Oral thrush, also known as oral candidiasis, is a condition where the fungus Candida albicans accumulates on the lining of the mouth, leading to symptoms. It commonly causes creamy white lesions on the tongue or inner cheeks, but can also affect other areas like the roof of the mouth, gums, tonsils, or the back of the throat. While anyone can develop oral thrush, it is more likely to occur in infants, older adults, people with suppressed immune systems, certain health conditions, or those taking specific medications.
Symptoms of oral thrush may include:
Creamy white lesions on the tongue, inner cheeks, roof of the mouth, gums, and tonsils
Raised lesions with a cottage cheese-like appearance
Redness, burning, or soreness, which may make eating or swallowing difficult
Slight bleeding when the lesions are rubbed or scraped
Cracking and redness at the corners of the mouth
Cottony feeling in the mouth
Loss of taste
Redness, irritation, and pain under dentures (denture stomatitis)
In severe cases, particularly in individuals with weakened immune systems, the infection may spread to the esophagus, causing difficulty swallowing and the sensation of food getting stuck.
In infants and breastfeeding mothers, oral thrush can cause feeding difficulties, fussiness, and irritability. The infection can be passed back and forth between the mother’s breasts and the baby’s mouth. Breastfeeding mothers may experience red, sensitive, cracked, or itchy nipples, flaky skin on the areola, unusual pain during nursing, or stabbing pains deep within the breast.
Oral thrush occurs when the immune system fails to repel the overgrowth of Candida fungus. Risk factors include weakened immunity, diabetes, vaginal yeast infections (which can be passed to the baby), certain medications, wearing dentures, and conditions that cause dry mouth.
Complications from oral thrush are rare for healthy individuals, but for those with compromised immunity, such as cancer patients or people with HIV/AIDS, it can lead to more serious systemic candida infections. Prevention measures include rinsing the mouth after using corticosteroid inhalers, maintaining good oral hygiene, checking dentures for proper fit and cleanliness, regular dental check-ups, limiting sugar intake, controlling diabetes, treating vaginal yeast infections promptly, and managing dry mouth.
Diagnosis of oral thrush depends on the location and identifying any underlying causes. It can involve a physical examination of the mouth, microscopic examination of lesion scrapings, and blood tests to identify potential underlying medical conditions. If thrush extends to the esophagus, additional tests like biopsy, endoscopic exam, and further blood tests may be required.
Treatment aims to stop the spread of the fungus and depends on age, overall health, and the cause of the infection. Antifungal medications in the form of lozenges, tablets, or liquid may be prescribed. In the case of infants and breastfeeding mothers, mild antifungal medication for the baby and an antifungal cream for the mother’s breasts may be recommended. For adults with weakened immune systems, antifungal medication is often prescribed. Treating underlying causes, such as disinfecting dentures or addressing inhaled steroid use, is essential to prevent recurrence of thrush