Oral Thrush or Candidiasis

Oral thrush is an infection caused by the fungus Candida albicans, which accumulates on the lining of the mouth. Oral thrush causes fluffy white lesions on the tongue and inner cheeks. The lesions are so painful and also bleed when scraped. Thrush can spread to palate (roof of the mouth), gums, and back of the throat or tonsils in some cases.

Thrush can also occur in other body parts causing vaginal yeast infections in women and diaper rash in toddlers. Not only in women and toddlers, it can also affect anyone having weak immune system, those who wear dentures or use inhaled corticosteroids.

Causes of Oral Thrush

Oral thrush is usually caused when the immune system is weakened by drugs or diseases, or when antibiotics interfere with the natural balances of microorganisms in the body.  The normal function of immune system is to maintain a balance between useful and harmful microbes, so as to repel against harmful invading microbes, such as bacteria, fungi and viruses. When these mechanisms fail, there is a higher chance for oral thrush to occur.

The diseases conditions that increase the risk of oral thrush infection include:

HIV/AIDS – HIV (human immunodeficiency virus) which causes AIDS destroys or damages the immune system cells, making the immune system highly susceptible to infections. The first signs of HIV infection are repeated bouts of oral thrush.

Cancer – If you are suffering from cancer, the immune system is likely to get weakened from the disease and from treatments like radiation and chemotherapy. Both the disease and treatments can highly increase the risk of oral thrush.

Diabetes mellitus – When diabetes mellitus is not treated or controlled, the saliva may contain large mass of sugars, encouraging the growth of candida.

Vaginal yeast infections – These infections are also caused by candida fungus which usually causes oral thrush. They are dangerous especially when present in pregnancy stage as it can be passed to the baby during delivery. Newborn can therefore develop thrush.

Symptoms of Oral Thrush

In Children and Adults

In the initial stages, you will not notice any oral thrush symptoms. However, the symptoms develop suddenly and persist over prolonged periods. They include the following:

  • Fluffy white lesions on the tongue, inner cheeks and also sometimes on gums, roof of the mouth, tonsils and back of the mouth
  • Cottage cheese like appearing lesions
  • Pain and slight bleeding if you scrape or rub lesions
  • Redness and cracking at the mouth corners, in those who wear dentures
  • Loss of taste
  • Smooth feeling in the mouth

In severe cases, the lesions spread into the esophagus (swallowing tube that stretches from back of the mouth to the stomach). In this case, one can experience difficulty in swallowing food.

In Infants and Nursing Mothers

Infants have difficulty feeding or become irritable and fussy. They transfer the infection to their mothers while breast feeding. Thus the infection spreads back and forth between baby’s mouth and mother’s breasts. Women with Candida infected breasts will experience the following symptoms:

  • Itchy, sensitive and red nipples
  • Flaky or shiny skin on the circular, darker area of the nipple
  • Stabbing pain deep within the breast
  • Abnormal pain during feeding

Diagnosis of Oral Thrush

Oral thrush can be diagnosed just by observing at the lesions, however at times a microscopic examination of a tissue sample will confirm the diagnosis.

Thrush which spreads into the esophagus requires some diagnostic tests. These tests can include –

Throat culture – In this test, the back of the throat is swabbed with a sterile cotton pad and the sample is cultured in a medium and studied, to determine the cause.

Endoscopy – In this test, the esophagus, stomach and the small intestine are examined using a flexible tube with a camera mounted at its tip.

Treatment for Oral Thrush

The aim of the treatment is to prevent the active spread of the infection; however, the best approach will depend on the age, cause of infection and overall health.

For children and adults

These primary home treatments can help children and adults to get rid of oral thrush:

  • Eating unsweetened yogurt
  • Taking acidophilus medications

These help to restore the normal bacterial flora in the body.

For infants and nursing mothers

If your infant is suffering from oral thrush and is on breast feeding, you may likely to get the infection and it keeps on transferring back and forth.

  • Antifungal medications for the infant and antifungal cream for the breasts
  • Rinse pacifiers and nipples in a solution of 1:1 water and vinegar and then allow drying to prevent growth of fungus
  • In case you use breast pump, wash the parts in vinegar and water solution

For adults with weak immune system

Antifungal prescriptions – These are available in many forms, tablets, liquid or lozenges that can be chewed and swallowed.

Amphotericin B – Candida fungus develops resistance to antifungal medications in those with final stages of HIV infection. Therefore this medication is prescribed when the former does not work well.

Certain antifungal drugs can cause liver damage. In this case, the physician will perform blood tests to determine the functioning of the liver.

Care / Prevention of Oral Thrush

Here are the preventive measures that will help in reducing the chance of developing candida infections.

Clean your mouth – If you use regular corticosteroid inhalers, make sure you clean your mouth and brush your teeth after inhaling the medication.

Use fresh culture yogurt – Always use fresh yogurt which contain lactobacillus acidophilus or bifidobacterium and choose acidophilus capsules when you are on antibiotics

Treat vaginal yeast infections – When you develop any vaginal yeast infections especially during pregnancy, get treated as soon as possible.

Consult dentist quite often – Go for regular checkups when you have diabetes or wear dentures. Be sure to clean your dentures every night before going to bed.

Watch your diet – Limit the amount of yeast and sugar containing foods as these may help in the growth and spread of candida.