Thrush: Symptoms, Treatments, and Prevention

Thrush is a common yeast infection caused by a yeast called Candida.

Thrush is a common yeast infection caused by a yeast called Candida. The most common strain of this fungus is Candida albicans (C. albicans). The mouth and throat are one of the most common sites of Candida infections, which lead to oral thrush. Thrush is also called oral candidiasis or oropharyngeal candidiasis.  

Most common causes include:

• The immune system and body's normal bacteria usually keep Candida in balance. When this balance is interrupted, it can result in an overgrowth of the Candida fungus, causing thrush.
• Young babies are more susceptible to oral thrush.
• Wearing dentures, especially if they are not taken out at night, or not kept clean can cause oral thrush.
• Antibiotic medicines, steroid tablets, inhalers, and mouthwash can sometimes cause oral thrush.
• Having a dry mouth due to lack of saliva may cause thrush.
• Having diabetes, anemia, or lack of vitamins and iron are common causes of oral thrush.
• Having a poor immune system (human immunodeficiency virus/acquired immunodeficiency syndrome [HIV/AIDS]) may lead to growth of yeast infection.
• Poor oral hygiene and proper diet may lead to oral thrush.
• Smokers are more likely to develop oral thrush than other individuals.

Most common symptoms include:

• Thrush is characterized by a white coating or white patches on the tongue, mouth, inner cheeks, and the back of the throat. 
• The tissue under the white patches is often red, raw, and sore. Lesions can be painful and even bleed when scraped. 
• Oral thrush often looks like cottage cheese or milk curds.
• Bad breath
• Cheilosis (Cracking at the outer edges of the lips)
• Feeling of food stuck in the throat or sore throat
• Strange or unpleasant taste in the mouth
• Burning mouth syndrome: Symptoms of a painful burning sensation, mouth dryness, soreness, tingling, or numbness throughout the mouth and tongue. Symptoms can be associated with abnormal bitter or metallic taste in the mouth.
• In severe cases of thrush, the esophagus (food pipe), which leads down to the stomach, may also be involved. This will cause pain with swallowing, fever, shaking or chills, or difficulty swallowing.

Candidiasis is clinically diagnosed by a doctor or dentist when the characteristic-looking white patches are found in the mouth or throat. The doctor or dentist can scrape off a small amount of the white matter from the mouth or throat and look at it under a microscope and view the characteristic yeast-shaped fungi. Thrush located farther down the throat or in the esophagus is usually found by performing a procedure called an endoscopy. In this procedure, the doctor passes a small camera through the back of the throat into the esophagus and into the stomach to observe the tissue and take samples. If the white lesions are found, they may be biopsied or scraped to confirm the diagnosis of thrush. This procedure is usually performed by a gastroenterologist.

Most common ways to prevent thrush:

• Brush the teeth with a soft toothbrush
• Rinse the mouth with a diluted 3% hydrogen peroxide solution or with warm saltwater
• Avoid mouthwash
• Keep dentures clean
• Maintain oral hygiene
• Limit foods rich in yeast and sugar
• Get regular checkups with your dentist
• Probiotics: Adding probiotic foods, cultured dairy, and/or oral probiotics into routine may help to kill the Candida overgrowth in the body and balance the pH level in the mouth.
• Vitamin C: Vitamin C helps the immune system by encouraging white blood cell production, which protects the body against infection.

Thrush is a treatable condition:

• Mild oral thrush: The usual treatment is Nyamyc (nystatin), which is a topical application that is in liquid drop form. Miconazole mouth gel or lozenges are also effective but may sometimes lead to vomiting or diarrhea.
• Severe oral thrush: Tablets containing the common antifungal medications Diflucan (fluconazole) or Sporanox (itraconazole) can also clear fungal infections from the body. In rare cases, antifungal injections may be given.