Oral Thrush: Symptoms, Causes and Treatments
Synopsis: Information regarding Oral thrush or oral candidiasis, a condition that causes white creamy lesions in the mouth, tongue and cheeks.1
Author: Thomas C. Weiss Contact: Disabled World
Published: 2016-02-21 Updated: 2018-03-16
While oral thrush may affect anyone, it is more likely to occur in seniors, babies and in people with suppressed immune systems or certain health conditions, or in people who take certain medications. Oral thrush is a minor issue if someone is healthy, although if a person has a weakened immune system, symptoms of oral thrush might be more severe and hard to control.
Candidiasis is defined as a fungal infection due to any type of Candida - a type of yeast. More than 20 types of Candida can cause infection with Candida albicans being the most common. Oral thrush, also referred to as, 'oral candidiasis,' is a condition in which the fungus, 'Candida Albicans,' accumulates on the lining of a person's mouth. Candida is a regular organism in people's mouths, yet at times it may overgrow and cause symptoms such as white, creamy lesions, most often on a person's tongue or inner cheeks. At times, oral thrush might spread to the roof of the person's mouth, their gums or tonsils, or in the back of their throat. Candidiasis is commonly treated with antimycotics; these antifungal drugs include topical clotrimazole, topical nystatin, fluconazole, and topical ketoconazole.
Symptoms of Oral Thrush
In children and adults, you might not even notice symptoms of oral thrush. Depending on the underlying cause, signs and symptoms may develop slowly or quickly and they may persist for days, weeks or even months. Signs and symptoms might include the following:
- Loss of taste
- A, 'cottony,' feeling in your mouth
- Cracking and redness at the corners of your mouth
- Slight bleeding if the lesions are scraped or rubbed
- Slightly raised lesions with a cottage cheese-like appearance
- Soreness or redness that might be severe enough to cause difficulties with eating or swallowing
- White, creamy lesions on your tongue, inner cheeks and at times – on the roof of your mouth, gums and tonsils
In severe instances, the lesions may spread downward into a person's esophagus. If this happens, the person may experience difficulties with swallowing or feel as if their food is getting stuck in their throat.
Symptoms of Oral Thrush in Infants and Breast-Feeding Mothers:
Along with the distinctive white mouth lesions, infants may have trouble feeding, or be irritable and fussy. They may pass the infection to their mothers during breast-feeding. The infection might then pass back and forth between the mother's breasts and her baby's mouth. Women whose breasts are infected with candida may experience the following signs and symptoms:
- Stabbing pains deep within the breast
- Unusually sensitive, red, itchy or cracked nipples
- Shiny or flaky skin on the darker, circular area around the nipple
- Unusual pain during nursing or painful nipples between feedings
Causes of Oral Thrush
Usually, a person's immune system works to repel harmful invading organisms such as bacteria, viruses and fungi while maintaining a balance between, 'good,' and, 'bad,' microbes that inhabit the body. Yet at times these protective mechanisms fail, increasing the number of candida fungi and allowing an oral thrush infection to occur. Oral thrush and other candida infections may happen when a person's immune system is weakened by disease or by drugs such as prednisone, or when antibiotics disturb the natural balance of micro-organisms in the body. The following conditions or diseases may make you more susceptible to oral thrush infection:
HIV damages or destroys cells of a person's immune system, making them more susceptible to opportunistic infections the person's body would usually resist. Repeated bouts of oral thrush, along with additional symptoms, may be early indications of an immune deficiency such as HIV infection.
If a person has cancer their immune system is likely to be weakened from the disease as well as from treatments such as radiation and chemotherapy. Both the treatments and the disease may increase a person's risk of candida infections such as oral thrush.
If a person has untreated diabetes or the disease is not well-controlled, their saliva might contain large amounts of sugar which encourages the growth of candida.
Vaginal Yeast Infections:
Vaginal yeast infections are caused by the same fungus that causes oral thrush. While a yeast infection is not dangerous, if you are pregnant you can pass the fungus to your baby during delivery. The result is your newborn may develop oral thrush.
Oral Thrush Risk Factors
Anyone may develop oral thrush, but the infection is more common in certain people. The risk factors for oral thrush can include the following:
- Wearing dentures
- Being a senior or an infant
- Having a weakened immune system
- Having conditions that cause dry mouth
- Having certain health conditions such as diabetes
- Undergoing radiation or chemotherapy treatment for cancer
- Taking certain medications such as oral or inhaled corticosteroids, or antibiotics
Complications of Oral Thrush
Oral thrush is seldom an issue for children and adults who are healthy, although the infection may return even after it is being treated. For those with lowered immunity, such as from cancer or HIV; however, thrush might be more serious. Untreated oral thrush can lead to more serious systemic candida infections. If you have a suppressed immune system:
- The infection may spread to your intestines, making it hard to receive adequate nutrition
- Thrush is more likely to spread to other parts of your body, such as your lungs, liver, heart valves or digestive tract
- You may have particularly severe symptoms in your mouth or esophagus, which may make eating both difficult and painful
Diagnosing Oral Thrush
If thrush is limited to a person's mouth, it can usually be diagnosed just by looking at the lesions, yet at times a small sample is examined underneath a microscope to confirm the diagnosis. In older children and adolescents who have no identified risk factors, an underlying medical condition may be the cause of oral thrush. If a doctor suspects this is the case, they will likely perform a physical examination and recommend certain blood tests to help find the source of the issue.
If thrush is in a person's esophagus, it may be serious. To help diagnose this condition a doctor might ask you to have one or more of the following tests:
In this procedure, a doctor examines a person's esophagus, stomach and the upper portion of the small intestine using a lighted and flexible tube with a camera on the tip.
In this procedure, the back of the person's throat is swabbed with sterile cotton. The tissue sample is then cultured on a unique medium to help determine which fungi or bacteria are causing the person's symptoms.
Treating Oral Thrush
The goal of any oral thrush treatment is to stop the rapid spread of the fungus. The best approach might depend on the person's age, overall health and the cause of the infection.
Healthy Children and Adults:
a doctor may recommend antifungal medication, which comes in several forms to include tablets, lozenges, or a liquid a person may swish around their mouth and then swallow.
Adults with Weakened Immune Systems:
Most of the time, a doctor will recommend antifungal medication. Yet candida albicans can become resistant to many antifungal medications, particularly in people with late-stage HIV. If this is the instance, a drug called, 'amphotericin B,' might be used, yet only when other drugs are not effective because it may cause serious side-effects.
Infants and Nursing Mothers:
If you are breast-feeding and your infant has oral thrush, both you and your baby could pass the infection back and forth. A doctor might prescribe a mild antifungal medication for your baby and an antifungal cream for your breasts.
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