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Encyclopedia -> Disease -> O -> Oral thrush Alternate Names: Candidiasis - oral; Moniliasis - oral Causes and Risks: The mouth normally contains many microorganisms. One of these normal microorganisms is the fungus Candida albicans, which is the same fungus associated with vaginal yeast infections or other Candida infections. The growth of Candida is normally kept under control by the presence of normal bacteria. Uncontrolled overgrowth of Candida in the mouth may be caused by factors that reduce the natural resistance, such as illness, stress, long-term use of corticosteroids or medications that suppress the immune system, and immune disorders such as AIDS. It may also be caused by conditions that upset the balance of normal microorganisms in the mouth. This is most commonly associated with use of antibiotics but it may also occur with uncontrolled diabetes mellitus and with the hormonal changes associated with pregnancy or the use of birth control pills. Oral thrush is most common in infants and toddlers, in the elderly, and in people who are debilitated or whose immune system has been suppressed by disease or medical treatments. Thrush in infants is common and is usually not associated with other disease. Infant thrush that resists treatment or recurs frequently should raise suspicions for an underlying disorder. In adolescents, young adults and middle age adults, an oral Candida infection should always be viewed as a possible symptom of an underlying medical problem such as diabetes or HIV infection and should be evaluated. Prevention: People with recurrent outbreaks of oral thrush, or those who are at very high risk for development of the disorder, may be given prophylactic (preventive) antifungal medications. If an infant who is breast feeding has oral monilia, the mother also should use a topical antifungal medication on her nipples to prevent continuous spread to the infant. In bottle fed babies, discard the nipples and buy new one as the babies mouth begins to clear, because the fingus may get into the nipples and can not be easily eradicated. Good oral hygiene is important in controlling the disorder. Avoid overuse of mouthwash, mouth sprays, etc. which may upset the balance of microorganisms in the mouth. Symptoms:
Signs and Tests: An examination of the mouth by the health care provider or dentist shows distinctive lesions of the mouth, tongue, or cheeks. Lesions are easily brushed away revealing a reddened, tender area that may bleed slightly. A microscopic examination of tissue from a lesion confirms Candida infection. Treatment: The goal of treatment is to control the rapid growth of Candida. Antifungal medications such as nystatin, clotrimazole, miconazole, etc. are given for 7 to 10 days. Underlying conditions/disorders should be identified and treated. Good oral hygiene is important to aid healing. Patches may be gently brushed off with the toothbrush. Warm salt water rinses (1/2 teaspoon of salt in one cup of water) may be soothing. Prognosis: For infants, oral thrush may be painful but is rarely serious. It can interfere with eating because of the discomfort. The infection is usually controlled with treatment, but it may recur. Thrush may spread to the palate, tongue, cheeks, or throat. Other spread of the infection is uncommon but it may occur. For adolsecents and adults, the significance of thrush is dependent on the underlying disorder. Complications:
Infants: If your infant has thrush a period of watchful waiting may be appropriate since uncomplicated thrush is frequently self-limiting. If the condition does not resolve in 2 weeks call for an appointment with your health care provider. Adolescents and adults: If you think you have oral thrush, call for an appointment with your health care provider. If you are being treated for thrush and symptoms worsen or persist despite treatment, symptoms recur, or new symptoms develop call your physician.
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