- Oral thrush is not uncommon but is rarely serious.
- Some people are at higher risk for developing this infection.
- Understanding the cause of thrush may help reduce the risk.
- A variety of treatments – including several that are natural – can offer quick relief.
Children with weak immune systems are more likely to get oral thrush infections. In adults, this condition can be an indication of more serious health concerns. Here we detail the causes and symptoms of oral thrush, as well as treatment options that are recommended by doctors.
What Is Oral Thrush?
Oral thrush – also referred to as oropharyngeal candidiasis – is a condition in which an overproduction of a fungus called Candida causes white spots or patches to appear in the mouth, on the tongue, gums, tonsils and/or in the throat. It is most commonly observed in young children and elderly people.
Candida, of which there are more than 150 species, is generally harmless, and is considered a beneficial flora in healthy people. It lives on the skin, in the mouth and in the digestive tract. More specifically, oral thrush is often linked to the Candida albicans strain.
Oral thrush can be transmitted in the following situations:
- When adults pass the infection back and forth through saliva
- When small children share toys
- In newborn babies who often contract the infection from their mothers during birth
Toronto, ON dentist Gary Glassman, D.D.S, FRDC(c), a vocal proponent of good oral care beyond healthy teeth and gums, confirms that thrush is indeed common in small children. He cautions however that “if it is diagnosed in older children, teenagers or adults, an underlying condition like diabetes should be considered.”
In most people, oral thrush does not pose a significant health threat and can be quite easily treated with a variety of natural remedies, although it may become a more serious concern for those who are at higher risk.
Factors That Increase the Risk of Oral Thrush
While even mild illnesses can increase the risk of thrush, the presence of more serious illnesses is more likely to trigger an outbreak. In the following cases, the body’s natural defense – the immune system – is weakened or compromised and cannot easily fight infection:
- HIV/AIDS — As many as 95% of people living with HIV/AIDS will experience oral thrush at some point over the course of their disease.
- Leukemia — Cancers like leukemia also have an effect on the immune system, leaving the body more susceptible to thrush.
- Diabetes — People with diabetes have higher levels of sugar in their saliva, which can lead to an environment welcoming to infections such as thrush. The risk is particularly high when diabetes is poorly controlled.
Several commonly-prescribed medications are also considered culprits that heighten risk:
- Antibiotics — Antibiotics are disruptive to the natural balance of ‘good’ bacteria in the body, which are needed to inhibit the development of thrush.
- Steroids — Steroids, particularly inhaled steroids to treat asthma or other respiratory diseases, also suppress the immune system.
- Birth control pills — The ‘estrogen dominance’ that results from taking oral contraceptives may leave women at greater risk for thrush.
Organ transplants and other medical interventions are also hard on the immune system, as is chemotherapy or radiation, particularly of the head and neck.
Nutrition plays a role as well. People who are malnourished, have dietary deficiencies like a lack of vitamin B12 or folic acid, and those whose diets are heavy in carbohydrates are at risk.
Other common risk factors include the following:
- Wearing dentures
- Mouthwash overuse
- Dry mouth resulting from medication use
Symptoms of Oral Thrush: What Should You Look For?
White spots or patches are the most obvious sign, and may appear on the insides of your mouth, gums or tongue. Other symptoms include:
- Raised lesions; some describe these as resembling cottage cheese
- A burning pain in the mouth
- Difficulty swallowing liquids or solids
- Taste alteration; salty, bitter, acidic or metallic tastes in the mouth
- Hoarseness, suggesting that oral thrush has affected the larynx or trachea
- A cotton-like feeling in the mouth
- Tooth enamel erosion
How to Prevent and Treat Oral Thrush
Prevention is key and can be addressed with the following simple, largely common-sense approaches.
- Brush your teeth with a soft toothbrush and use mouthwash (but don’t overuse it); warm salt water is a better choice. “Consider replacing your toothbrush everyday until the infection has cleared,” advises Dr. Glassman.
- Keep your dentures clean and ensure that they are properly fitted.
- If you use inhaled steroids for asthma, chronic obstructive pulmonary disease or cough, use a spacer or inhaler with the medication to reduce the amount of steroid that might contact mouth tissue; rinse your mouth with water after medication use.
- If you have a dry mouth, often the result of certain medications, drink plenty of water and suck on hard, unsweetened candies to stimulate saliva production.
- If you’re a smoker, consider adopting a quit plan that works for you.
- Reduce your sugar consumption, particularly if you are living with diabetes.
- Vary your diet to ensure an adequate intake of all essential nutrients, particularly B complex vitamins.
- Avoid a diet too high in carbohydrates.
- Enjoy probiotic yogurt, or cultured dairy products like kefir.
- Brew a cup of tea with a cinnamon stick in it (not recommended for pregnant women).
- Reach for unsweetened cranberry juice.
- Use garlic – it has antifungal properties.
- Some starchy vegetables, like sweet potatoes, squash, beets and carrots, particularly eaten warm, can combat the negative effects of candida.
- Fermented vegetables like sauerkraut and pickles can help boost the levels of healthy bacteria in your body.
If you have had thrush before, you likely know the symptoms, and may know how to treat it. However, Dr. Steven Golubow, DMD, who runs a busy family and cosmetics dental practice in Macon, GA, notes that it is always important to check with a licensed healthcare provider before embarking on any treatment plan.
“Typically,” he says, “thrush is treated with antifungal medications like nystatin, miconazole, and amphotericin B, products that must be prescribed by a physician.”
They may be available as drops, tablets or lozenges. For more aggressive cases of oral thrush, intravenous administration may be recommended.
Home Remedies to Combat Thrush
Mild cases of oral thrush can be quickly controlled using a variety of home remedies.
- Salt water
A salt water rinse creates an environment unfriendly to oral thrush and therefore presents an easy, effective and inexpensive remedy. Dissolve up to a teaspoon of salt into 1 cup of warm water and gargle with a fresh blend several times a day. You can also rinse your mouth with a diluted solution of 3% hydrogen peroxide.
- Baking soda
Creating a paste by adding a tablespoon or two of water to baking soda is another simple way to ease symptoms. Apply the paste to your tongue or the sides of your mouth; allow it to soothe your discomfort/pain for a few minutes before you rinse it away. You can do this several times a day for a few days.
- Apple cider vinegar
Touted as a cure for many conditions, apple cider vinegar can help reduce thrush symptoms due to its antifungal properties, and help restore the body’s normal pH level. Drink it daily (1 tablespoon mixed into 8 ounces of water) for relief of symptoms.
- Coconut oil
Coconut oil is known to have antimicrobial properties that combat the yeast associated with thrush and has been found to be active against several species of candida. It can be applied on the affected areas with a cotton swab several times a day. A nursing mother can use raw virgin coconut oil on her nipples and on her baby’s mouth to prevent spreading thrush.
With coconut oil, you may also try a technique called oil pulling. This involves swishing a tablespoonful of oil around your mouth for 10 minutes before spitting it out and rinsing with warm water. According to Dr. Glassman, “oil pulling with raw virgin coconut oil has become a big trend in oral care over the last year and can be helpful in this instance.”
- Essential oils
Oregano, myrrh and clove essential oils can effectively fight thrush with their antifungal and antibacterial properties. Clove oil, for example, says Dr. Golubow, “has long been used in dentistry as an analgesic and antiseptic.”
One final word of advice: Dr. Golubow cautions patients to read the labels for any homeopathic or natural remedy carefully. “Some websites advise using borax to treat symptoms of thrush, which can be harmful and potentially deadly if ingested in large quantities or by small children. And some homeopathic recommendations are more preventive than curative. There is not yet sufficient research to support or refute the efficacy of homeopathic remedies.”
- Centers for Disease Control and Prevention: Candida Infections of the Mouth, Throat, and Esophagus (2017) cdc.gov/fungal/diseases/candidiasis/thrush/index.html
- Oral Candidiasis (2002) pmj.bmj.com/content/78/922/455
- Singh, A., Verma, R., Murari, A., & Agrawal, A. (2014). Oral candidiasis: An overview. Journal of Oral and Maxillofacial Pathology : JOMFP, 18(Suppl 1), S81–S85. doi.org/10.4103/0973-029X.141325