Oral Thrush

Overview

Oral thrush — also called oral candidiasis, is an ailment in which the fungus Candida albicans grows on the lining of your mouth. Candida is a natural organism in your mouth. However, it can overgrow and create symptoms.

Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. Sometimes oral thrush may develop on the roof of your mouth, your gums or tonsils, or the back of your throat.

Although oral thrush can affect anyone, it’s more likely to happen in babies and older adults because they have decreased immunity; in other people with suppressed immune systems or specific health conditions, or people who take particular medications. Oral thrush is a minor problem if you’re healthy, but symptoms may be more severe and difficult to control if you have a weakened immune system.

Symptoms For Children and Adults

Initially, you may not even notice symptoms of oral thrush. Signs and symptoms may include:

• Somewhat raised sores with a cottage cheese-like look
• A cottony feeling in your mouth
• Loss of taste
• Burning, redness, or soreness that may be severe enough to cause trouble swallowing or eating 
• Slight bleeding if the lesions are rubbed or scraped
• Cracking and redness at the corners of your mouth
• Redness, irritation, and pain under dentures (denture stomatitis)
• Creamy white lesions on your tongue, inner cheeks, and sometimes on your tonsils, gums, and the roof of your mouth

In severe cases, usually related to cancer or a weakened immune system from HIV/AIDS, the lesions may spread downwards into your esophagus — the long, muscular tube ranging from the back of your mouth to your stomach (Candida esophagitis). If this happens, you may feel difficulty swallowing and pain or feel like food is getting lodged in your throat.

Infants and breastfeeding mothers

In addition to the characteristic white mouth lesions, infants may have trouble feeding or be irritable. They can transfer the infection to their mothers during breastfeeding. The condition may then move back and forth between the mother’s breasts and the baby’s mouth.

Women whose breasts are infected with candida may encounter these signs and symptoms:

• Unusually red, sensitive, cracked, or itchy nipples
• Shiny or flaky skin on the darker, circular area around the nipple (areola)
• Unusual pain during nursing or painful nipples between feedings
• Stabbing pains deep within the breast

When to see a doctor

If you or your child develops white lesions inside the mouth, see your doctor or dentist.

Thrush is unusual in healthy older children, teenagers, and adults, so if thrush develops, see your doctor to learn if further evaluation is needed to check for an underlying medical condition or other cause.

Causes

Usually, your immune system acts to resist harmful invading organisms, such as viruses, bacteria, and fungi, while supporting a symmetry between “good” and “bad” microbes that usually inhabit your body. Although sometimes, these protective mechanisms falter, boosting the number of candida fungus and allowing an oral thrush infection to happen.

The most prevalent variety of candida fungus is Candida albicans. Various determinants, such as a vulnerable immune system, can enhance 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 inclined to transpire in infants and older adults due to decreased immunity. Some medical conditions and medications can suppress your immune system, such as cancer and its medicines, organ transplantation, required drugs that suppress the immune system, and HIV/AIDS.
• Diabetes. If you have untreated diabetes or the disease isn’t under control, your saliva may carry large amounts of sugar, promoting the growth of candida.
• Vaginal yeast infections. Vaginal yeast infections are produced by the same fungus that causes oral thrush. You can transfer the condition to your baby.
• Medications. Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the normal balance of microorganisms in your body can enhance your chance of oral thrush.
• Other oral conditions. Using dentures, particularly upper dentures, or having conditions that produce dry mouth can boost the risk of oral thrush.

Complications

Oral thrush is rarely a problem for healthy children and adults.

For people with depressed immunity from cancer treatment or HIV/AIDS, thrush can be more severe. Untreated oral thrush can lead to more serious systemic candida infections. If you have a weakened immune system, thrush may spread to your esophagus or other parts of your body.

Prevention

These steps may assist in reducing your risk of forming 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 advises.
• Check your dentures. Remove your dentures at night. Make sure dentures fit correctly and don’t create irritation. Clean your dentures daily. Ask your dentist for the best way to clean your kind of dentures.
• See your dentist regularly, especially if you have diabetes or wear dentures. Ask your dentist how often you should be seen.
• Watch what you eat. Try restricting the amount of sugar-containing foods you eat. These may promote the increase of candida.
• Maintain good blood sugar control if you have diabetes. Well-controlled blood sugar can decrease the amount of sugar in your saliva, inhibiting 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.