Oral thrush is one of the most common forms of thrush, a fungal disease that can affect the skin and mucous membranes and is caused by the yeast Candida. The umbrella term for all infections caused by this fungus is candidiasis. Oral thrush is therefore also called oral candidiasis. The fungal infection can occur on or in the mouth or throat. Babies are often affected, but the infection is also often seen in adults with a weak immune system. Read here how to recognize and treat oral thrush.
Forms of candidiasis in the mouth
Oral thrush is defined as a thrush infection in or around the mouth. Typically, oral thrush develops on the inside of the cheeks or lips. However, the throat, tongue (tongue fungus), or palate can also be affected. Oral thrush can come in different forms, and one form of oral thrush can develop from another. These are the different types of oral thrush and their signs:
- Pseudomembranous candidiasis: white, wipeable coating on red, inflamed mucosa.
- Acute erythematous candidiasis: burning, severely reddened mucosa without coatings, especially on the tongue.
- Hyperplastic candidiasis: fixed white coating with red edges on the mucosa and tongue.
Pseudomembranous candidiasis as the most common form.
In the most common form of oral thrush, pseudomembranous candidiasis, initially form isolated white speckles in the oral cavity, which can be easily detached. Underneath, the oral mucosa usually appears shiny, dry and reddened. In addition to the tongue, the mucous membranes of the cheeks, lips and palate are frequently affected. As the fungal infection progresses, larger and larger white, creamy-looking patches form, which can cause bleeding of the mucosa when detached. If left untreated, oral thrush can spread to the throat, esophagus (thrush esophagitis), or gastrointestinal tract.
Other symptoms of oral thrush
In addition to the described coatings and redness of the mucosa, oral thrush can cause other symptoms – especially in advanced stages. These include:
- Furry or burning sensation in the mouth.
- Dry mouth
- Increased thirst
- Bad breath
- Unpleasant or metallic taste in the mouth
- Swollen lymph nodes
- Difficulty swallowing or pain when eating or drinking (especially in babies or when spread to the throat and esophagus)
Untreated oral thrush may be accompanied by vomiting or heartburn. Unlike oral thrush, which is caused by the herpes simplex virus, oral thrush in children is accompanied at most by a slight fever. Tongue diagnosis: This means spots, coatings and Co.
Causes and risk factors
Cause of oral thrush are always the Candida fungi belonging to the yeast fungi, mostly Candida albicans. In many healthy people, the fungi are found in the mouth, in the intestines or on the skin and usually do no harm there as long as they are kept in check by the immune system and other microorganisms. However, if they find a gap in these endogenous defenses, they can multiply quickly and cause discomfort. Therefore, oral thrush often affects people with a weakened immune system. These include, in particular, babies, the elderly or people suffering from diseases such as cancer, HIV or diabetes.
Common triggers of oral thrush
In babies, oral thrush is often caused by infection in the mother – they often become infected at birth with an unnoticed vaginal fungus from the mother or later via the pacifier. Oral thrush often occurs in babies together with diaper thrush, a thrush infection in the diaper area. In adults, missing teeth, braces or ill-fitting dentures often cause irritation of the oral mucosa. The fungi then nest under the denture, for example, or penetrate the oral mucosa through injuries. Smoking and a dry mouth can also promote the development of oral thrush. In addition, the long-term use of certain medications is one of the possible triggers of oral thrush. Antibiotics, cortisone (for example, in the form of cortisone spray for asthma) and cytostatics (during chemotherapy) can throw the immune system or the oral flora out of balance and pave the way for the development of the fungal infection.
Diagnosis based on characteristic symptoms
The diagnosis of oral thrush is usually based – especially in young children – on the characteristic, usually clearly visible symptoms. In addition, there is usually an interview with the affected person (or parents) about the symptoms, accompanying circumstances and previous illnesses. The diagnosis can be made just as easily by a dentist or dermatologist as by a pediatrician or general practitioner. For a definite diagnosis, a swab of the oral mucosa is usually taken and examined microscopically. In addition, fungal cultures can be prepared to determine the exact type of Candida fungus. This may be particularly necessary if the thrush infection is not responding to drug treatment as expected and a change of drug is being considered. Ideally, the physician will also clarify where the entry site for the fungi is located and, if necessary, treat the corresponding lesion in the mouth. If diseases are responsible for the weakening of the immune system, these should also be treated.
Treat oral thrush
For the treatment of oral thrush, the doctor usually prescribes antifungal agents (antifungals) that are specially suited for the oral area. These often contain the active ingredients nystatin, miconazole or amphotericin B. The drugs are often in the form of lozenges, gels, mouth rinses or suspensions. In each case, the agent should remain in the mouth as long as possible. When treating oral thrush, it is important to adhere exactly to the dosage of medication prescribed by the doctor and the duration of therapy. Even if no more plaque is visible, the therapy must be completed as prescribed. Discontinuation may cause the fungus to return or even spread to other areas. Experts strongly advise against treating oral fungus on one’s own. Home remedies such as gargling with chamomile tea can make the infection worse by further drying out the oral mucosa. Recognize oral diseases – these pictures help!
Watch out, contagious!
To combat oral thrush, good oral hygiene is essential. Since Candida fungi like to hide in teeth affected by caries, brushing your teeth should be especially conscientious while treating oral thrush. Dentures, pacifiers, teats, toothbrushes or braces should be thoroughly sterilized or replaced if possible. Also be careful not to infect others around you. Even a kiss or sharing dishes can be enough to transmit the Candida fungus. Oral thrush is often stubborn, but can usually be treated within eight to ten days with the measures mentioned. If the fungal infection does not go away over a longer period of time, stronger medications are usually used.
Prevention: Hygiene is the be-all and end-all
Risk groups can take various measures to prevent thrush infection in the mouth. Above all, hygiene is crucial. Specifically, the following measures help prevent oral thrush:
- Wearers of dentures should clean them thoroughly after every meal and make sure that the dentures fit properly. In addition, it is recommended to clean them two to three times a week with cleaning tablets intended for this purpose.
- In immunocompromised people (for example, during chemotherapy) is often prescribed an antifungal agent to prevent oral thrush.
- If people are fed artificially or their salivation is greatly reduced for other reasons, the nursing staff usually operates a so-called thrush and parotitis prophylaxis. This includes, for example, regularly moistening the mucous membranes of the affected person.
- For babies, pacifiers, teats and toys that are put in the mouth should be cleaned regularly and thoroughly. Remember that parental saliva can also be a possible source of infection for the child. So “cleaning” a dropped pacifier with your own saliva can actually promote infection.
- Since babies are often infected with Candida fungi by an undetected vaginal fungus of the mother at birth, an appropriate treatment of the mother before birth may be recommended.
- Nursing mothers often suffer from thrush infection of the nipples (breast thrush). So that affected women do not infect their child, they should temporarily not breastfeed and include the baby in the treatment of thrush, if necessary.Keep in mind that the contagion can go both ways.
In principle, it is advisable to consult a doctor immediately if you suspect oral thrush, to prevent the spread of the fungus to the throat and esophagus or to prevent infection of other people.
