Oral Thrush

Written By Sharon Boyd, RDH       |       Reviewed by Lara T. Coseo, DDS

Definition

oral-thrush

What is oral thrush? Thrush is a fairly common infection of the mouth due to a yeast infection. Typically the infection lasts for about two weeks and appears as a white velvety patch, or sometimes red, raw skin.

Also known as candidiasis, this is a fungal infection caused by the candida albicans fungus, or yeast. Candidiasis is the most common form of fungal infection, typically in those with a reduced immune function. Oral thrush usually presents white lesions on the tongue or cheeks, but can spread to the gums, tonsils, throat, and the roof of the mouth. Healthy individuals can experience thrush, but it's found more frequently in those with compromised immune systems. If you are healthy, it can be treated pretty easily, however, in those with weaker immune systems the symptoms can be much more severe and more difficult to manage.

Causes

What causes oral thrush and yeast infections? Thrush is due to an imbalance in the natural oral flora in the mouth. Certain people are more likely to develop thrush than others. Common risk groups include:
  • Infants
  • Elderly
  • Denture wearers
  • Immunocompromised (diabetes, HIV/AIDS)
  • Poor oral hygiene
  • Xerostomia (dry mouth)
  • Use of steroid, antibiotic or asthma medication
  • Chemotherapy

People with suppressed immune systems are more likely to develop infections like oral thrush. Diabetics may have a difficult time managing the infection due to elevated blood sugar levels. Because yeast feeds off of sugar, imbalances in diabetics may make the infection worsen. Typically most of the above-listed factors are the primary causes for oral thrush. (1)  

Signs And Symptoms

Because thrush can affect different parts of the body, the signs and symptoms can vary greatly from case to case. It usually develops suddenly, but can become chronic and persist over a long period of time. The most common sign of thrush is the presence of creamy white, slightly raised lesions in the mouth. These lesions, which may have a "cottage cheese" appearance, can be quite painful and may bleed if scraped or when brushing your teeth. 

Other symptoms associated with thrush are oral discomfort, pain when eating, loss of taste, dry mouth, fever, pain when swallowing, pain in and behind the breast bone area, painful eyes, gradual decrease in vision, joint pain, painful or increased urination, constipation, neck stiffness, diarrhea, nausea, loss of appetite, headache, or symptoms of heart failure such as ankle swelling and shortness of breath.

Most yeast infections are not painful, but they may be uncomfortable in some people depending on the severity.

Dangers And Health Risks (If Any)

It is very rare for oral thrush infections to cause severe adverse reactions although it is worth mentioning that severe infections that are uncontrolled may possibly place other parts of the body at risk due to spread of infection through the touch or cardiovascular system. Examples of increased secondary infection sites are the eyes, esophagus, heart and brain.

The real danger of thrush is that it can easily spread to and affect other parts of the body if your immune function is not performing properly. This can be a result for those who suffer from immune dysfunctions like HIV or AIDS, or those who are undergoing chemotherapy or radiation therapy for different forms of cancer. In these cases where it spreads there have been numerous cases of death from the infection.

How To Prevent Oral Thrush

clean-dentures
Prevention of thrush weighs heavily on how well you can control the contributing factors. The candida fungus will always be around, it's just a matter of maintaining the environment required to keep it in check. 
Practicing good oral hygiene and maintaining a healthy lifestyle are the best ways to prevent oral thrush or yeast infections. Some simple ways to prevent oral thrush include:
  • Practice good oral hygiene every day – brush, rinse, and floss
  • Use pure botanical ingredients to kill the bad bacteria that lead to oral health problems
  • Limit the use of antibiotic or steroid medication
  • Give up smoking
  • Replace your toothbrush frequently or after illnesses
  • Remove dentures and clean them thoroughly each day
  • Manage blood sugar levels

Treatment

The goal in any treatment of thrush is to prevent the spread of the fungus, but the best approach to this may vary on your age, health, and the cause of the infection. For nursing mothers and babies suffering from thrush, it is likely that both mother and child will be treated. Doctors may prescribe the antifungal medication for the baby and creams for the mother. This is important, because otherwise you could be continually passing the infection back and forth. For adults or children who are otherwise healthy, anti-fungal medications are a normal treatment. However, eating unsweetened yogurt can help restore the normal bacteria in the mouth and thus help regulate the candida fungus. In those with compromised immunity, candida can often build resistance to medications, so be sure to consult your doctor.

Oral thrush treatment can be through conventional or home remedies. Natural, over-the-counter treatments to get rid of oral thrush are typically successful but professional intervention may be needed if the infection is too severe.

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Conventional Treatment

Your dentist will most likely recommend that you use preventive home remedies to help clear up your fungal thrush infection. For severe cases of oral thrush, your dentist or doctor may recommend:

  • Prescription antifungal medication
  • Topical medication in the form of a mouth rinse

Home Remedies

Home remedies for oral thrush include:

  • The use of essential oils (2)
  • Decreased sugar intake (yeast thrives on sugar)
  • Increased intake of yogurt or acidophilus
  • Giving up smoking

  Here are some more things to know about oral health nutrition. Here’s more essential oils benefits.   

Oral Thrush In Babies

baby-sore-throat    

Causes

It is very common for young infants or babies to develop yeast infections or thrush in the mouth. This may be due to breastfeeding by a mother who is taking antibiotics, poor hygiene of bottle nipples or pacifiers, or in some cases from unknown reasons.    

Trace amounts of candida fungi are always present on the skin and in the mouth and digestive system of most healthy people. These fungi are usually kept in check by other bacteria and other micro-organisms. Certain illnesses, stress and medications can alter the environment in the body to make it more susceptible to infections. When these situations present themselves, candida fungi can grow out of control and cause thrush.

Uncontrolled diabetes, cancer, dry mouth, pregnancy, and HIV are health conditions that can create environments that are more likely to be susceptible to thrush. Ill fitting dentures can be another risk factor, as well as smoking. Infants are often more likely to be affected by thrush as sometimes their immune systems, are still developing, and in this case they can pass it to their mothers while breast feeding. Medications like birth control pills and antibiotics can upset the balance as well as they can eliminate some of the helpful bacteria that normally regulate candida.

Prevention

Always keep your child’s mouth clean, as well as any nipples or pacifiers that they use. Infants can have their mouth cleaned with warm water on a soft washcloth, gently wiping the tongue, roof of mouth, gums and inside of the cheeks. Mothers who breastfeed will want to use good hygiene habits to prevent spread of infection to their child, and treat any yeast infections in themselves appropriately.  

Treatment And Remedies

Infants that develop oral thrush should have all of their pacifiers or bottle nipples sterilized or thrown away. Using a soft washcloth to wipe the child’s mouth and remove some of the bacteria by improving hygiene can help the infection go away.

Conventional Treatment

In severe cases, prescription medication such as pilocarpine or cevimeline may be used to manage xerostomia and get rid of dry mouth.  

Your Questions Answered About Oral Thrush

Is oral thrush contagious? The fungus can be spread. You should change out your toothbrush. Infants with thrush should have pacifiers and bottle nipples sterilized or replaced.

How long does oral thrush take to heal? Most oral thrush infections don't last too long and should go away within two weeks.

What causes oral thrush? Oral thrush is a yeast infection due to an imbalance of natural flora or bacteria in the mouth. Typically the infection is due to lack of adequate hygiene or a compromised immune system, allowing the yeast or fungus to infect the area.

Who can get oral thrush? Most people who get oral yeast infections are the very young of elderly. Other people who get thrush of the mouth may have recently taken antibiotics, be diabetic, have a compromised immune system or smoke.

What does thrush look like? Usually thrush infections look like white film or velvet on the surface of the tongue or roof of the mouth. In some cases a red, raw patch of skin may also be visible.  

Click here to learn how to kill the cause behind your teeth and gum problems.

References:

  1. Krishnan PA.; Fungal Infections Of The Oral Mucosa.; Indian J Dent Res. 2012 Sep;23(5):650-9. doi: 10.4103/0970-9290.107384.
  2. Ninomiva K, Maruyama N, Inoune S, Ishibashi H, Takizawa T, Oshima H, Abe S,; The Essential Oil Of Melaleuca Alternifolia (Tea Tree Oil) And Its Main Component, terpinin-4-ol protect mice from experimental oral candidiasis.; Biol Pharm Bull. 2012:35(6):861-5.

Article Written By Sharon Boyd

Sharon has been a Registered Dental Hygienist since 2001. She also holds a Bachelor of Science degree in Human Relations and Business. In 2011, she began implementing her dental knowledge into freelance writing services that aided dentists, product designers, continuing education providers and web marketing firms for their online and distribution purposes. She has since bridged her services into the medical and cosmetic surgery fields.

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Article Reviewed By Dr. Lara Coseo

Lara T. Coseo, DDS, is a 2004 graduate of Baylor College of Dentistry.  She has 13 years of experience practicing general dentistry.  She currently serves as a part-time faculty instructor at Texas A&M College of Dentistry and writes dental website content and blog material. Website / Linked In / Instagram

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