What Is Thrush? Symptoms, Causes, Diagnosis, Treatment, and Prevention

• Infants Oral thrush is most common in babies under 1 month old and less common in infants older than 6 months.
• Pregnant women
• Those wearing dentures It’s estimated that 50 to 65 percent of people who wear removable dentures get thrush.
• Smokers This includes users of e-cigarettes (with or without nicotine), according to a study published in January 2019 in the International Journal of Environmental Research and Public Health.
• Individuals with uncontrolled diabetes
• Cancer patients
• Those with HIV/AIDS
• People experiencing dry mouth
• Residents in care facilities A report in Postgraduate Medical Journal noted that between 65 and 88 percent of individuals living in acute and long-term care facilities are diagnosed with oral thrush.

In addition, folks who are taking certain medications can raise their chances of developing thrush. These meds include:

• Chemotherapy drugs
• Corticosteroids, including prednisone and inhaled corticosteroids for conditions like asthma
• TNF (tumor necrosis factor) inhibitors, which treat autoimmune diseases such as inflammatory bowel disease, psoriasis, and rheumatoid arthritis
• Antibiotics
• Medications that cause dry mouth, including antidepressants, high blood pressure meds, some antihistamines, pain medications, and others

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Thrush and Breastfeeding

• Red, cracked nipples
• Sensitive, painful, itchy nipples
• Shiny or flaky skin on the areola
• Painful nursing
• Deep, stabbing pain within the breast

“If you are nursing, it’s best to consult your doctor before beginning any antifungals,” says Nina L. Shapiro, MD, the director of pediatric otolaryngology at the David Geffen School of Medicine at UCLA. In all likelihood, you won’t need to stop breastfeeding with thrush. “If your breasts are cleaned in between feedings, and antifungals are being used, you can continue to breastfeed if it’s comfortable,” she says.

Thrush is generally easy to diagnose. Healthcare providers, whether general practitioners or dentists, can usually make the call simply by looking inside the mouth for white lesions. Diagnosis may also involve the following:

• Scraping the lesions Your practitioner will scrape a small amount of tissue from the lesions and will look for bleeding or examine the specimen under a microscope.
• Throat culture A provider will swab the back of the throat and examine the microorganisms under a microscope.
• Endoscopy A tube outfitted with a lighted camera will be passed through the esophagus, stomach, and small intestine. Again, this is reserved for those whose thrush has likely moved to the esophagus.

Medication Options

These medications include:

• Clotrimazole
• Miconazole
• Nystatin

Alternative and Complementary Therapies

Beyond antifungal medications, healthcare providers may also suggest you take the following steps to help treat the infection.

Brush and floss regularly. Replace your toothbrush often until the thrush infection is gone.

Try oil pulling. This involves swishing 1 tablespoon of sesame or coconut oil for 15 to 20 minutes, then spitting it out, rinsing, and brushing your teeth. It’s thought that the antifungal properties of the oil may kill yeast. This isn’t advisable for children under 5 years old, and it shouldn’t be the only treatment you take for the infection. If you are thinking about trying this, make sure to discuss it with a healthcare provider first.

Not all cases of oral thrush can be prevented, but here are some things that you can do to help reduce the chances.

• Quit smoking.
• Practice good oral hygiene. Brush teeth at least twice a day; floss at least once a day; see the dentist every six months for cleaning.
• Treat dry mouth.
• Control diabetes. When your blood sugar is well-controlled, it can reduce the amount of sugar in your saliva, which discourages the growth of yeast.
• Rinse your mouth. It’s important to either rinse your mouth or brush your teeth after using a corticosteroid inhaler. “This can clear the residual steroid that may sit on the lips, tongue, or inside the cheeks,” explains Dr. Shapiro.
• Use a spacer. Teenagers under 16 and older adults should use a corticosteroid inhaler with a spacer if they have asthma. A spacer is a tube with a mouthpiece that sends medicine to the lungs and not to the mouth, tongue, and back of the throat, where it can cause thrush.
• Clean pacifiers and nipples. If your baby uses a pacifier or bottle, thoroughly clean both in hot water after each use. This helps to avoid reinfection if there is yeast on the pacifier or nipple.
• Use probiotics. “We’ve found that taking probiotics can help modulate the overgrowth of existing candida, thereby reducing the likelihood of thrush,” says Shapiro. In fact, a study published in September 2015 in the Journal of Dental Research found that twice daily use of probiotics (specifically two strains of Lactobacillus) reduced the prevalence of high candida amounts in elderly nursing-home residents.

Again, oral thrush can be passed through kissing and oral sex with an individual with a yeast infection, so it’s best to avoid these activities if one of you has an active thrush infection.

Here are some additional sources with trusted info on thrush.

KidsHealth From the Nemours Foundation

This nonprofit children’s health system provides readers with easy-to-understand information on a wide variety of health topics. You can find articles on one topic written for different audiences — for parents, for kids, or for teens.

Office on Women’s Health

Thrush is a common breastfeeding issue, but sometimes it’s hard to know what’s thrush and what’s another breast infection or issue. Here, the OWH goes over numerous breastfeeding challenges, including fungal infections, clogged ducts, and mastitis.

American Academy of Pediatrics

The AAP is a professional organization of 67,000 pediatricians that strives to present complicated health and wellness info to parents in a user-friendly manner via its HealthyChildren.org website. The Symptom Checker feature — where parents can click on illustrations to find their way to answers — is especially helpful.