Thrush: Symptoms, Causes, Treatment

What are the symptoms of thrush?

Thrush, also known as oral candidiasis, is a fungal infection in the mouth caused by the Candida yeast. The symptoms of thrush include:

• White, Creamy Patches: Patches that resemble cottage cheese, often found on the tongue, inner cheeks, gums, tonsils, or the roof of the mouth.
• Redness and Soreness: The affected areas may become red and sore, sometimes causing discomfort or pain.
• Difficulty Swallowing: In more severe cases, thrush can cause difficulty swallowing or a feeling that food is stuck in the throat.
• Cracking at the Corners of the Mouth: Also known as angular cheilitis, this can occur alongside thrush.
• Loss of Taste: A reduction in the sense of taste or an unpleasant taste in the mouth.
• Slight Bleeding: The patches can sometimes bleed when scraped or brushed.
• Dry Mouth or Cotton-Like Feeling: A sensation of dryness or a cotton-like feeling in the mouth.
• Burning Sensation: A burning feeling in the mouth or throat, particularly when eating or drinking.

Infants with thrush may become irritable or have trouble feeding, and breastfeeding mothers can experience pain, redness, or itching in the nipples if the infection is passed back and forth.

What are the causes of thrush?

Thrush, or oral candidiasis, is primarily caused by an overgrowth of the fungus Candida albicans, which is normally present in small amounts in the mouth, digestive tract, and skin. Under certain conditions, this fungus can grow uncontrollably, leading to thrush. Some of the causes and risk factors include:

• Weakened Immune System: People with weakened immune systems, such as those with HIV/AIDS, cancer, or those taking immunosuppressive medications, are more prone to thrush.
• Medications: Antibiotics, corticosteroids (like inhalers for asthma), and immunosuppressants can disrupt the natural balance of microorganisms, allowing Candida to grow unchecked.
• Diabetes: High blood sugar levels can encourage the growth of Candida, especially in poorly controlled diabetes.
• Dry Mouth: Conditions or medications that reduce saliva production can lead to an increased risk of thrush.
• Dentures: Poorly fitting dentures, especially when not regularly cleaned, can create an environment where Candida thrives.
• Infants and the Elderly: Both age groups have weaker immune systems, making them more susceptible to infections like thrush.
• Poor Oral Hygiene: Not maintaining proper oral hygiene can lead to an imbalance in the mouth’s natural flora, contributing to thrush.
• Smoking: Tobacco use can alter the natural environment in the mouth, increasing the risk of thrush.
• Hormonal Changes: Hormonal changes during pregnancy, menstruation, or from using birth control pills can increase the risk of developing thrush.
• Nutritional Deficiencies: Deficiencies in iron, folic acid, or vitamin B12 can contribute to the development of thrush.

Thrush often occurs when the immune system is compromised or when there’s an imbalance in the natural microorganisms in the body, allowing Candida to multiply excessively.

What is the treatment for thrush?

The treatment for thrush typically involves antifungal medications to control the overgrowth of Candida. The specific treatment approach can vary depending on the severity of the infection, the patient’s age, and any underlying conditions. Here are the common treatments for thrush:

• Antifungal Medications: These are the mainstay of treatment and can be administered in various forms:
• Oral Antifungal Medications: These include fluconazole (Diflucan), itraconazole (Sporanox), or nystatin (Nystop) in liquid or tablet form.
• Topical Antifungals: For mild cases, antifungal mouthwashes or lozenges, such as clotrimazole (Mycelex) troches or nystatin suspension, can be used. These are often applied directly to the affected areas in the mouth.
• Antifungal Gels or Creams: These are sometimes prescribed for infants, children, or breastfeeding mothers to apply to the affected areas.
• Addressing Underlying Causes: If an underlying condition is contributing to the thrush, such as diabetes or dry mouth, managing that condition is crucial to prevent recurrence. This may involve better blood sugar control, adjusting medications, or improving oral hygiene practices.
• Oral Hygiene: Maintaining good oral hygiene is essential. Brushing and flossing regularly, cleaning dentures thoroughly, and avoiding mouthwashes that can disrupt the natural balance of bacteria in the mouth can help manage and prevent thrush.
• Dietary Adjustments: Reducing sugar intake, as sugar can promote the growth of Candida, may be recommended. In some cases, probiotics are suggested to help restore the natural balance of bacteria in the mouth.
• For Infants: In cases of thrush in infants, treatment often involves applying a topical antifungal to the infant’s mouth. If the mother is breastfeeding, she may also need treatment to prevent the infection from being passed back and forth.
• For Breastfeeding Mothers: If the mother has a yeast infection on her nipples, antifungal creams are often prescribed. Sterilizing all feeding equipment and pacifiers is also important to prevent re-infection.
• Lifestyle Changes: Quitting smoking and managing stress can also help in preventing and treating thrush, as these factors can contribute to the imbalance of microorganisms in the body.

Thrush usually responds well to treatment, but in some cases, it may recur, requiring longer or repeated courses of antifungal therapy. If the infection is persistent or severe, it’s important to consult a healthcare provider to rule out any underlying health issues.