Thrush

What is thrush?

Thrush is a yeast infection. It occurs on your tongue and the lining of your mouth. It can occur in both newborns and adults with certain health conditions.

Symptoms of thrush

For newborns, the signs of thrush include:

  • White, creamy patches on their tongue or in their mouth.
  • Red or dry mouth.
  • Trouble nursing, due to mouth pain.
  • Diaper rash (rarely).
  • Fussy mood.
  • On the nursing mother, symptoms of a yeast infection include cracked, red, itchy, sore, or tender nipples.

For adults, the main symptom of thrush is the sores, or patches. These can bleed if you scrape them or when you brush your teeth. You also may have pain when swallowing.

What causes thrush?

Thrush is caused by the fungus, Candida. Although everyone has germs in their mouth, your immune system works to regulate them. You can have too much Candida. Having too much of this fungus causes the oral thrush infection.

Thrush is most common in newborns because their immune systems are still developing. Newborns also can sometimes have thrush at birth if their mother had a vaginal yeast infection at the time of delivery.

Children and adults can get thrush too. Your risk of thrush increases if you:

  • Are in poor health.
  • Have a weak immune system.
  • Have HIV or AIDS.
  • Have chemotherapy treatment.
  • Have had an organ transplant.
  • Have diabetes.
  • Take several antibiotics (too much can kill the good bacteria that helps regulate candida).
  • Take steroid medicine (some inhalers for asthma and chronic obstructive pulmonary disease, or COPD, contain steroids).
  • Take other medicines that dry the mouth.
  • Wear ill-fitting dentures.
  • Are a smoker.

How is thrush diagnosed?

Thrush is easy for a doctor to diagnose. He or she will look at your tongue and mouth to check for sores. The doctor may scrape one of the sores to get a sample to examine. If you have sores in your throat, your doctor may do a throat culture to examine the fungus.

Can thrush be prevented or avoided?

You can help prevent thrush by practicing good oral hygiene. Brush your teeth, and floss every day. If you use an inhaler, rinse your mouth out after each use. People who have diabetes need to monitor their blood sugar. When your blood sugar is high, extra sugar collects in your saliva and fuels candida. If you are at risk of getting thrush or have chronic thrush, talk to your doctor about ways to manage the condition.

You cannot avoid newborns from getting thrush, but you can help lower their risk.

  • Clean and disinfect all bottle and feeding parts after each use.
  • Clean and disinfect pacifiers and toys that babies put in their mouths.
  • Change your baby’s diapers often. This can prevent yeast infections and diaper rashes.
  • If you have a yeast infection on your nipples while breastfeeding, talk to your doctor and get treatment.
  • If you have a vaginal yeast infection during pregnancy, talk to your doctor and get treatment.

Thrush treatment

Your doctor will decide if you have a mild or severe case of thrush. Even mild cases should be treated by your doctor. After treatment, you can try to prevent getting thrush again by eating yogurt and taking acidophilus pills. These pills are sold over the counter. They help balance the good and bad germs in your mouth. Replace your toothbrush to avoid bad germs. If you have diabetes, you’ll need to lower your blood sugar level.

Severe cases require prescription antifungal treatment, such as:

  • medicine (in either pill or liquid form)
  • mouthwash
  • lozenges

The same is true for newborns. Mild cases of thrush may resolve on their own, but your doctor will help you decide if that’s an option in your case. If you have a yeast infection on your nipples while breastfeeding, you also will need treatment. The doctor can prescribe an antifungal cream to apply. If you don’t treat the infection, you can continue to pass it to your baby. Most cases of newborn thrush are treated with prescription antifungal medicine. Often, these are drops that you apply to your baby’s tongue and mouth.

Living with thrush

For most people, oral thrush goes away with treatment. However, it is possible to get chronic, or recurring, thrush. This is more common if you have a weak immune system or related health issue. Talk to your doctor about how to manage thrush. You may need to take an ongoing antifungal medicine.

If thrush is left untreated, the fungus candida can sometimes spread. It can cause infection in your:

  • esophagus (esophagitis)
  • eyes (endophthalmitis)
  • brain (meningitis)
  • heart (endocarditis)
  • joints (arthritis)

Questions to ask your doctor

  • How dangerous is thrush?
  • Is thrush contagious?
  • How long do I have to take antifungal medicine?
  • What can I take, or give my children, for the pain?
  • Do you have any tips for breastfeeding a newborn that has thrush?