underlying medical condition may be the cause. If your doctor suspects that to be the case, he or she will perform a physical exam as well as recommend certain blood tests to help find the source of the problem.
Thrush that extends into the esophagus can be serious. To help diagnose this condition, your doctor may ask you to have one or more of the following tests:
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.
If you are breast-feeding an infant who has oral thrush, you and your baby will do best if you are both treated. Otherwise, you are likely to pass the infection back and forth.
Adults or children who have oral thrush but are otherwise healthy can try one of these:
Yogurt and acidophilus do not destroy the fungus, but they can help restore the normal bacterial flora in your body. If your infection persists, your doctor will prescribe an antifungal medication.
Most often, your doctor will recommend the following:
Some antifungal medications may cause liver damage. For this reason, your doctor will likely perform blood tests to monitor your liver function, especially if you require prolonged treatment or have a history of liver disease.
These suggestions may help during an outbreak of oral thrush:
The following measures may help reduce your risk of developing candida infections:
This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.
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