What is oral thrush?
Oral thrush, also known as oral candidiasis, is a yeast infection that develops inside the mouth. It is caused by an overgrowth of the Candida fungus, which normally lives in small amounts in the mouth and digestive tract without causing issues. When conditions are right, the Candida fungus can multiply quickly, resulting in white lesions on the tongue, inner cheeks, gums, tonsils and sometimes the roof of the mouth.
Oral thrush is fairly common and can affect people of all ages, although it is most often seen in infants, the elderly and those with weakened immune systems. It is estimated that up to 7% of babies, about 60% of chemotherapy patients and more than 90% of HIV/AIDS patients will develop thrush at some point.
What are the symptoms of oral thrush?
Some common signs and symptoms of oral thrush include:
– White patches or sores on the inner cheeks, gums, tonsils, tongue or lips that can be wiped away, leaving a red and bleeding surface
– Reddening or inflammation of the affected areas
– Cracking and redness at the corners of the mouth
– A cottony feeling in the mouth
– Loss of taste
– Creamy white lesions on the tongue, inner cheeks and sometimes on the roof of the mouth, gums and tonsils
– Slight bleeding if the lesions are scraped
– Cracked skin at the corners of the mouth
– A burning sensation in the mouth that may make eating, drinking or swallowing painful
In very severe cases, the lesions can spread down the esophagus and cause pain or difficulty swallowing. Oral thrush symptoms may also spread to the larynx and cause hoarseness or loss of voice.
What causes oral thrush?
Oral thrush occurs when the normal environment of the mouth is disturbed or altered in a way that encourages fungal growth. Potential causes include:
– Weakened immune system due to illness or medical conditions like HIV/AIDS, diabetes, cancer, nutrient deficiencies, etc. The immune system helps keep Candida levels under control, so weaker immunity allows overgrowth.
– Medications like inhaled corticosteroids, antibiotics, dentures, chemotherapy drugs, etc. can reduce saliva flow or alter chemical balances in the mouth in a way that promotes thrush.
– Very young or very old age. Babies and elderly individuals often have underdeveloped or weakened immunity.
– Poor oral hygiene. Not properly brushing and flossing can allow Candida to thrive.
– Dry mouth. Reduced saliva flow from medications, illnesses, stress, or dehydration limits the mouth’s ability to wash away excess Candida.
– Breastfeeding. Contamination from mother’s breast or use of bottles exposes baby’s mouth to yeast.
– Weakened immune system due to illness like HIV/AIDS or diabetes
– Use of improper fitting dentures
– Smoking
– Prolonged use of inhaled corticosteroids
– Cancer treatments like chemotherapy or radiation to the head/neck
– Taking antibiotics that kill off too much healthy bacteria needed to keep Candida in check
– Deficiency in nutrients like vitamin B12, iron, calcium, magnesium or zinc that are needed for proper immune function
Who is at risk for developing oral thrush?
While anyone can develop oral thrush, it is more frequently seen in the following populations:
– Infants under 2 months old
– Adults over 60 years old
– Individuals with HIV/AIDS or other immune deficiencies like leukemia and lymphoma
– Patients taking corticosteroids or antibiotics long-term
– Cancer patients undergoing chemotherapy and radiation treatment
– People who wear dentures, especially if they are not properly cleaned and fitted
– Diabetics and those with metabolic conditions
– Smokers
– People with vitamin or nutrient deficiencies
– Those with endocrine disorders like hypothyroidism and Addison’s disease
– Individuals with dry mouth from medications, stress, breathing through mouth, etc.
– People who frequently use inhaled corticosteroids like those for asthma
So in summary, people with weakened immune systems, babies and the elderly, those taking certain medications long-term, and those with medical conditions affecting oral health are most prone to developing thrush.
How is oral thrush diagnosed?
Oral thrush can often be diagnosed just by the characteristic appearance and location of the white lesions. In straightforward cases, that is enough for a doctor or dentist to make a diagnosis. However, the following tests may be used if the case is severe or persisting:
– A scraping of the lesion may be examined under a microscope to look for signs of the Candida fungus.
– A culture may be taken by gently swabbing the affected areas to determine the specific subtype of Candida fungus causing the infection.
– Blood tests can check for certain antibodies in the blood indicative of oral thrush.
– A biopsy may be done on a small piece of the lesion tissue to examine it further.
So in mild cases, a simple visual exam by a medical professional is sufficient for diagnosis. But for complicated or recurrent cases, lab tests, bloodwork and biopsies may be used for confirmation and to determine the best treatment options.
Is oral thrush contagious?
Oral thrush is mildly contagious in the sense that the Candida fungus can be passed from person to person in certain cases:
– An infant can get thrush from contact with the mother’s breast or from contaminated bottles/pacifiers.
– In adults, Candida can be passed through intimate kissing and oral sex.
– Dentures can harbor Candida and transfer it if shared between individuals.
– Individuals with thrush should avoid sharing food, drinks, utensils, toothbrushes, etc. to prevent spread.
However, a healthy person’s immune system should keep them from developing an actual infection from Candida exposure. Those with already weakened immunity are most at risk.
So while oral thrush can potentially spread by contact, it rarely causes illness in healthy people. But those with compromised immune function are more vulnerable. Practicing good hygiene is important to avoid transmitting thrush-causing yeast.
Is oral thrush serious?
For most healthy individuals, oral thrush is easily treated and not a major cause for concern. However, thrush can potentially be serious if:
– It is widespread, covering large areas of the mouth and throat.
– It persists or recurs frequently, especially if it is antibiotic-resistant.
– It spreads to other areas like the esophagus or airways.
– It occurs in infants as it can interfere with nutrition.
– It develops in those with severely weakened immune systems like chemotherapy patients, indicating a major problem.
– It occurs along with signs of acute infection like fever, swelling and fatigue.
So while thrush is rather benign in otherwise healthy people, it can signal more serious underlying conditions in high-risk populations, the chronically ill and those with compromised immunity. Seeking medical care is recommended if thrush is problematic, severe and accompanied by other concerning symptoms.
How is oral thrush treated?
Treatment of oral thrush involves:
– Prescription anti-fungal medications in the form of mouthwashes, lozenges or pills. Common antifungal drugs include Nystatin, Fluconazole and Clotrimazole. These help eliminate fungal overgrowth.
– For mild cases, topical antifungals may be used including antiseptic mouthwashes, miconazole gel or gentian violet paints.
– Addressing underlying causes may be important, like managing diabetes or HIV, taking vitamins and supplements, using proper fitting dentures, etc. This helps prevent recurrence.
– In severe cases, intravenous antifungals may be administered in hospitalized patients.
– Probiotics can help restore the natural bacteria balance in the mouth and digestive tract to keep the Candida fungus under control.
In uncomplicated cases, topical antifungals are often effective. But oral prescription medications may be needed for more stubborn infections. Seeking proper medical treatment helps relieve symptoms and prevents complications.
What home remedies help with oral thrush?
Some natural home remedies that can help treat oral thrush include:
– Saltwater or baking soda rinses – Dissolve 1/2 tsp salt or baking soda in 1 cup warm water and swish around mouth to reduce inflammation and soothe tissues. Can be done 2-3 times a day.
– Coconut oil – Has natural antifungal properties. Swish around mouth for several minutes then spit out. Can also eat 1-2 tsp per day.
– Yogurt – Contains live cultures that can help fight Candida overgrowth. Eat a few servings daily. Can also be applied inside the mouth.
– Aloe vera – Known for anti-fungal and healing properties. Use aloe juice as a mouth rinse or apply gel directly.
– Apple cider vinegar – Contains antifungal acetic acid. Mix with warm water and use as a mouthwash. Can also drink 1-2 tbsp diluted in water or tea.
– Honey – Has antimicrobial properties. Slowly dissolve 1 tsp in mouth 2-3 times daily. Avoid giving honey to infants.
– Garlic – Contains antifungal compound allicin. Chew raw garlic clove or add to food. Can also use garlic oil.
– Tea tree oil – Has anti-Candida effects. Add 2-3 drops to 1/4 cup water and use as mouthwash.
While these remedies may help, they should not be used as full thrush treatment and antifungal medication may still be needed. It is best to consult a doctor if symptoms persist or worsen.
Can oral thrush be prevented?
Some ways to help prevent getting oral thrush include:
– Maintain good oral hygiene by brushing teeth twice a day and flossing at least once daily. This prevents Candida overgrowth.
– If you have dentures, clean them properly and remove them at night. Soaking in antiseptic solution helps.
– Avoid smoking and limit alcohol intake.
– Manage medical conditions like diabetes that increase risk.
– Take any medications as prescribed and consult doctor about side effects.
– Eat a balanced diet rich in vitamin C and zinc which support immune function.
– Avoid sharing utensils, toothbrushes, etc. with those who have thrush.
– Rinse mouth after using inhaled corticosteroids for asthma.
– If breastfeeding when you have thrush, pump and discard milk until treated. Sterilize any breastfeeding equipment.
– Limit intake of sugary foods.
With vigilance regarding oral hygiene habits and overall health, many people can avoid developing oral thrush. But if it does occur, prompt treatment can often clear it up quickly.
When to see a doctor for oral thrush
You should consult a doctor or dentist if you have:
– Severe symptoms like widespread white lesions, bleeding, or difficulty/pain swallowing
– Thrush that persists for over 2 weeks despite home care
– Signs of spreading infection like fever or swollen lymph nodes
– Recurring bouts of thrush with unknown trigger
– Thrush while pregnant, breastfeeding or immunocompromised
– Lesions that look unusual or suspicious in any way
– Oral thrush along with vaginal yeast infection
– Underlying medical condition like diabetes or vitamin deficiency
While mild thrush often resolves on its own, more severe or persistent cases should be professionally evaluated to identify and properly treat the underlying cause. Seeking medical advice helps prevent complications and recurrent infections.
Conclusion
In summary, oral thrush or oral candidiasis is a common fungal infection that can cause characteristic white lesions and inflammation in the mouth. While annoying, it is typically not serious for most healthy individuals and can be easily treated with proper oral hygiene, topical antifungals and sometimes oral medication. However, thrush can potentially signal a greater health problem in certain groups like the very young, elderly, pregnant/nursing women, diabetics, cancer patients and the immunocompromised. Recurring, severe or persistent thrush warrants medical attention to address the root cause. With appropriate treatment guided by a doctor or dentist, thrush can be readily overcome before becoming a more worrisome condition. Being aware of the signs and risk factors allows early identification and steps to prevent thrush from occurring in the first place.