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Oral thrush


Disease: Oral thrush Oral thrush
Category: Mouth and teeth diseases

Disease Definition:

When the fungus Candida albicans accumulates on the lining of someone’s mouth, oral thrush occurs. It results in creamy white lesions, often on the tongue or inner cheeks. Scraping the lesions could be painful and might bleed slightly. In some cases, oral thrush might spread to the roof of the mouth, gums, the back of the throat and tonsils.


Although oral thrush is more likely to occur in babies and people wearing dentures, using inhaled corticosteroids or having compromised immune systems, but it could still affect anyone. When someone has a weakened immune system, symptoms of oral thrush might be more severe and tough to manage; however, this condition is considered a minor problem for healthy people.

Work Group:

Symptoms, Causes


Symptoms in children and adults:


  • The affected person might not primarily have noticeable oral thrush symptoms. Signs and symptoms might develop abruptly and they might remain for a long time and could include:
  • Pain
  • Lesions with a cottage cheese-like look
  • Loss of taste
  • A cottony feeling in the mouth
  • Cracking at the corners of the mouth
  • Creamy, white lesions on the tongue, inner cheeks and occasionally on the roof of the mouth, gums and tonsils.
  • Slight bleeding in the case of rubbing or scraping the lesions


The lesions might spread downward into the esophagus in severe cases, which is the long, muscular tube stretching from the back of the mouth to the stomach (Candida esophagitis). When this takes place, the patient might feel as if food is getting stuck in the throat or he/she might experience difficulty swallowing.

Symptoms in breast-feeding mothers and infants:

Babies might have trouble feeding or they may be fussy and irritable in addition to the typical white mouth lesions. They could also pass the infection to their mothers throughout breast-feeding. Later on, the infection might pass back and forth between the mother’s breasts and the baby’s mouth. Women whose breasts are infected with candida might experience the below listed signs and symptoms:


  • Shiny or flaky skin on the areola
  • Unusually red, sensitive or itchy nipples
  • Stabbing pains deep within the breast
  • Unusual pain throughout nursing or painful nipples between feedings


When a person or their baby grows painful white lesions inside the mouth, they should consult their doctor or dentist. When thrush grows in older children or adolescents who have no risk factors, they should seek medical care because an underlying condition like diabetes might be the source.


When the immune system is weakened due to disease or drugs such as prednisone or in the cases of antibiotics disturbing the natural balance of microorganisms in the body, oral thrush and other candida infections could occur.
The immune system normally works to fight off harmful invading organisms such as viruses, bacteria and fungi, while maintaining a balance between “good” and “bad” microbes that are naturally found in the body. But these protective mechanisms fail sometimes, allowing an oral thrush infection to take charge.


There are some illnesses that may make a person more susceptible to oral thrush infection, such as:


Cancer and its treatments such as radiation and chemotherapy usually result in the weakening of the immune system, increasing the risk of oral thrush or other candida infections.

Vaginal yeast infections:

The same fungus that results in thrush causes vaginal yeast infections. Despite the fact that a yeast infection isn’t dangerous, but in the case of pregnancy, the woman might pass the fungus to her baby throughout delivery. The newborn may develop oral thrush as a consequence. 

Diabetes mellitus:

The development of candida may be encouraged in case someone’s saliva contains large amounts of sugar, which happens when a person has diabetes and doesn’t know about it, or when the diabetes is poorly controlled.


Repeated bouts of oral thrush might be the initial sign of an HIV infection, which causes AIDS that damages or destroys cells of the immune system, exposing the affected person to opportunistic infections that the body would normally fight off.


Some of the factors that may increase a person’s risk of developing oral thrush include:


  • Having conditions that result in dry mouth (xerostomia)
  • Smoking
  • Wearing dentures
  • Having a compromised immune system
  • Undergoing chemotherapy or radiation treatment for cancer
  • Being an infant
  • Having other health conditions, such as anemia or diabetes
  • Taking certain medications, such as oral or inhaled corticosteroids, or antibiotics



Only in some rare cases is oral thrush a problem for healthy children and adults, thought the infection might come back even after being treated. Thrush could be more serious for people who have compromised immune systems.
Making eating difficult and painful, people with HIV may have particularly severe symptoms in their mouth or esophagus. Receiving adequate nutrition becomes difficult in case the infection spreads to the intestines. Additionally, when someone has cancer or other conditions that weaken the immune system, thrush is more likely to spread to other parts of the body. In this case, the lungs, liver and digestive tract are the most commonly affected areas.


Every oral thrush treatment aims at preventing the rapid spread of the fungus, but the best approach might depend on the patient’s age, overall health and the cause of the infection.



When a woman’s breast-feeding an infant with oral thrush, the mother and the baby will do best if they’re both treated. Otherwise, they are likely to pass the infection back and forth. A mild antifungal medication may be prescribed for the mother and her baby, in addition to an antifungal cream for her breasts. In case the baby uses a pacifier or feeds from a bottle, the mother has to wash the nipples and pacifiers in a solution of equal parts water and vinegar daily and allow them to air dry to block fungus from developing. In addition, when a breast pump is used, rinsing any of the detachable parts coming in contact with the mother’s milk in a vinegar and water solution is also required.



Eating unsweetened yogurt or taking acidophilus capsules or liquid might help lessen the infection of healthy adults or children suffering from oral thrush. Even though yogurt and acidophilus could help restore the common bacterial flora in the body, but they don’t destroy the fungus. A person will also be prescribed an antifungal medication in case the infection persists.



Doctors usually recommend an antifungal medication that might come in the form of a liquid that is swished in the mouth and then swallowed, lozenges or tablets.


Particularly in people with late-stage HIV infection, Candida albicans can become resistant to antifungal medications. When other medications aren’t effective, a drug called amphotericin B could be used.


Liver damage may be caused by some antifungal medications. Because of this, especially if a person requires prolonged treatment or has a history of liver disease, the doctor will perform tests in order to monitor the patient’s liver function.



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