Oral thrush

Overview

Oral thrush, also called oral candidiasis (kan-dih-DIE-uh-sis), is a condition in which the fungus Candida albicans builds up in the mouth. It's natural for candida, a yeast, to live in the mouth. But sometimes it can grow too much and cause symptoms.

Oral thrush causes creamy white patches or spots, usually on the tongue or inner cheeks. Sometimes oral thrush may spread to the roof of the mouth, gums or tonsils, or the back of your throat.

Although oral thrush can affect anyone, it's more likely to occur in babies and older adults because they have lower immunity. It's also more likely to occur in other people with weakened immune systems or certain health conditions or people who take certain medicines. Oral thrush is a minor problem if you're healthy. But if you have a weakened immune system, symptoms may be more serious and harder to control.

Symptoms

Children and adults

Symptoms of oral thrush may include:

• Creamy white patches or spots on your tongue, inner cheeks and sometimes on the roof of your mouth, gums and tonsils.
• Slightly raised patches that look like cottage cheese.
• Redness, burning or soreness that may be serious enough to cause a hard time eating or swallowing.
• Slight bleeding if the patches or spots are rubbed or scraped.
• Cracking and redness at the corners of your mouth.
• A cottony feeling in your mouth.
• Loss of taste.
• Redness, irritation and pain under your dentures.

In severe cases, usually related to cancer or a weakened immune system from HIV/AIDS, the patches or spots may spread downward into your esophagus — the long, muscular tube stretching from the back of your mouth to your stomach. This is called Candida esophagitis. If this occurs, you may have trouble swallowing and feel pain or feel as if food is getting stuck in your throat.

Babies and breastfeeding mothers

In addition to the distinctive white mouth spots, babies may have trouble feeding or be fussy and irritable. They can pass the infection to their mothers during breastfeeding. Then the infection may pass back and forth between the mother's nipples and the baby's mouth.

Women whose breasts are infected with candida may have these symptoms:

• Unusually red, sensitive, cracked or itchy nipples.
• Shiny or flaky skin on the darker, circular area around the nipple, called the areola.
• Unusual pain during nursing or painful nipples between feedings.
• Stabbing pains deep within the breast.

When to see a doctor

If you or your child gets white patches or spots inside the mouth, see your medical or dental professional. Thrush is uncommon in healthy older children, teenagers and adults. So if you get thrush, see your healthcare professional to find out if you need to be checked for an underlying medical condition or another cause.

Causes

A healthy immune system works to get rid of harmful invading organisms, such as viruses, bacteria and fungi. This maintains a balance between "good" and "bad" microbes in your body. But sometimes these protective measures fail. Then candida fungus grows and allows an oral thrush infection to take hold.

The most common type of candida fungus is Candida albicans. Several factors, such as a weakened immune system, can raise your risk of oral thrush.

Risk factors

You may have a higher risk of oral thrush infection if you have any of these issues:

• Weakened immunity. Oral thrush is more likely in babies and older adults due to lower immunity. Some medical conditions and treatments can weaken your immune system. They include cancer and its treatments, an organ transplant, medicines that weaken the immune system, and HIV/AIDS.
• Diabetes. If you have diabetes that isn't treated or the disease isn't well controlled, your saliva may contain large amounts of sugar. This sugar causes candida to grow.
• Vaginal yeast infections. The same fungus that causes oral thrush causes vaginal yeast infections. You can pass the infection to your baby.
• Medicines. Medicines such as prednisone, inhaled corticosteroids or antibiotics that disturb the natural balance of microorganisms in your body can raise your risk of oral thrush.
• Other oral conditions. Wearing dentures, especially upper dentures, or conditions that cause dry mouth can raise the risk of oral thrush.

Complications

Oral thrush usually isn't a big concern for healthy children and adults. But for people with lowered immunity, such as from cancer treatment or HIV/AIDS, thrush can be more serious. Oral thrush that isn't treated can lead to more-serious systemic candida infections. If you have a weakened immune system, thrush may spread to your esophagus or other parts of your body.

Prevention

These measures may help lower your risk of getting candida infections:

• Rinse your mouth. If you need to use a corticosteroid inhaler, be sure to rinse your mouth with water or brush your teeth after taking your medicine.
• Brush your teeth at least twice a day and floss daily or as often as your dentist recommends.
• Check your dentures. Remove your dentures at night. Make sure dentures fit properly and don't cause irritation. Clean your dentures daily. Ask your dentist for the best way to clean your type of dentures.
• See your dentist regularly, especially if you have diabetes or wear dentures. Ask your dentist how often you need to be seen.
• Watch what you eat. Try limiting how much sugar you eat, including foods that contain sugar. These foods may cause candida to grow.
• Control your blood sugar if you have diabetes. Well-controlled blood sugar can lower the amount of sugar in your saliva. This keeps candida from growing.
• Treat a vaginal yeast infection as soon as possible.
• Treat dry mouth. Ask your healthcare professional about ways to avoid or treat your dry mouth.