Thrush

Thrush is a yeast infection caused by Candida, also known as Monilia. Most of us have yeast on our skin, and in our mouth and digestive tract. It usually does not cause a problem because normal bacteria keeps it from growing out of control. But if this balance is disturbed by an illness, medications, or stress, Candida can cause an infection known as oral thrush. It can also cause diaper rash in infants or a vaginal yeast infection in women.

Oral thrush appears as creamy, white, curd-like patches on the surface of the tongue, sides of the mouth, gums, back of the throat or tonsils. It can cause reddened, raw areas that are painful. These areas may sting or burn when hot or acidic foods are eaten. Thrush is contagious, so care needs to be taken to keep from passing it on to others.

It is often found in newborns and infants, since their immune system is not developed enough to fight infections. Newborns come in contact with the yeast in their mother's vagina during birth and infants can get it from close contact with other family members. Thrush is rare during the first week of life. It is more common after the 4th week and usually not seen after 6 to 9 months. However thrush can occur at any age.

Thrush can result from:

• smoking
• wearing poorly fitted dentures
• coming in contact with infected items (such as diapers, pacifiers, or toys)
• taking antibiotics, steroids, or birth control pills for a long period of time (These destroy the normal balance of bacteria in the mouth, allowing an overgrowth of yeast.)
• a weakened immune system, caused by HIV/AIDS, cancer, diabetes and other immune disorders. Because the immune system is unable to fight the infection, thrush can be more severe, widespread, and difficult to control.

Thrush is usually diagnosed by just looking at the patches or by examining a small sample under a microscope. Oral thrush often flares up and then goes away on its own. Mild cases can be treated by gently removing the white patches from the mouth with a cotton swab. This removes the yeast and allows the "good" bacteria to grow.

If you are breastfeeding an infant who has oral thrush, you both need to be treated. Otherwise, you may pass the infection back and forth. Your healthcare provider may order a mild antifungal medication for your baby and an antifungal cream for your breasts. Breast shells may allow sore nipples to rest and dry between feedings. Breastfeeding should continue if at all possible. If you get thrush when taking antibiotics, try eating unsweetened yogurt or taking acidophilus capsules to help restore the natural balance of bacteria. Acidophilus is available in natural food stores and drug stores.

For persistent or severe cases, an antifungal antibiotic liquid, such as Mycostatin, Nystop, Diflucan, or Lotrimin may be needed. These liquids may be swished in your mouth, applied directly to the patchy areas, or placed inside the cheek of children. They should be given after meals and without any other liquid, so they will stay in contact with the affected areas longer. The treatment should be continued for 2 days after the infection appears to have cleared. These are also available in lozenges.

In severe cases, thrush may spread downward into the esophagus, the tube that leads to your stomach. If that occurs, you may have pain, difficulty swallowing or a feeling that food is stuck in your throat or mid-chest. If this occurs, you need to see your provider. If thrush occurs, it should be evaluated and treated by a provider as soon as possible. Those who get thrush often, due to a chronic condition, may be given daily medication to keep it from coming back.

To prevent thrush, keep these tips in mind:

• be careful, when changing diapers, not to transfer thrush from the mouth to the diaper area or from a diaper rash, caused by thrush, to the mouth
• follow good hygiene, including careful hand washing and disposal of nasal and oral secretions
• notify child care workers that a child has thrush, so extra precautions can be taken
• sterilize all bottles, nipples, pacifiers, and teething toys by boiling for 5 minutes, then boil everything again once the thrush has disappeared
• eat yogurt or take acidophilus capsules when taking antibiotics
• treat any vaginal yeast infection that develops during pregnancy as soon as possible
• if you smoke, ask your healthcare provider for ways to quit
• see your dentist every 6 to 12 months, especially if you have diabetes or dentures
• brush and floss your teeth after every meal
• limit the amount of sugar and yeast-containing foods you eat (such as bread, beer and wine)

See your healthcare provider if thrush does not go away on its own or tends to recur.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File DENT4380.rf2 VRS# 4380 Data Version 7.0 Copyright 1999, 2003 McKesson Health Solutions LLC. All rights reserved.