Oral Thrush: Causes and Treatment

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Have you noticed a strange white rash inside your mouth? If yes, you might have a condition called oral thrush. It is also called oral candidiasis. It is a common infection caused by the candida fungus, which is yeast. You can get these rashes in your mouth and other parts of the body. These can cause diaper rash in infants or vaginal yeast infections in women.

Anyone can get thrush, but it is commonly seen in babies and toddlers, older adults, and specific people with weakened immune systems. It is a yeast infection of the genus candida that generally tends to develop on the mucous membranes of your mouth.

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For the majority of people, oral thrush generally does not cause any serious health problems. However, the story is totally different for people with a weakened immune system. For such people, the signs and symptoms might be much more severe.

This article discusses all aspects of oral thrush, including the causes, symptoms, and treatment.

What is Oral Thrush?

A yeast germ known as candida causes the infection thrush. The human mouth is the most common site where candida causes infection. When candidal infection occurs in your mouth, it is called oral thrush. Other common locations where thrush can develop are the nappy area, nail folds, and vagina.

According to stats, the treatment for oral thrush generally provides very good results. People often respond well to treatment. However, oral thrush can reappear, especially if the causal factor like smoking is not removed. Hence you need to quit smoking to prevent the disease from coming back.

When you start to notice a strange white rash-like growth inside your mouth, you may be having a condition called oral thrush. The condition is also called oral candidiasis. You must visit your doctor or dentist immediately for an examination. It is an infection caused by the candida fungus, which is actually yeast. Do not worry, as you might get these rashes in your mouth and other parts of your body as well. 

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Anyone can get thrush, but the disorder happens mostly to babies and toddlers, older adults, and specifically to people with weakened immune systems. This infection can cause diaper rash in infants or vaginal yeast infections in women.

Oral thrush is more likely to happen in babies and older adults, primarily because they have reduced immunity at this age. Thrush is also visible in people with suppressed immune systems or having certain health conditions, or people who take certain medications. Thrush is a minor problem if you are healthy. But in a scenario you have a weakened immune system, your symptoms might be more severe and even more challenging to control.

Quick Facts on Oral Thrush

These are some key points you should know about oral thrush. 

  • Oral thrush is a common condition, but for most people, it does not cause significant problems.
  • The fungus candida typically survives on your mucous membranes, but if too much grows in an area, it can cause symptoms.
  • People having a reduced immune system are worst affected.
  • Oral thrush could be noticed more regularly after chemotherapy or radiotherapy sessions to your head and neck.
  • The condition can be more pronounced in people who take steroids, wear dental dentures, or have diabetes.
  • The most apparent symptom of thrush is the formation of white-colored or creamy deposits in your mouth and tongue.
  • Your doctor might prescribe oral treatments or local antifungal medication that can be helpful to treat thrush.
  • If you practice good hygiene, you can help prevent it from recurring.

Oral Thrush Symptoms

Children and adults

The thrush symptoms are so minor that initially, you might be able to notice them. Signs and symptoms might include:

  • White, creamy lesions are noticed on your tongue, inside the cheeks, roof of your mouth, gums, and tonsils. They might appear even on the backside of your throat.
  • Some might have slightly raised lesions, mostly like a cottage cheese-like appearance.
  • Inflammation, redness, burning, or soreness that might be severe enough to cause difficulty swallowing or eating. 
  • You might notice slight bleeding if these lesions are scraped or rubbed.
  • Cracks and redness occur at the corners of your mouth.
  • You might have a cottony feeling in your mouth.
  • Loss of taste.
  • Irritation, redness, and pain under dentures are called denture stomatitis.

It is usually noticed in individuals with cancer or a weakened immune system from HIV/AIDS in most severe cases. In such serious cases, these lesions are likely to spread downward into the esophagus. Your esophagus is the long, muscular tube that stretches from the back of your mouth to your stomach.

If oral thrush occurs, you might experience difficulty swallowing your food. You might also experience pain or feel as if the food is stuck in your throat. In serious conditions, you must seek medical help.

Infants and breastfeeding mothers

Apart from the distinctive white mouth lesions, which is a common symptom, infants might have trouble feeding and hence become irritated and fussy. There are chances that the Infant can even pass the infection to their mothers while they breastfeed. 

Women whose breasts are infected with the fungus candida might experience the following symptoms:

  • Unusually red, sensitive, cracked, or itchy nipples.
  • Shiny or flaky skin on the circular, darker area around the nipple or also called areola.
  • Unusual pain during nursing. Also, you might notice painful nipples, especially between feedings.
  • Throbbing or stabbing pain deep within the breast.

When to see a doctor

If you or your child develop white lesions or creamy layers inside your mouth, visit your doctor or dentist. Oral thrush rarely happens in healthy older children, teenagers, and adults. So if you notice any signs of thrush developing, talk to your doctor to check if further evaluation is needed. Your dentist will actually check for an underlying medical condition or other causes.

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What Causes Oral Thrush?

Everyone’s mouth has small amounts of the candida fungus. They are also present in your digestive tract and your skin. It is supposed to be present there, and the fungus is generally kept under control by the other bacteria in your body. But at times, certain medications or illnesses like antibiotics or corticosteroids can disturb your balance. As a result, the fungus might grow out of control. That is when you get oral thrush. Stress can also cause oral thrush. Other several medical conditions cause oral thrush:

  • Cancer
  • Uncontrolled diabetes
  • HIV infection

If you smoke frequently or wear dentures that do not fit properly – you are likely to get oral thrush. Newborn babies often tend to pass the infection to their mothers when they are breastfeeding.

What is the Treatment for Oral Thrush?

Treatment of thrush depends on the severity and cause of your infection. If your doctor identifies that there was some reversible condition that caused your oral thrush, then those factors must be corrected as part of the treatment plan. These conditions could be taking antibiotics, ill-fitting dentures, poorly controlled diabetes, or smoking. 

Toddlers, infants, and children often do not require treatment. In children who have oral thrush that persisted for more than weeks, your pediatrician might prescribe antifungal nystatin drops.

Locally applied treatment

For mild oral thrush symptoms, the usual treatment that your doctor will try first is miconazole mouth gel. The effect of the medicine is checked for a week. At times you might need a two-week course. If your dentist cannot use miconazole, he might try gel Nystatin drops, which is another option. It is given to individuals known to be allergic to it.

You should follow the instructions on the packet:

  • The drops or gel should be used after you had meals. 
  • Smear a little amount of gel on your affected areas using your clean finger. Apply this four times a day.
  • You can also use a dropper to place the liquid drops inside your mouth on the area that is affected. 
  • Ideally, you should avoid drinking or eating – for about 30 minutes after using the gel or the drops. This step would help you to prevent the medicine from being washed out of your mouth.

Anti-thrush tablets

Tablets for oral thrush contain fluconazole,  a medicine that can help to clear fungal and thrush infections from your mouth. Your doctor will prescribe tablets only when your condition is more severe. For example, people with a poor immune system develop extensive oral thrush. Your doctor will prescribe tablets for a week, and this will usually clear your oral thrush.

Adjustment of other medication

If you were taking other medicines that might have given rise to symptoms of oral thrush like antibiotics or steroids, your doctor might need to change this medication. Else your doctor might reduce the dose to help clear up your oral thrush.

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Risk Factors for Oral Thrush

Adult oral thrush is seen to become a problem for the following group of people:

  • Adults who wear dentures – especially if dentures do not fit properly, they are not kept clean or are not taken out before going to bed.
  • Antibiotics – if you are on antibiotics, you might have a higher risk of developing oral thrush. Antibiotics might be helpful in destroying the bacteria that prevent the candida from coming out of control.
  • Steroid medication – People dependent on long-term use of steroid medication might have an increased risk of oral thrush.
  • Excessive mouthwash use – If you overuse antibacterial mouthwashes, you tend to destroy the bacteria which keep candida at bay. As a result, such groups have an increased risk of developing oral thrush.
  • Weakened immune system – People with weakened immune systems are more likely to develop oral thrush.
  • Diabetes – Individuals with diabetes, especially if it is poorly controlled, might develop oral thrush.
  • Dry mouth – if your mouth has less than a normal quantity of saliva or xerostomia, you are more prone to oral thrush.
  • Diet – Diet malnutrition makes you prone to oral thrush. This could be caused by a poor diet or a disease that might affect the absorption of nutrients. In particular, if you are on diets low in vitamin B12, iron, and folic acid, you might have a higher chance of infection. 
  • Smoking – Researchers believe that heavy smokers are more at risk. The reasons behind this are still unclear.

Lifestyle and Home Remedies

These measures may help reduce your risk of developing oral thrush:

  • Practice good oral hygiene. You should brush your teeth twice a day and floss daily or as frequently as your dentist advises. Try to replace your toothbrush frequently until your fungal infections clear up. Also, avoid sharing toothbrushes.
  • Rinse your mouth. Dissolve about a half teaspoon of salt in one cup of warm water and use it as a mouthwash. Swish the rinse, and then throw it out.
  • Disinfect your dentures. Remember to remove your dentures at night. Clean your dentures daily a few times a day. Make sure your dentures fit correctly and should not cause irritation. Ask your dentist for the best method to clean your dentures.
  • See your dentist regularly. Especially if you have diabetes or you are wearing dentures. 
  • Keep a watch on what you eat. Try limiting your amount of sugar-containing food. These might encourage the growth of the fungus candida.
  • Maintain good blood sugar control if you are diabetic. Even if you have diabetes, having well-controlled blood sugar can reduce the amount of sugar in your saliva. This would discourage the growth of candida.

With treatment, your oral thrush usually goes away after a couple of weeks. If you are prone to it, you might need to visit your specialist doctor frequently for medical advice. Sometimes the oral thrush goes away completely and comes back. This often happens in cases when the underlying cause has not gone away. Whatever be the reasons, your doctor will be able to suggest the best medication and treatment plan.

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