Oral Thrush - Symptoms, Risks, Diagnosis, treatment, and Prevention

Introduction

Oral thrush is also known as candidiasis, oropharyngeal candidiasis, or thrush on the tongue. This condition is more widely seen in infants and old adults as they are known to have weaker immune systems. The fungus Candida albicans is a common inhabitant of various parts of our body, like the oral cavity, vagina, and throat. However, in some people with weaker immune systems, this fungus is known to multiply more severely and is known to cause several symptoms.

What is Oral Thrush?

Oral thrush is a condition of the oral cavity characterized by forming a creamy white layer in the inner cheeks, tongue, and throat. The fungus Candida albicans is a common inhabitant of the oral cavity, throat, and vagina. It does not cause any problems for most people. However, in people with weaker immunity levels, the multiplication of the fungus Candida albicans is more rapid and hence causes symptoms. It causes minor symptoms and can be cured by proper treatments. In very few cases, unmanaged candidiasis can result in more severe complications.

When Candida albicans affects the mouth and throat, it is called oropharyngeal candidiasis. When Candida albicans affects the esophagus (food pipe that connects the oral cavity and stomach), the condition is called esophageal candidiasis. Oral thrush is more commonly seen in patients infected by HIV.

What Are the Common Signs and Symptoms of Oral Thrush?

The signs and symptoms of oral thrush, candidiasis, or thrush on the tongue are almost the same among infants and adults.

The most common signs and symptoms seen in patients with oral candidiasis are as follows,

• Creamy white lesions are seen on the roof of the mouth, inner layers of the cheek, tongue, tonsils, and throat.

• Bleeding on scraping the white lesions is also evident.

• A cottony feeling in the mouth.

• Loss of taste as the layers of accumulated Candida albicans cover the taste buds.

• Raised white creamy lesions.

• Pain on swallowing or inability to swallow.

• Cracked red corners of the mouth.

What Are the Early Signs of Oral Thrush?

Oral thrush symptoms might be very subtle, so many people could not detect the signs on time. Identifying these precursors early enough to specify the treatment that will enter it immediately is important. Early signs may include:

• Red and White Lesions on the Tongue: White and creamy patches on the tongue are one of the main early symptoms of oropharyngeal thrush. These can have a cottage cheese-type appearance and sometimes be a little elevated. Patches can also appear on other parts of the mouth, including the inside of the cheeks, gums, tongue, and roof of the mouth or tonsils.

• Mild Irritation: At first, you might feel a slight burning or tingling in your mouth. This may be even more noticeable in spicy or acidic foods.

• Redness and Soreness: Red and sore patches can also develop in the mouth, tongue, or other areas along with white patches. Well, this can give the appearance of a "sore" or "raw" mouth that is tender to touch, especially around the areas where the white lesions are.

• Loss of Taste: Others lose taste or have different-tasting food. This can occur if the fungus strikes the taste receptors on your tongue.

• Angular Cheilitis: Cracking or redness at the corners of the mouth. Occasionally, oral thrush may give rise to large cracks or red sores at the corners of the mouth. This is also called angular cheilitis and can be yet another candida symptom.

• Dry Mouth or Cottony Feeling: Another possible symptom is a sensation of dryness or cotton in the mouth as if something were in the mouth or on the tongue. This can make swallowing difficult and make the mouth feel sore.

Who Is at the Risk of Getting Oral Thrush?

Though fungus Candida albicans is a common inhabitant of the oral cavity, not everyone is affected by oral thrush. People with compromised immunity are affected by oral thrush.

• Immunity is known to be compromised in infants below one year of age.

• Immunity is also known to be compromised in older adults who wear dentures.

• Cancer patients.

• People affected by HIV are known to develop oral thrush due to compromised immunity.

• People on long-term antibiotics and corticosteroids.

• Inhaled corticosteroids in asthma patients may cause oral thrush.

• Unmanaged diabetes.

• Uncontrolled smoking habit.

• Intake of drugs that causes dry mouth.

How to Diagnose Oral Thrush?

The diagnosis of oral thrush or thrush on the tongue depends upon the site of involvement. For proper management, the underlying cause of oral thrush should also be diagnosed.

• Oral examination of the lesions by the general physician or dentist.

• A slight scraping of the white lesion is done. Oral candidiasis lesions are known to have mild bleeding on scraping.

• Sending the scraped lesion to a laboratory to be viewed under a microscope.

• Endoscopy is done in case of candidiasis of the throat.

• Specific blood tests are required to determine the underlying cause of oral thrush.

How to Treat Oral Thrush?

The oral thrush treatment depends upon the causes and severity of the oral thrush. If any drug like corticosteroids causes oral thrush, the drug is withdrawn from the patient for a few days until complete recovery. In most cases, an antifungal drug is prescribed.

Antifungal drugs include,

• Clotrimazole.

• Miconazole.

• Nystatin.

These antifungal medications can be prescribed to the lesions or given to swish in the mouth and then swallow.

• Fluconazole is prescribed in more severe conditions or cases when the candidal infection has spread to the esophagus. It can be given intraorally or intravenously.

What Are the Preventive Measures for Avoiding Oral Thrush?

The following steps can prevent oral thrush:

• Practice Good Oral Hygiene: Practice good oral hygiene by brushing and flossing. Replace your old brush with a new one after recovery, and never share your toothbrush with others.

• Disinfect Dentures: Denture wearers can develop oral thrush due to poor hygiene and improper maintenance of dentures. Disinfect and rinse your dentures every day, and always make sure to remove them at night before sleep.

• Gargling With Disinfectant Solutions: Use good disinfectant solutions to gargle your mouth regularly.

• Have a Balanced Diet: Poor food habits cause reduced immunity, which can lead to oral thrush. Therefore, maintaining a balanced diet with food rich in vitamins and minerals is crucial.

• Quit Smoking: Smoking habits lead to various oral and general healthcare problems, and hence, it is mandatory to quit smoking to lead a healthy and long life. Oral thrush or oral candidiasis is more commonly seen among chronic smokers. Therefore, try reducing the frequency of smoking and slowly quitting smoking habits will help reduce the risk of oral thrush.

What Are the Home Remedies for Oral Thrush?

Saltwater Gargling:

• Saltwater gargling can help with oral thrush as salt has antiseptic and soothing properties.

• Mix half a teaspoon of salt in a glass of warm water.

• Swish the solution in the mouth for a few minutes, and do not swallow.

• Spit the solution in a few minutes.

Baking Soda:

• Mix half a teaspoon of baking soda in a glass of warm water.

• Swish in the mouth and spit it after a few minutes.

Apple Cider Vinegar:

• Apple cider vinegar can be used as a home remedy for oral thrush.

• Mix one teaspoon of apple cider vinegar in a glass of water.

• Swish the solution in the mouth for a few minutes and spit the mixture out.

Conclusion

As oral thrush is known to be contagious, proper preventive measures should be taken to prevent the spread of infection. Accurate diagnosis of the cause of oral thrush and effective treatment can help speed up recovery from it.