THRUSH

Thrush is a common infection that causes white patches on your tongue and inner cheeks. It’s caused by an overgrowth of a fungus called Candida albicans, which naturally lives in your mouth in small amounts. While anyone can get thrush, babies, older adults, and people with weakened immune systems are more at risk.

Who Gets Thrush?

Anyone can develop this infection, but it’s more frequent in:

Babies and toddlers
Older adults
People with weakened immune systems due to illness, HIV/AIDS, or medications

What Causes Thrush?

Several factors can trigger this infection, including:

Antibiotics: These medications kill bacteria, including the good ones that keep Candida in check.
Medical conditions: Diabetes, cancer, and uncontrolled HIV/AIDS can weaken your immune system, making you more susceptible to thrush.
Steroids: Medications like corticosteroids can also disrupt the balance of bacteria in your mouth.
Dentures: Poorly fitted dentures can trap moisture and create a breeding ground for Candida.
Dry mouth: Saliva helps keep your mouth clean and prevent fungal growth. Dry mouth caused by medications or medical conditions can increase thrush risk.

Recognizing Thrush Symptoms

White or red patches inside the mouth, on the tongue, or at the back of the throat
Raised spots resembling cottage cheese
Cracking and redness at the corners of the mouth (angular cheilitis)
A cottony sensation in the mouth
Loss of taste

In some cases, this infection may also lead to:

Redness, irritation, and pain beneath dentures (denture stomatitis)
A large red, painless mark at the center of the tongue (median rhomboid glossitis)
Gum irritation or inflammation (linear gingival erythema)

Severe cases of this infection can extend to the esophagus, causing symptoms such as:

Pain or difficulty swallowing
The sensation of food being stuck in the throat or chest
Fever if the infection spreads beyond the esophagus

The candida fungus responsible for thrush can potentially spread to other parts of the body, including the lungs, liver, and skin, particularly in individuals with weakened immune systems due to conditions like cancer or HIV.

What thrush looks like

The appearance of oral thrush varies depending on its type.

The white type (pseudomembranous) is the most common, characterized by a white tongue with creamy lesions that can be wiped off, possibly leading to bleeding.
Red type (erythematous) typically manifests as a red and raw outline around dentures.
Hyperplastic (plaque-like candidiasis) presents as solid white plaques on the tongue and mouth that cannot be wiped off, primarily affecting those with HIV.

Oral thrush sores may cause discomfort, especially if scraped, leading to bleeding. While some individuals may not experience pain from the raised spots, they might still have overall mouth soreness.

Is Thrush Contagious?

While the Candida fungus itself can be passed through saliva, the infection is not easily spread from person to person. However, newborns can contract thrush from their mothers during breastfeeding if the mother has a vaginal yeast infection.

Risk factors

Various factors can disturb the natural balance of bacteria in your mouth, increasing the risk of developing this infection. These include:

Uncontrolled diabetes
Cancer
Smoking
Dentures
Organ transplant
Chemotherapy or radiation
Age, with older individuals and infants being more susceptible to thrush.

Diagnosing Oral Thrush

Your doctor can diagnose thrush by examining your mouth for white spots and creamy lesions. They may also take a scrape of a lesion to confirm the diagnosis through lab testing. If there’s concern that the candida fungus has spread to your esophagus, additional tests such as throat culture, endoscopy, or X-rays may be conducted.

Treatments

Oral thrush is typically easily treatable in healthy individuals with antifungal medications. Treatment duration usually lasts 7-14 days. However, symptoms may be more challenging to manage in those with weakened immune systems.

Common medications for thrush include clotrimazole (Mycelex Troche), miconazole (Oravig), and nystatin (Bio-Statin). In severe cases, fluconazole (Diflucan) may be prescribed orally or intravenously.

Duration of Thrush

With proper medication, thrush often responds well and should clear up within a few weeks in healthy individuals. However, recovery may take longer for those with compromised health.

Home Remedies for Thrush

Maintaining good oral hygiene, including regular brushing and flossing, can help alleviate thrush symptoms over several weeks. Other home remedies to consider include:

Rinsing the mouth with a saltwater solution (1/2 teaspoon of salt dissolved in a cup of warm water).
Gargling with a baking soda solution (1/2 teaspoon of baking soda dissolved in a cup of warm water).
Consuming foods and beverages rich in probiotics, such as yogurt, kombucha, or kefir, to restore yeast balance in the mouth.
Rinsing with a mixture of apple cider vinegar (1 teaspoon) and water (1 cup), then spitting it out.
Following proper denture care as recommended by your dentist.

Home Remedies for Thrush in Babies

If your baby has oral thrush, it may clear up on its own, but consult with your pediatrician before attempting any home remedies. To prevent oral thrush in newborns, consider these measures:

Wash your hands before and after touching their mouth.
Sterilize bottle nipples and pacifiers by boiling them for 10 minutes after each use.
Avoid allowing others to put your child’s pacifiers in their mouth.
If breastfeeding, clean your breasts with water before each feeding and allow them to air-dry.
Limit feeding sessions to 20 minutes to prevent mouth irritation.
If pumping breast milk, sterilize all pump parts after each use.
Ensure your child stays hydrated by providing plenty of fluids.

Complications of Thrush

In most cases, complications from thrush are unlikely in healthy individuals. However, in rare instances, the candida fungus can enter the bloodstream and spread to other parts of the body, including the brain and heart. This can lead to septic shock, a severe and life-threatening condition characterized by a dangerous drop in blood pressure following an infection.

Prevention

To reduce the risk of developing oral thrush, consider the following preventive measures:

Maintain good oral hygiene by brushing your teeth at least twice a day and flossing daily.
Schedule regular dental checkups, especially if you have diabetes or wear dentures.
Manage chronic health conditions effectively and adhere to prescribed medications.
Avoid excessive use of mouthwashes or sprays, as they can disrupt the natural balance of bacteria in your mouth.
Clean inhalers after each use to eliminate germs, and rinse your mouth afterward.
Limit consumption of sugary and yeast-containing foods.
Refrain from smoking, vaping, or using tobacco products.
Ensure proper fit and cleanliness of dentures, removing them at night and cleaning them daily.

Key Points to note

The candida fungus actively causes a fungal infection in your mouth, known as oral thrush. While toddlers and children are most commonly affected, it can occur in individuals of any age. The condition arises when the normal balance of bacteria in the mouth is disrupted, often due to illness or medication. Symptoms include creamy white lesions on the tongue and mouth, typically treated with antifungal medications.

When to See a Doctor

If you suspect you have thrush, consult your doctor for proper diagnosis and treatment. Early intervention is essential, especially for people with weakened immune systems.

By understanding the causes and symptoms of thrush, you can take steps to prevent it and keep your mouth healthy.

Sources:

CDC: “Candida infections of the mouth, throat, and esophagus.”
Mayo Clinic: “Oral Thrush.”
Oral Cancer Foundation: “Candida Infection.”
Dentaly.org: “What is Oral Thrush? Candida Home Remedies, Causes and Prevention.”
Nutrients: “Effect of Probiotics on Oral Candidiasis: A Systematic Review and Meta-Analysis.”
Cleveland Clinic: “Thrush,” “Thrush – the White Stuff Growing in Your Mouth (and How to Get Rid of it).”
WebMD: Thrush