What Is Oral Thrush?

If you notice a strange white rash inside your mouth, you may have a condition called thrush. It’s also called oral candidiasis. It’s an infection caused by the candida fungus, which is yeast. You can get it in your mouth and other parts of the body. It can cause diaper rash in infants or vaginal yeast infections in women.

Anyone can get thrush, but it happens most often to babies and toddlers, older adults, and people with weakened immune systems.

 

What Causes Thrush?

Small amounts of the candida fungus are in your mouth, digestive tract, and skin. It’s supposed to be there, and it’s usually kept under control by the other bacteria in your body. But sometimes, certain illnesses or medications -- like corticosteroids or antibiotics -- can disturb the balance. This can cause the fungus to grow out of control. That’s when you get thrush.

Stress can cause it. So can a number of medical conditions, like:

If you smoke or wear dentures that don’t fit right might, you’re also more likely to get thrush. And babies can pass the infection to their mothers while breastfeeding.

 

Oral Thrush Symptoms

If you have thrush, you may notice these signs in your mouth:

  • White, slightly raised areas, often on the tongue, inner cheeks, roof of mouth, gums, tonsils, or back of throat

  • Raised spots that look like cottage cheese

  • Cracking and redness at the corners of your mouth (angular cheilitis)

  • A cottony feeling

  • Loss of taste

Sometimes thrush may also cause:

  • Redness, irritation, and pain under dentures (denture stomatitis)

  • A large red, painless mark in the center of the tongue (median rhomboid glossitis)

  • A band of gum irritation or inflammation (linear gingival erythema)

 In very bad cases, thrush can spread into your esophagus and cause:

  • Pain when you swallow or difficulty swallowing

  • A feeling that food is stuck in your throat or in the middle of your chest

  • Fever, if the infection spreads beyond the esophagus

When breastfeeding infants have thrush, they can pass it to their mother’s breast and cause:

  • Red, sensitive, cracked, or itchy nipples

  • Shiny or flaky skin on the areola, the area around the nipple

  • Painful nursing or painful nipples between feedings

  • Stabbing pains deeper in the breast

The fungus that causes thrush can spread to other parts of the body, like the lungs, liver, and skin. This happens more often in people with cancer, HIV, or other conditions that weaken the immune system.

Thrush may be grouped into three types:

  • Pseudomembranous -- the mouth surfaces look white and creamy

  • Erythematous -- the mouth looks red and raw

  • Hyperplastic -- you’ll have white plaque-like lesions or speckled red spots

 

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Oral Thrush Diagnosis

Your dentist or doctor can probably tell by taking a look inside your mouth. Your doctor might also send a tiny sample of the spot to a lab just to make sure.

If the fungus that causes thrush spreads into your esophagus, you may have to have other tests, like:

  • Athroat culture (a swab of the back of your throat)

  • An endoscopy of your esophagus, stomach, and small intestine

  • X-rays of your esophagus

Oral Thrush Treatments and Home Remedies

Thrush is easy to treat in healthy children and adults. But the symptoms may be worse and harder to treat in people with weak immune systems.

Your doctor will probably prescribe antifungal medications that you’ll have to take for 10-14 days. These come in tablets, lozenges, or liquids, and are generally easy to take.

Since the infection can be a symptom of other medical problems, your doctor may also want to run other tests to rule these out.

In addition to medical treatment, there are some things you can try at home that may help ease thrush or its symptoms:

  • Keep your mouth clean with regular brushing and flossing.

  • Rinse with about ½ teaspoon of salt in a cup of warm water.

  • Try rinsing with water mixed with apple cider vinegar, hydrogen peroxide, lemon juice, or baking soda.

  • Probiotics, such as yogurt or over-the-counter pills may help.

  • If you are breastfeeding, use nursing pads and keep bras and any bottles or breast pump parts clean.

  • If you wear dentures, be sure to disinfect them as recommended by your dentist.

Oral Thrush Prevention

Practice good oral hygiene. Brush your teeth at least twice a day and floss at least once a day.

Get regular dental checkups. Especially if you have diabetes or wear dentures. Even if you’re healthy and don’t have dental issues, you should get your teeth cleaned by your dentist every 6 months.

Treat chronic health issues. A condition such as HIV or diabetes can disturb the balance of bacteria in your body and lead to thrush. If you’re taking medications for an ongoing health condition, take them regularly, as directed.

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Don't overuse mouthwashes or sprays. Rinse with an antibacterial mouthwash once or twice a day to help keep your teeth and gums healthy. Using any more than that may upset the normal balance of bacteria in your mouth.

Clean inhalers after using them. If you have a condition like asthma or chronic obstructive pulmonary disease (COPD), clean your inhalers after each use to kill germs.

Limit foods that contain sugar and yeast. Bread, beer, and wine will cause extra yeast growth.

If you smoke, quit. Ask your doctor or dentist about ways to help you kick the habit.

 

 

Oral Thrush Outlook

With treatment, oral thrush usually goes away after a couple of weeks. If you are prone to it or don’t get better, you may need to see an ear, nose, and throat specialist. Sometimes thrush goes away and comes back. This often happens because the underlying cause hasn’t gone away. 

In some people, thrush can turn into a more serious systemic infection. This happens most often in people with another health condition such as:

  • HIV

  • Cancer

  • Kidney failure

  • Diabetes

  • Prior surgery

  • Other critical health conditions requiring treatment in an intensive care unit

In this case, doctors will treat the infection with oral or IV antifungal medicines.

 
WebMD Medical Reference Reviewed by Brunilda Nazario, MD on June 18, 2020

Sources

SOURCES:

Mayo Clinic: "Oral Thrush."

The Oral Cancer Foundation: “Candida Infection.”

European Journal of Dentistry: “Median Rhomboid Glossitis: A Clinical and Microbiological Study.”

Journal of Periodontology: “The Relationship of Candidiasis to Linear Gingival Erythema in HIV‐Infected Homosexual Men and Parenteral Drug Users.”

Frontiers in Microbiology: “Clinical Appearance of Oral Candida Infection and Therapeutic Strategies.”

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 — the White Stuff Growing in Your Mouth (and How to Get Rid of it).”

National Center for Advancing Translational Sciences: “Systemic candidiasis.”

 

 

 

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