What Is Thrush?
Medically reviewed by Lyndsey Garbi, MD
Thrush is a fungal infection caused by the overgrowth of a type of yeast called Candida. Candida lives on the skin and inside the body, usually without causing problems. But under certain conditions, like when your immune system is weakened, Candida can multiply and cause an infection in moist areas of the body. When this occurs in the mouth and throat, it is called oral thrush or oral candidiasis—sometimes simply referred to as thrush.
A main symptom of thrush is white patches on the tongue, inner cheeks, and throat. You may also have redness and soreness in the mouth. Antifungal medication is the most common treatment for thrush.
Thrush is uncommon among healthy adults. But certain populations, such as infants, denture wearers, and people with diabetes, may be more likely to develop the infection.
Thrush Symptoms
Symptoms of thrush vary depending on the severity of the infection. Thrush symptoms can include:
White, velvety patches on the tongue, inner cheeks, and throat
Soreness and redness in the mouth and throat
Difficulty chewing food or swallowing
A cottony feeling in the mouth
Loss of taste
Redness and cracking at the corners of the mouth
Burning sensation on the tongue or throat
Bleeding when scraping the white patches and brushing your teeth
Thrush is common in infants because their immune systems are still developing. Symptoms of thrush in infants can include:
White, creamy patches on the tongue and mouth
Redness in the mouth
Fussiness
Trouble feeding due to pain
Diaper rash
What Causes Thrush?
An overgrowth of the Candida albicans fungus can cause thrush. Candida albicans is naturally present in your mouth, digestive tract, and skin and does not usually cause problems. That's because your immune system and good bacteria keep the fungus from growing out of control. However, if your immune system is weakened or you do not have enough good bacteria, Candida can multiply and lead to thrush.
Certain health conditions, medications, and lifestyle habits that weaken the immune system or disrupt the normal balance of bacteria, fungi, and saliva in your mouth can create opportunity for thrush to develop.
Risk Factors
Anyone can develop thrush, but certain risk factors can make you more vulnerable, such as:
Taking antibiotics, which kill some healthy bacteria in the mouth
Having a weakened immune system
Taking steroid medications, including inhaled corticosteroids for asthma and chronic obstructive pulmonary disease (COPD)
Maintaining poor oral hygiene
Wearing dentures
Having dry mouth due to a medical condition or certain medications you take
Smoking
Undergoing cancer treatments, such as chemotherapy or radiation
Having diabetes
Having nutritional deficiencies, such as low levels of iron; zinc; magnesium; folic acid; or vitamins A, B6, B12, and C
Oral thrush is more common in infants because their immune systems are not yet fully developed. In older adults, age-related changes in the immune system and underlying medical conditions can increase the risk of thrush.
How Is Thrush Diagnosed?
Healthcare providers can usually diagnose thrush by examining the mouth and throat to look for the classic signs, such as white patches on the tongue and inside the cheeks. Your healthcare provider may gently scrape one of the sores to obtain a sample and send it to the laboratory for testing.
Severe thrush infections can sometimes affect the esophagus, which is the tube that carries food and liquid from the throat to the stomach. Thrush of the esophagus is one of the most common infections among people with HIV/AIDS. If your healthcare provider suspects your esophagus has a Candida infection, they may order additional tests.
One such test is a throat culture. For this, the provider will gently scrape the back of your throat with a cotton swab to obtain a sample of cells. The sample is sent to the lab for analysis on what is causing the infection.
A provider may also order an endoscopy. For this diagnostic procedure, a long, flexible tube equipped with a light and camera is inserted into the mouth and throat to visualize the esophagus and look for signs of thrush.
Treatments for Thrush
Thrush is usually successfully treated with antifungal medication. The type of medication can vary depending on the severity of the infection and your overall health. For most people, oral thrush usually clears within one to two weeks of treatment.
Antifungal medications prescribed to treat thrush include:
Nystatin: Available in antifungal mouthwash, lozenge, and topical cream forms
Clotrimazole: Taken as a lozenge that dissolves in the mouth
Miconazole: Taken as a dissolvable tablet or applied topically
Sporanox (itraconazole): Available in liquid or syrup forms
Diflucan (fluconazole): Available in tablet form or given intravenously (through a vein) for more severe infections
Over-the-counter probiotics, like acidophilus supplements, might help with thrush, as well. Talk to your healthcare provider to determine if at-home treatments will suffice to clear up your thrush or would be good to use in conjunction with other treatment.
How to Prevent Thrush
If you are at higher risk for thrush or tend to get it over and over, a healthcare provider might prescribe you an antifungal to take on a regular basis to prevent thrush. The medication would kill fungus or slow its growth.
Older adults can talk to their healthcare provider about taking a probiotic, as that might help prevent the fungus from growing.
You may also be able to prevent thrush my mitigating risk factors. For instance, if you have diabetes, you try managing your blood sugar the best you can. And if you use inhaled corticosteroids, rinse your mouth or brush your teeth after using them.
Other than practice good oral hygiene, there is not much else that someone not at increased risk for thrush needs to do—or even can do—in terms of prevention.
Complications
One complication of oral thrush is that it can spread to the esophagus. This complication is particularly common among people with HIV/AIDS.
When left untreated in people who are immunocompromised, thrush can lead to serious complications. Systemic candidiasis, or invasive candidiasis, can occur if Candida spreads throughout the body. This can cause serious and potentially life-threatening problems with the blood, brain, bones, eyes, heart, and other parts of the body.
Living With Thrush
Most cases of thrush can be successfully treated with antifungal medications, and symptoms typically soon resolve. Recurrent thrush may require longer-term treatment and monitoring.
While thrush can be uncomfortable and inconvenient, there are ways to manage the infection and improve quality of life while waiting for the infection to pass. Research shows that gargling or rinsing your mouth with apple cider vinegar may help soothe symptoms of oral thrush and help combat the Candida overgrowth.
You can also try to eat foods that wouldn't cause as much pain. You can:
Eat soft foods
Avoid hot or alcoholic drinks
Use honey as a sweetener instead of sugar
Talk to your healthcare provider if you continue to have symptoms after taking all your medication or symptoms get worse.
Frequently Asked Questions
Does thrush go away by itself?
Thrush typically requires treatment with antifungal medications to resolve fully. Left untreated, oral thrush can last for months or even years. Untreated thrush can also increase your risk of serious complications.
How long does oral thrush last?
The duration of oral thrush can vary depending on the infection's severity and the treatment's effectiveness. In most cases, the infection should fully resolve within two weeks of treatment.
Is it bad to kiss with oral thrush?
Oral thrush is not contagious, but open-mouthed kissing can spread bacteria and yeasts, such as Candida, from one person to another. While you won't spread thrush from kissing, you can pass the yeast onto another person, and they may develop thrush if they have any of its risk factors.
Should you brush your teeth if you have oral thrush?
Yes, brushing your teeth twice a day if you have oral thrush is recommended to maintain good oral hygiene and remove any plaque or debris that may contribute to the infection. Use a soft-bristled toothbrush to avoid irritating the affected areas and causing further discomfort. Rinse your mouth with water or a saltwater solution after brushing to help soothe any soreness or inflammation.
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