What to Do and When to See a Doctor

Written by WebMD Editorial Contributors

Medically Reviewed by Robert Brennan on April 02, 2023

• Remedies and Treatments for Oral Thrush
• When to See Your Doctor

Oral thrush is a fungal infection in your mouth, throat, or esophagus. It occurs when Candida a fungus, that’s found in your mouth and digestive tract, multiplies. White patches similar to a rash appear in the mouth, on the tongue and cheeks, and in the throat. 

Anyone can develop thrush. Candida, or yeast, is responsible for diaper rash as well as vaginal yeast infections in women. Oral thrush is most common in babies, toddlers, older adults, and people with weakened immune systems. 

Oral Thrush Symptoms in Adults 

Oral Thrush has different symptoms depending on your age and the type of infection, including: 

• White, rash-like patches on the tongue, cheeks, upper mouth, tonsils, and throat
• A dry sensation, or cotton-like feeling in your mouth
• Loss of taste
• Raised red spots similar to cottage cheese 
• Redness and cracking around your mouth

If the yeast overgrowth has traveled to your esophagus, you may experience throat pain and have trouble swallowing. People who smoke or wear dentures are also more prone to developing oral thrush. 

Oral Thrush Symptoms in Infants And Mothers

If your child has oral thrush, you’ll see the same thick, white patches on the tongue as well as in the mouth and throat. Other symptoms of this condition in babies include: 

• A sore mouth
• Decreased sucking when breastfeeding or bottle-feeding, which results in consuming less milk
• White coating on the tongue
• Sensitive, cracked, or sore nipples if you’re breastfeeding

Oral thrush clears up within a few weeks with the proper antifungal treatment. The condition may be harder to treat if you have a weakened immune system from HIV infection, cancer, or diabetes.

Immediate Treatment

Treatment is designed to stop the fungus from spreading, but it’s also important to determine the infection’s underlying causes. This can prevent future infections and keep yeast under control.  

Take care of your teeth by brushing and flossing at least twice a day. Don’t share your toothbrush with anyone and replace it often until the infection clears. If you wear dentures, disinfect them as fungus-covered dentures can lead to reinfection. Talk to your dentist to determine the best way to clean your appliances. 

If oral thrush is developed while breastfeeding, place pads on your breasts to prevent the infection from spreading to your clothing. Avoid pads with plastic barriers, which can cause yeast to grow. Wear a clean bra every day and talk to your doctor to determine how to clean bottles, pacifiers, and breast pumps if you use one.

If you have a mild case of oral thrush after a course of antibiotics, consider eating yogurt or taking an over-the-counter (OTC) acidophilus pill. Probiotics help repopulate the “good” bacteria in your body. 

Long-Term Treatment

Severe cases of thrush are usually treated with antifungal medications. They’re available as tablets, lozenges, or liquids that you swish around in your mouth before swallowing. Common medications include: 

• Antifungal mouthwash (nystatin)
• Lozenges (clotrimazole) 
• Antifungal medicines like fluconazole (Diflucan) or itraconazole (Sporanox). These are taken in tablet or liquid form. 

The course of treatment depends on your age and the cause of the fungal infection. A course of medication lasts from 10 to 14 days. 

If your immune system is uncompromised, oral thrush should resolve within two weeks. If you are immunocompromised or have an underlying medical condition, call your doctor. Here are some symptoms that may be warning signs:

• Thrush-like sores that don’t go away
• Difficulty or pain when swallowing
• Thrush symptoms with an underlying medical condition, like HIV

If you suspect your child has oral thrush, seek medical care if they:

• Are dehydrated
• Haven’t urinated in more than eight hours
• Have dark urine and a dry mouth
• Bleeding sores in the mouth
• Look or act very sick.

A Candida infection may be an indication of other diseases or medical problems. Talk to your doctor to set up any additional treatment plans.

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Symptoms, Causes, Treatments, and Prevention

Thrush is a yeast (fungus) infection that commonly occurs in the mouths of babies and toddlers. It’s rarely serious but can pass between babies and nursing parents.

It’s typical for a small amount of fungus to live in your mouth. But in some cases, the fungus may rapidly multiply and lead to a yeast infection.

Oral thrush happens when this type of yeast infection develops inside your mouth. It’s also known as oral candidiasis, oropharyngeal candidiasis, or simply thrush.

Oral thrush is more common in babies and older adults, who tend to have weaker immune systems. But it can occur at any age.

Read on to learn about oral thrush, what it can look like, who it affects, what causes it, and how it’s treated.

In its early stages, oral thrush may not cause any symptoms. But as the infection gets worse, one or more of the following symptoms may develop:

• white or yellow spots on your inner cheeks, tongue, tonsils, gums, or lips
• slight bleeding if the spots are scraped
• soreness or burning in your mouth
• a cotton-like sensation in your mouth
• dry, cracked skin at the corners of your mouth
• difficulty swallowing
• a bad taste in your mouth
• a loss of taste
• redness, irritation, and pain under dentures (denture stomatitis)

In some cases, oral thrush can affect your esophagus, though this is uncommon. The same fungus that causes oral thrush can also cause yeast infections in other parts of your body.

Learn more about the symptoms of oral thrush.

What are the symptoms of oral thrush in babies?

Oral thrush most often affects infants and toddlers. About 65% of infants have Candida albicans (C. albicans). fungus in their mouths. About 5-7% of babies under one month old will develop the infection.

Babies can contract the fungus from their birthing parent during pregnancy, delivery, or nursing or just from yeast that is naturally present in their environment.

If your baby has oral thrush, it may develop the same signs and symptoms that can affect adults with the condition. It may also cause difficulty feeding and irritability or fussiness.

Read more about thrush in babies, as well as thrush and breastfeeding or chestfeeding.

Oral thrush and other yeast infections are caused by an overgrowth of C. albicans. It exists naturally in the microbiomes of 50% of the population.

It’s typical for a small amount of C. albicans to live in your mouth without causing harm. When your immune system is working properly, beneficial bacteria in your body help keep C. albicans under control.

But if your immune system is compromised or the balance of microorganisms in your body is disrupted, the fungus can grow out of control.

Oral thrush is the most common opportunistic infection in people living with HIV. It can also develop with other conditions or medications that weaken your immune system, such as:

• cancer treatments, including chemotherapy and radiation therapy
• cancer like leukemia
• uncontrolled diabetes

Other risk factors include:

• being a baby or older adult
• having a condition that causes dry mouth
• taking corticosteroids, or immunosuppressant drugs
• smoking
• wearing dentures
• taking antibiotics

If your immune system is weakened, you’re more likely to develop complications from thrush.

Without proper treatment, the fungus that causes thrush may enter your bloodstream and spread to your heart, brain, eyes, or other body parts. This is known as invasive or systemic candidiasis.

Systemic candidiasis can cause problems in the organs it affects. It can also cause a potentially life threatening condition known as septic shock.

To treat oral thrush, your doctor may prescribe medications. These include:

• fluconazole (Diflucan)
• generic nystatin
• itraconazole (Sporanox)
• amphotericin B (AmBisome, Fungizone)

Learn more about antifungal medications.

Once you begin treatment, oral thrush usually goes away within a couple of weeks. But in some cases, it can return.

For adults who have recurring cases of oral thrush with no known cause, their healthcare professional will evaluate them for underlying medical conditions that might be contributing to thrush.

Infants may have several episodes of oral thrush in their first year of life.

In addition, your doctor may also recommend some home remedies for oral thrush.

Treatment for babies and nursing parents

If your baby develops oral thrush or you develop a breast or nipple yeast infection, your healthcare professional may advise you to do the following:

• Treat your baby with antifungal medications and apply an antifungal cream to your breasts. Make sure to wipe the cream off your breasts before nursing.
• Sterilize your baby’s pacifiers, teething rings, bottle nipples, breast pump pieces, and any other items they put in their mouth.
• Keep your nipples clean and dry between feedings. If you use nursing pads, avoid those that have a plastic liner, which may trap moisture and create favorable conditions for fungus to grow.

Your doctor may be able to diagnose oral thrush simply by taking a history of your symptoms and examining your mouth for the characteristic lesions that it causes.

They may do a biopsy of the affected area to confirm the diagnosis. They may also do a throat swab culture or endoscopy to see if you have a fungal infection in your throat or esophagus.

If you need help finding a primary care doctor, then check out our FindCare tool.

To reduce your risk of oral thrush, try the following:

• Avoid sharing cups and utensils with others.
• Eat a nutritious diet and practice an overall healthy lifestyle to support the functioning of your immune system.
• Practice good oral hygiene by brushing your teeth twice a day, flossing every day, and visiting your dentist on a regular basis.
• If your mouth is chronically dry, make an appointment with your doctor and follow their recommended treatment plan.
• If you have dentures, remove them before you go to bed, clean them daily, and ensure they fit properly.
• If you have a corticosteroid inhaler, rinse out your mouth or brush your teeth after using it.
• If you have diabetes, take steps to manage your blood sugar levels.

If you develop a yeast infection in another part of your body other than your mouth, get treatment. In some cases, an infection can spread from one part of your body to another.

Get more tips for managing the risk of yeast infection while breastfeeding or chestfeeding.

Is oral thrush contagious?

Transmission of oral thrush can occur via:

• kissing
• contact with yeast infections in other body parts
• vaginal sex, anal sex, or oral sex
• breastfeeding or chestfeeding when you have a breast yeast infection or nipple yeast infection
• breastfeeding or chestfeeding when your baby has oral thrush

Though C. albicans can pass from one person to another, it doesn’t always cause infection. Also, developing an infection may not mean that you contracted it from someone else, as C. albicans is so common in our environment.

Learn more about how you get thrush.

What should I eat with oral thrush?

Some studies suggest that eating certain probiotic foods or taking probiotic supplements might help limit the growth of C. albicans. However, more research is needed in this area.

Some people believe that limiting or avoiding certain foods may also help curb the growth of C. albicans. The “candida diet” has been developed based on these beliefs. However, this diet lacks scientific support.

It’s a good idea to speak with your doctor or your child’s pediatrician before beginning any supplement of making any dietary changes.

Oral thrush is a yeast infection in the mouth. It most often affects babies but can also occur in adults. Fungi normally live in our mouths, but rapid multiplication can cause an infection.

This is more likely to occur in those with weaker immune systems, but anyone can develop it. If you or your baby develop oral thrush, there are home remedies and medical treatments that can help. It’s usually not a serious infection, but in rare cases can lead to a life threatening blood infection.

Thrush in the mouth in adults: symptoms, treatment – ROOTT

Causes Types Danger Treatment Remedial measures Drugs against thrush

Oral candidiasis (thrush) is an infectious disease of the mucous membranes. It is caused by a fungus of the genus Candida.

Mucous membranes are covered with whitish plaques resembling curd mass. Patients have unpleasant sensations in the mouth, a burning sensation. Eating, sometimes even speaking, becomes painful. Patients complain of dry mouth and bad breath.

Thrush is very common in infants but is easily tolerated and heals quickly. It often occurs in people with dentures, those taking corticosteroids, or undergoing chemotherapy.

Causes of the disease

Yeast fungi are present in the body of any person. Under the influence of certain factors, they begin to multiply uncontrollably.

Thrush in the mouth is caused by:

• Hormonal changes, e.g. during pregnancy
• Taking certain medications
• Weakening of immunity due to illness
• Inadequate oral hygiene
• Mucosal injuries
• High carbohydrate diet
• Taking contraceptives
• Smoking
• Candidiasis is contagious, it can be transmitted through shared utensils, kissing.

Classification

Symptoms of thrush manifest themselves in different ways, depending on the form of the disease. In dentistry, the following forms of candidiasis are distinguished:

1. Acute pseudomembranous
   – Mild form: the only symptom is the presence of plaque. If you scrape it off, a swollen, reddened mucous membrane is visible.
   – Moderate: plaque is difficult to remove, there are unpleasant sensations while eating. The submandibular lymph nodes are enlarged.
   – Severe form: extensive, off-white plaque. Signs of tissue infiltration. Plaques are removed with difficulty, bleeding mucous membrane is visible under them.
2. Acute atrophic
   Mucosa red, painful to touch, smooth. The plaque is dense, covers the cheeks from the inside, tongue, palate. The mouth is dry. There are teeth marks on the tongue. There may be a bitter, sour, metallic taste in the mouth. The acute course can become chronic, usually in patients with removable dentures. Therefore, its second name is prosthetic stomatitis. Under the prosthesis, the mucous membrane is dry, red. There is almost no plaque, but the pain syndrome is pronounced. On the back of the tongue papillae atrophy. This leads to a change in taste sensations.
   Sometimes atrophic candidiasis is called erythematous (“erythema” – redness).
3. Chronic hyperplastic
   It occurs only in adults, mainly in smokers. The coating is dirty gray, located in the corners of the lips, on the tongue. It scrapes off badly, has an unpleasant smell. The plaques merge, covering the mucosa almost completely. Saliva changes: it becomes viscous and foams. The most common such thrush in men.

Why is thrush dangerous? But candida is a yeast-like fungus, and, therefore, is capable of rapid reproduction, like any yeast. From the mucous membranes of the mouth, thrush can spread to the throat. This causes changes in the voice, makes it hoarse. Spreading to the esophagus, it provokes inflammation of the esophageal mucosa (esophagitis), making it painful for food to pass through it.

Untreated hyperplastic candidiasis develops into malignant neoplasms.

Most importantly, the reproduction of the fungus indicates a malfunction in the body’s defenses.

Only a doctor is able to prescribe the necessary examination and, based on its results, prescribe the appropriate treatment for a fungal infection.

How to treat thrush

Successful treatment requires an accurate diagnosis. For this, a number of laboratory tests are prescribed. Bacteriological culture is mandatory. He will not only confirm the thrush, but also determine which type of fungus caused it. This is important when prescribing drugs. After a clinical examination, the dentist may recommend blood glucose or HIV testing.

Recommended consultations with narrow specialists:

• Endocrinologist
  To make sure there are no endocrine disorders.
• Allergist
  To detect sensitivity to dentures.
• Therapist
  To clarify the nature of somatic diseases.

Treatment of thrush in adults and children should be comprehensive and include activities aimed at strengthening general immunity, teaching adequate oral hygiene, and changing the diet.

Algorithm of therapeutic measures

• For the best result, the intervention begins with the sanitation of the oral cavity. Carious teeth are treated by replacing the affected tissues with filling material. Remove hard plaque and tartar from enamel. Plaque is a hotbed of infection, it is necessary to get rid of it.
• Eliminate the factors provoking candidiasis. Replace dentures if they cause an allergic reaction or do not fit well. Stop the exacerbation of common diseases. Take steps to improve your hormone levels. Conduct activities that increase immunity.
• Administer antifungals based on culture results. Prescribed antihistamines, restorative agents, immunomodulators.
• Give recommendations on the normalization of the microflora in the oral cavity.

To prevent relapses, it is useful to establish regular hygiene, to exclude foods rich in fast carbohydrates and sugars from the diet. Restorative activities include physical activity and stress-reducing activities (hobbies). It is important not to take medicines uncontrollably, according to recommendations from the Internet or from friends.

Thrush medicines

• Candidiasis medicines come in various forms:
• Suspensions (Diflucan, Amphotericin B)
• Tablets (Nystatin, Flucanosole, Itriconazole)
• Gels (Mikanozol)

A good effect in candidiasis is brought by rinsing with antiseptic agents: Chlorhexidine, Miramistin. This is especially important if the patient wears removable dentures or, for various reasons, cannot maintain adequate hygiene.

Patients should be advised to regularly disinfect their prostheses.

Physician’s opinion: Most drugs for the treatment of thrush are prescription drugs. Their independent use can cause serious complications. Therefore, do not self-medicate, contact your dentist. The doctor will prescribe treatment only after determining the sensitivity of the fungus to certain drugs. This will increase the effectiveness of the intervention and prevent relapses.

Thrush (candidiasis) in the mouth – treatment, types and causes of the disease

Contents

Oral candidiasis is an inflammatory disease. It can develop due to damage to the mucosa. Thrush in the mouth in adults and children is formed due to the defeat of the Candida fungus. Doctors often associate this disease with a decrease in immunity. According to recent studies, about 90% of the population are carriers of this fungus. Most often, the presence of this fungus does not manifest itself.

Causes of candidiasis

Oral candidiasis can be a sign that there are big problems in the body. In order for the fungus to actively multiply, special conditions are required. As a rule, those who ignore oral hygiene face candidiasis in the mouth. Increase the risk of caries, gum disease. All this in combination has a detrimental effect on the protective barrier of our body.

Another list of causes is the presence of the following diseases:

• human immunodeficiency virus;
• diabetes mellitus;
• presence of malignancy;
• vitamin deficiency;
• dystrophy;
• severe infectious diseases;
• recent surgery.

There are also specific reasons for the development of candidiasis. For example, thrush can form after long-term antibiotic treatment. The use of such strong medicines adversely affects not only the harmful microflora, but is also capable of killing the beneficial one. This causes an imbalance and promotes the reproduction of the fungus.

Also, the disease can develop after inhalation with corticosteroids. In this case, ulcers will appear in those places where there was contact with medicines. Affects the reproduction of the fungus and the diet. Consumption of large amounts of carbohydrates causes Candida activity.

Increase the risk of thrush and bad habits. In particular, smoking. Acute pseudomembranous candidiasis is common in people with tongue piercings.

Among the risks is the presence of bridges. However, there is a risk only if the patient does not comply with hygiene standards. Therefore, it is important to carefully disinfect as a preventive measure against candidiasis. In addition, do not forget to remove the prosthesis at night. Otherwise, the disease will progress very actively. Also, during sleep, the prosthesis can provoke microdamages, which affects not only the mucosa, but also the state of the enamel.

Quite often, candidiasis can be caused by drying out of the mucosa. Often this factor is accompanied by other diseases. Therefore, it is important to consider all the symptoms.

Oral candidiasis is much more common in children than in adults. Doctors explain this by the fact that the child has not yet fully formed immunity. Therefore, bacteria enter the baby’s body during childbirth.

Types of oral candidiasis and symptoms

Depending on the individual case, symptoms may vary. This is also affected by the level of damage to the mucous membranes. There are several forms of the disease:

• acute pseudomembranous;
• acute atrophic;
• atrophic in the chronic stage;
• hyperplastic in the chronic stage.

Despite the different symptoms, the treatment for all forms is almost identical.

Acute pseudomembranous candidiasis

This form often has no symptoms. The patient only feels a slight discomfort associated with the appearance of a light film on the mucosa. If the disease proceeds easily, the film lags behind the mucosa without effort. In this case, the part under the film is painted in a bright pink hue. If the disease is severe, the plaques will be larger. Most often, the severe course of the disease occurs in infants. Less common in adults after taking antibiotics or corticosteroids.

Acute and chronic atrophic candidiasis

A vivid symptom of the acute form is too active burning. In this case, a light plaque may not even form. Most patients report a metallic taste in their mouth. There may also be a salty or bitter taste. Many patients with this form of candidiasis call dryness of the oral mucosa a separate symptom. Most often, this form provokes the intake of appropriate medications.

Chronic atrophic candidiasis is characterized by less pronounced redness and itching. The most common cause of the development of the disease is the installation of prostheses.

Chronic hyperplastic candidiasis

Chronic hyperplastic candidiasis mainly occurs in adult patients. The spread of the fungus can even go to the corners of the mouth, affects the lips, soft palate. The resulting ulcers and plaques begin to merge together. With the course of the disease, they become covered with a rough crust, acquire a yellow tint.

Methods of diagnosis

Oral thrush in adults can be treated by a dentist. Initially, it is necessary to conduct an examination, collect an anamnesis. The specialist will note what medications you took, whether there are diseases in a chronic form. Be sure to take an analysis of the plaque for research. Often, non-fungal elements can be confused with fungal ones.

It is important to properly prepare for sampling. Scraping is taken in the morning on an empty stomach. Do not brush your teeth or rinse your mouth with mouthwash before the procedure. The day before the test, it is worth reducing food with a large amount of carbohydrates. This will reduce the risk of developing pathogenic flora. Thanks to a qualitative study, you can not only establish whether the disease is really caused by the Candida fungus, but also find out how sensitive the flora is to certain medications. Depending on the results of this analysis, the specialist prescribes the appropriate therapy.

Features of treatment

The attending physicians prescribe local antifungal medicines as the basis for therapy. Today, there are many of them in the pharmaceutical segment, but the indicator of drug resistance of fungi also changes every year. Today, for example, Candida has almost complete resistance to Fluconazole, although earlier this drug was used most actively.

Depending on the clinical picture, it is important to select the treatment on an individual basis. The scheme can be influenced by the type of pathogen, personal characteristics, previously collected anamnesis.

It is mandatory to include topical medications in the treatment regimen as adjuvants. These include:

• mouth rinses;
• drug in the form of gels, suspensions;
• lozenges, special lozenges;
• irrigation solutions or sprays;
• ointments for topical application and tamponade.

The attending physician may prescribe specialized antiseptics, prescribe the use of saline solutions for irrigating the mouth. As a rule, among antiseptics, formulations with iodine, chlorhexidine, gentian violet are most often used. In some cases, the use of lozenges or lozenges works effectively.

Conditions for effective treatment

In order to effectively cure thrush, it is necessary to understand the cause of its occurrence. If the cause of the disease is poor oral hygiene, it is worth treating the gums, teeth, and eliminating caries. All these nuances can be considered as potential foci of inflammation. Therefore, having treated the entire dentition together with thrush, you can reduce the duration of treatment. It is also recommended to undergo a cleaning procedure from tartar – often it injures the mucous membrane with its sharp corners.

Given that removable dentures may be the cause, it is important to repeat the consultation with the patient, reminding him of hygiene procedures. If the period of use of the prosthesis comes to an end, it is worth replacing it. Otherwise, it will become a breeding ground for Candida.

Any crowns that have deteriorated must also be replaced. Repair any chips on the enamel surface. They can injure the gums and cause the spread of bacteria.

During treatment, smokers are advised to refrain from addiction. In the event that the disease was caused by taking corticosteroids, it is necessary to reconsider the treatment regimen. After using aerosols with the drug, it is important to rinse your mouth thoroughly with plenty of water.

When undergoing treatment, if the cause of the disease is taking antibiotics, it is necessary to add medicines to the therapy regimen to restore the balance of microflora. In this regard, the patient may need additional advice from a highly specialized specialist. The intake of probiotics and prebiotics is selected on an individual basis.

For all people undergoing therapy for thrush in the mouth, there is a list of recommendations:

• strictly follow all the rules of oral hygiene;
• limit intake of carbohydrate foods;
• give up sweets.

All food that is capable of irritating the mucous should be excluded from the patient’s diet. These are dishes that contain vinegar, a lot of spices and spices, smoked foods, fruits with high acidity. In addition, it is forbidden to consume yeast baked goods, sugar. The temperature of the food should be warm. Even after completing the course of therapy, it is necessary to follow such restrictions for about 2 months.

In some cases, your healthcare professional may recommend additional use of toothpastes with glucose oxidase or other ingredients. They form a protective mucosal barrier in the mouth. Also, such pastes are often included in preventive treatment. The paste is selected individually depending on the results of the analysis. In the same way, a toothbrush is selected.

Candidiasis prophylaxis

There is a specific Candida prophylaxis that is given to HIV-positive patients. The same prophylaxis is required when the patient is undergoing radiation therapy or a course of antibiotics. In the event that there are no such risk factors, the treating specialist will provide separate recommendations.

When carrying out prophylaxis for diabetics, patients with chronic lung diseases, it is important to control the course of the underlying disease. It is necessary to visit the attending physician in a timely manner and take a course of prescribed medications.

If it is impossible to do without antibiotics during the treatment of another disease, the main recommendations should be taken into account:

• antibiotic therapy should be prescribed exclusively by a doctor;
• the duration of the course is calculated by the attending specialist, you can not violate the regimen;
• If it is necessary to prescribe a longer course or repeat antibiotics, the patient should additionally be given appropriate antifungal therapy as a preventive measure.

If the patient also needs to treat bronchial asthma in the chronic stage, it is necessary to discuss with the attending physician the possibility of using a nebulizer.