What Is Oral Thrush?
Oral thrush occurs when a yeast infection develops on the inside
of your mouth and on your tongue. This condition is also known as oropharyngeal candidiasis.
The Candida albicans
fungus causes oral thrush. A small amount of this fungus normally lives in your
mouth without causing harm. However, when the fungus begins to grow
uncontrollably, an infection can develop in your mouth.
Oral thrush most often occurs in infants and toddlers. It causes
white bumps to form on the inner cheeks and tongue. These growths usually
go away once treatment is received.
Oral thrush is typically a mild infection that rarely causes complications.
However, the condition can be problematic for those with weakened immune
What Are the Symptoms of Oral Thrush?
In its initial stages, oral thrush may not cause any symptoms.
However, as time passes and the fungus continues to grow, the following
symptoms may develop:
- creamy white bumps on the tongue, inner cheeks,
gums, or tonsils
- slight bleeding when the bumps are scraped
- pain at the site of the bumps
- dry, cracked skin at the corners of the mouth
- difficulty swallowing
In infants, oral thrush may cause:
- difficulty feeding
Babies with oral thrush can pass the infection on to their
mothers during breast-feeding. Mothers and their infants can get caught in a cycle
in which they infect and re-infect one another. If you’re breast-feeding and
your breasts become infected with the fungus, you may experience:
- intense itching, sensitivity, or pain in the
- flaking or shiny skin on the area surrounding
- severe pain during breast-feeding
- sharp, piercing pain in the breast
What Causes Oral Thrush?
Oral thrush occurs when the C. albicans fungus
begins to grow out of control. Normally, the immune system uses good microorganisms
to keep C. albicans and
other bad microorganisms under control. When this balance is disrupted, however,
harmful bacteria and fungi begin to multiply. This causes an infection to
Oral thrush can occur when your immune system is weakened by
certain medications that reduce the number of good microorganisms that would
naturally prevent infection. Cancer treatments, including chemotherapy and
radiation, can also damage or kill healthy cells. This makes you more
susceptible to oral thrush and other infections.
Diseases that attack your immune system, such as HIV, AIDS, and leukemia,
also increase your risk for oral thrush. Diabetes, another illness that affects
your immune system, can contribute to oral thrush as well. If you have
uncontrolled diabetes, you likely have a high level of sugar in your
saliva. It’s thought that C. albicans can then use this extra
sugar to fuel its growth in your mouth.
In newborns, oral thrush can be contracted at birth. The same
fungus that causes oral thrush also causes yeast infections, so pregnant women with
a vaginal yeast infection can pass the infection on to their baby during
Who Is at Risk for Oral Thrush?
Babies and toddlers have the highest risk of developing oral
thrush. However, the infection can also affect people who have a weakened
immune system. You may have a weak immune system and be more at risk for oral
thrush if you:
- have HIV, AIDS, diabetes, or anemia
- have an illness that causes dry mouth
- take antibiotics or corticosteroids
- use chemotherapy, radiation, or drugs to treat
- wear dentures
- smoke cigarettes
- recently had an organ transplant
How Is Oral Thrush Diagnosed?
Your doctor will probably be able to diagnose oral thrush simply by
examining your mouth and tongue for the characteristic white bumps.
In some cases, your doctor may take a biopsy to confirm the
diagnosis. A biopsy involves scraping off a very small portion of a bump in the
mouth. The sample is then sent to a laboratory, where it will be tested for the
presence of C. albicans.
If your esophagus has become infected with oral thrush, your doctor
likely will perform more procedures to ensure an accurate diagnosis. These can
include a throat culture and an endoscopy.
During a throat culture, your doctor will use a cotton swab to
take a tissue sample from the back of your throat. The sample will then be sent
to a laboratory for analysis.
Endoscopy involves the
use of an endoscope, which is a thin tube with an attached light and camera. Your
doctor will insert the endoscope through your mouth and into your esophagus to
examine the affected area. They may also remove a sample of tissue for inspection.
How Is Oral Thrush Treated?
Treatment for oral thrush varies depending on your age and
overall health. The purpose of treatment is to prevent the growth and spread of
Medical treatment for oral thrush may consist of:
which is an oral antifungal medication
- a clotrimazole
lozenge, which is an antifungal medication that you leave in your mouth
until it dissolves
- nystatin, which is an antifungal
mouthwash that you swish around in your mouth and then swallow
- itraconazole, which is an oral
antifungal medication used for people who are resistant to initial treatments
or who have HIV or AIDS
B, which is a drug used to treat severe infections
You at-home regimen for treating oral thrush should include:
- brushing your teeth with a soft toothbrush to
avoid scraping the lesions
- replacing your toothbrush every day until the infection
- not using mouthwashes or sprays
- using a saltwater mixture to rinse your mouth
- maintaining appropriate blood sugar levels if
you have diabetes
- eating unsweetened yogurt to help restore and maintain
healthy levels of good bacteria
When a breast-feeding infant has oral thrush, both the mother and
infant should be treated to prevent a cycle of reinfection. Treatment in these
cases may include:
- using an antifungal medication for the baby and
an antifungal cream for the mother’s breasts
- rinsing pacifiers, bottle nipples, and all
pieces of a breast pump in a solution of half water and half vinegar and
allowing the items to air dry
- using nursing pads to prevent the fungus from
spreading to clothes
Once treatment begins, oral thrush usually goes away within a
couple of weeks. However, the infection may return again in the future. A
complete cure is more likely if you have a healthy immune system and are free
of other diseases.
What Are the Potential Complications of Oral Thrush?
Oral thrush rarely causes complications in people with healthy
immune systems. People whose immune systems are weakened by certain diseases or
medical treatments are the most likely to experience complications. If you have
a weak immune system, the fungus may enter your bloodstream and spread
throughout your body. This can eventually cause problems in various body
structures, including the brain, heart, and liver.
Infants who develop oral thrush also may get a severe diaper
How Can Oral Thrush Be Prevented?
You can reduce your risk for oral thrush by following these
- Practice good oral hygiene by brushing your
teeth. You should also floss daily. This is especially important if you have
diabetes or wear dentures.
- Rinse out your mouth after using a
- Add yogurt to your diet whenever you take
- Promptly treat a vaginal yeast infection,
especially if you’re pregnant.