Oral thrush is also known as oral candidiasis is a fungal infection of the mouth which can involve the buccal  mucosal , the tongue, inner lips and the gum. It is a common condition that usually doesn’t result in major complications. It is caused by the fungus Candida. Candida is a normal commensal or organism in the human body. However certain factors that aid excessive growth of the organism leads to the development of oral thrush. It commonly affects children but when it is seen in adults an underlying condition should be suspected

Risk factors

The following factors increase the likelihood of having an oral thrush

  • Long term corticosteroid use
  • Chemotherapy or radiotherapy
  • Diabetes
  • HIV/AIDS
  • leukemia
  • Wearing of dentures
  • Use of any immunosuppressive drug e.g. during organ transplant
  • Excessive antibiotics use
  • Excessive use of mouthwash
  • Smoking
  • Malnutrition
  • Term woman with vaginal candidiasis; she can spread the infection to the baby during delivery. This usually occurs within 10 days of delivery (incubation period of candida).

Signs and symptoms

Whitish patch in the mouth most especially the tongue. The white patch is not readily removable unlike milk patch seen in breast fed babies which can be easily scrapped off

  • The white patches can come together to form a large grey or yellow region known as a plaque
  • There might be redness of the buccal mucosa
  • Bleeding when patch is scrapped off
  • Difficulty with swallowing
  • Dry and cracked skin at the corners of the mouth
  • Pain at the site of the infection

Diagnosis

This can be done by taking some history and by inspecting the oral mucosa Confirmation can be done by taking a part of the patch for biopsy.

Treatment

Oral thrush should be promptly and effectively treated so as to avoid spread of the infection.

Medical treatment includes the use of oral anti-fungal drugs such as; fluconazole, nystatin, itraconazole .

Home remedies that can also be used include;

  • Consumption of unsweetened yoghurt to restore and maintain healthy levels of bacteria in the mouth
  • Use of white distilled vinegar and/or a dilute baking soda (1 tsp/8 oz water) to mother’s nipples.
  • If a breastfeeding baby has oral thrush it is important to treat both the mother and the baby to avoid reinfection. An antifungal cream can be applied to the mother’s breast.

Treatment of underlying disease is important in the management of oral thrush.

Prevention

  • Nursing mothers should avoid use of damp nursing pads and avoid wearing wet cloths.
  • Properly wash feeding bottles and pacifiers
  • Patients on long term oral corticosteroids should ensure they wash and rinse out their mouth after use of medication. They can also make use of a spacer.
  • Avoid excessive use of mouthwash.
  • Proper control of blood sugar levels especially in diabetic patients
  • Properly clean dentures before and after use.