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Oral thrush

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

Oral thrush is a yeast infection of the mouth. It is very common in children and babies and can be common in people who wear dentures or those who are prone to infections due to other medical conditions. Certain medications can put you at higher risk of developing oral thrush, including taking a course of antibiotics or using an asthma inhaler that contains a steroid.

If you have oral thrush, you will usually have a mouth that is more red than usual, with white patches over the top. The white patches can be rubbed off and may lead to slight bleeding underneath if you do so. Oral thrush can cause pain and changes to your taste, it may be sore when you eat and drink, and babies can be reluctant to start or continue feeding as it is painful.

Doctor’s advice

What causes thrush?

Thrush is caused by a yeast infection called candida, and it can occur in many different parts of the body, as well as the mouth. Candida is easily treated with antifungal medications that come in the form of oral drops, pessaries (vaginal), creams, or tablets. The recommended treatment depends on where the infection is.

It is possible to pass thrush on, and it is common for a baby with oral thrush to pass it on and cause a candidal nipple infection.

Healthwords pharmacists' top tips

There are some simple ways to avoid common causes of oral thrush. For children, sterilizing bottles and dummies (pacifiers) will reduce the chance of infection.

Adults should avoid smoking and ensure good dental hygiene.

If you use an inhaler, you should change your spacer once a year and make sure you are rinsing your mouth after using the inhaler. If you still find you are getting thrush even after this technique you can ask your doctor to switch your inhaler.

If you wear dentures you should avoid wearing dentures at night.

Is there a link between breastfeeding and oral thrush in babies?

While oral thrush can occur in individuals of any age, it is relatively common in infants, particularly those who are breastfeeding.

The main reason for the association between breastfeeding and oral thrush is the transfer of Candida albicans from the mother's nipple to the baby's mouth during breastfeeding. This can happen if the mother has a Candida infection on her nipples or in her milk ducts. Factors that increase the risk of Candida overgrowth in breastfeeding mothers include:

  1. If the mother's nipples are not cleaned properly before breastfeeding or if moisture is trapped under breast pads or clothing, it can create an environment conducive to yeast growth.

  2. Antibiotics can disrupt the balance of natural bacteria in the body, allowing Candida to proliferate. If the mother is taking antibiotics, there may be an increased risk of developing a Candida infection on the nipples or in the milk ducts.

  3. Cracks or wounds on the nipples provide an entry point for Candida albicans, increasing the risk of infection.

How to treat oral thrush

Oral thrush is typically treated using antifungal medications prescribed by your doctor, depending on the severity of the infection. Here are some common treatments for oral thrush in the US:

  1. Antifungal medications such as nystatin suspension are commonly used to treat oral thrush. These medications work by directly targeting the Candida fungus, helping to eliminate the infection and alleviate symptoms.

  2. In cases of more severe or persistent oral thrush, your doctor may prescribe stronger antifungal medications, such as fluconazole. These medications may be taken orally.

  3. Antifungal creams or ointments containing ingredients like clotrimazole or ketoconazole may be prescribed to treat thrush, particularly in cases where the infection has spread to the corners of the mouth (angular cheilitis) or the nipples in breastfeeding.

  4. In severe cases of oral thrush or in individuals who are immunocompromised, oral antifungal tablets may be best. These medications are taken by mouth and work systemically to eliminate the Candida infection throughout the body.

  5. In addition to antifungal medications, practicing good oral hygiene is essential for treating and preventing oral thrush. This includes brushing the teeth and tongue regularly, using a soft toothbrush to avoid irritation, and rinsing the mouth with water after using inhaled corticosteroids, which can increase the risk of oral thrush.

  6. If oral thrush is recurrent or persistent, it's essential to identify and treat any underlying conditions that may be contributing to the infection. This may include addressing immune system disorders, managing diabetes or other chronic health conditions, or adjusting medications that may be causing oral thrush as a side effect.

When should I see my doctor?

All children, or adults with an unexplained cause of oral thrush, should book a routine appointment with their doctor who can prescribe treatment.

You should also speak to your doctor if there is pain or soreness when eating and drinking or if the symptoms are particularly severe or recurrent.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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