When candidatis or any other fungal infection occurs in the mouth it’s called oral thrush. Many people carry candida in their mouths, but it is only when it disrupts the balance and invade the host’s tissue that it can come to evolve into a noticeable condition. The appearance of the infection can look different depending on what fungi it is that is causing the infection, but it mostly occurs as white or yellowish patches on the buccal mucosa, palate or tongue.

What’s on this page?

The thrush is caused by an exacerbated state of naturally occurring fungi in the mouth. Some see an oral thrush as a mere shift in the balance of the normal environment in the mouth, rather as an infection as such. The reason only some people get the more adverse effects of candida is that not all forms of it have the capability to stick to the mouths mucous.

What is oral thrush? 

Symptoms of oral thrush are:

  • White patches that are looking like curdled milk or cottage cheese in the mouth cavity (tongue, inner cheeks, gums, tonsils)
  • Slight bleeding when the patches are wiped
  • Tenderness in the affected area
  • Difficulty swallowing
  • Metallic, bitter or other funny taste in the mouth

The lesions are often not causing any pain or discomfort, but a slight burning sensation can sometimes be experienced. Another tell-tale sign is that one might have a metallic, salty or bitter taste in the mouth. In some cases, one can have difficulty swallowing or getting a hoarse voice. Candida can also cause other issues, such as inflammation of the corners of the mouth, dentures and inflammation of the gums, but mostly no other symptoms can be noticed except the lesions.

The condition can be both chronic and temporary, depending on the cause. It sits on the mucous membrane in the mouth, but the different forms of thrush can have different characteristics, so let’s have a look at the most common ones.

Pseudomembranous candidiasis

This form of candidiasis can be identified through a coat of white or light yellow patches. The patches can be wiped away and leave the mucous tissue red and sometimes bleeding. This is said to be the most common form of thrush, making up for about 35% of the cases.

Erythematous candidiasis

The erythematous form of fungi infections manifests as red and damaged sores. If it appears on the tongue it can leave smooth surfaces where the papillaes (the bumpy texture of the tongue) are lost. It is connected to use of steroid inhalers, corticosteroids, antibiotics and dentures.

Hyperplastic candidiasis

This form of candidiasis is characterized by a white plaque on the mucus that cannot be wiped off and the lesions might be rough or bumpy. This form is not common and when found it is often chronic. This condition is often hard to distinguish from leukoplakia.

Who can be affected?

Candidiasis can affect anyone, but there are some groups that are more susceptible than others. This can be the case if the affected person is:

  • Taking antibiotics
  • Taking immunosuppressant medications or have a disease compromising the immune system
  • Using topical corticosteroids or aerosol
  • Consuming a diet high in carbohydrates
  • Wearing dentures
  • Having a dry mouth
  • Smoking
  • Diabetes

The most common age group to be affected is infants, with lower rates in adults and newborns. When the body’s natural defences are compromised the risk of contracting this condition is raised, so it is more common in the very young and people who are sick or elderly.

Candidiasis can spread from person to person, for example through sexual contact.

Diagnosis

Many times candidiasis can be diagnosed only by appearance, but in some cases, further tests might be required, such as oral swabs, oral rinse or smears. In some situations, you might be tested for underlying conditions, so the candidiasis specific tests might be accompanied by blood tests.

Treatment options

The treatment of candidiasis is based on anti-fungal drugs of different forms, for example, fluconazol. After the treatment is initiated it will normally take a few weeks for the thrush to disappear. If you have lesions there are some cases where they might require surgery if the anti-fungal treatment is not efficient.

You can take measures to prevent reinfection through oral hygiene measures, such as regular toothbrushing and use of anti-microbial mouthwash or salt water wash. It is important that you treat your candidiasis, since it can spread to other parts of the body. It is believed that most cases of candidaitis are harmless, but some exacerbated states of the condition have been proven fatal.

If the cause of your oral thrush is a low immune defence, this can be treated as well to prevent a new infection. If you have a compromised immune system, such as if you have HIV/AIDS or have gone through chemotherapy, there are system medication that can help you prevent fungal infections.

If corticosteroids or antibiotics are the reason for the outbreak, it is not always ideal to stop the treatment but in some cases it is possible. If you have been using an inhaler you can rinse your mouth after use to prevent oral thrush.