Typically, the type of yeast causing the infection is the fungus, Candida albicans, yet other types of candida can lead to an oral thrush infection. In addition to the mouth, an oral candida infection can also be present in other mucous membranes of the esophagus and throat.
While typically speaking oral thrush is not something to be concerned about in healthy people, in some cases, oral thrush can become severe and problematic. This is especially seen in people who are immunocompromised, have certain health conditions that may make them more susceptible to infection, or those taking certain types of medications.
- Oral thrush is most commonly seen in infants and immunocompromised older adults.
- In the case of breast-fed infants, thrush can be passed from mother to infant or infant to mother during feeding.
- Treatment of oral thrush depends on several factors including the severity of the condition and general health.
Is thrush contagious?
It is not contagious in adults who are not otherwise at risk.
Certain individuals may be at a higher risk of developing thrush:
Who is at risk of developing thrush?
While oral thrush is not contagious in most adults, some may be at more risk of developing it, including those taking antibiotics or steroids.
Oral thrush in infants is common, especially within the first months of life. Infants at an even higher risk for developing thrush may include those who:
- are taking antibiotics or steroids
- are immunocompromised
- were born at a very low birth weight
In children who develop more chronic yeast infections or oral thrush, immunodeficiency may be the cause.
An example would be a child with human immunodeficiency virus (HIV) infection or another condition, which causes their immune system to not work to its fullest capacity and makes them more susceptible to infection.
Other risk factors for developing oral thrush in all age groups include:
- denture use
- certain medical conditions like diabetes, HIV, AIDS, or cancer
- treatment of cancer with chemotherapy or radiation
- organ or tissue transplant patients
- antibiotic or steroid use, including the use of inhalers for asthma containing corticosteroids
- dry mouth either from medication use or certain medical conditions
How is thrush transmitted?
While oral thrush in adults is not considered contagious, thrush can be passed back and forth from mother to infant during breast-feeding.
Mothers can have yeast on the nipple that is spread to the infant, or the infant passes thrush to the nipples during breast-feeding. Both may need to be treated.
Even though oral thrush in adults is not considered contagious, the yeast fungus can be spread through kissing. However, a yeast infection in itself may or may not occur.
Whether the uninfected person develops a yeast infection will depend on their current health status, medication use and other risk factors, which would place the person at risk for developing thrush.
Oral thrush may cause painful white patches on the tongue.
Image credit: James Heilman, MD, (2014, January 18)
Symptoms of oral thrush may include:
- painful, white-yellow patches in the mouth, on the tongue, lips, gums, roof of the mouth, tonsils and inner cheeks that may bleed when touched
- raised lesions with a white texture like cottage cheese
- painful swallowing or feeding if the infection is also present in the esophagus
- white tongue
- redness or soreness of the mouth
- a feeling of cotton in the mouth
- taste changes including loss of taste or a metallic taste
- cracking or redness in the corners of the mouth
- denture stomatitis in denture wearers that causes redness, irritation, and pain under the denture line
Some infants may also have a simultaneous yeast diaper rash. Nursing mothers may show symptoms of a breast yeast infection with symptoms like:
- red, cracked, or itchy nipples
- nipple sensitivity and pain which is typically during nursing and between feedings
- breast skin changes like shiny or flaky skin on the areola
- pain deep in the breast described as stabbing
Treatment and outlook
Thrush is typically treated with an oral antifungal medication, which is either applied directly to the affected area or swished in the mouth. In some cases, oral tablets, or, rarely, intravenous antifungals may be required in more severe cases of thrush.
Breast-feeding mothers may require treatment for a fungal infection to decrease repeated transmission of Candida during feedings.
Practicing good oral hygiene and keeping up with dentist appointments may help to prevent oral thrush.
There are some measures that can be taken to decrease the risk for oral thrush including:
- practice good oral hygiene by brushing teeth twice daily, flossing regularly, and keeping up with dental appointments
- clean gums and dentures regularly
- avoid smoking
- rinse the mouth and brush teeth after taking medications or using a corticosteroid inhaler
- practice good denture hygiene, avoid wearing dentures at night, and make sure they fit properly
- sterilize pacifiers and bottles for infants, babies, and children
- only use antibiotics when necessary
- speak with a doctor about using a chlorhexidine mouthwash during chemotherapy treatments to decrease the risk of thrush
- speak with a child's pediatrician if he or she is immunocompromised about using preventative antifungals
- having routine check-ups, especially if a person has a chronic health condition like diabetes that can increase the risk of infection
- control diabetes by controlling blood sugar levels
- treat other yeast infections like those of the vagina
- avoid and treat dry mouth if possible
- rinse mouth with salt water rinse
Nursing mothers should consider cleaning nipples, wearing nursing pads, wearing a clean bra each day and appropriately cleaning breast pump parts.
After nursing, letting the skin around the nipples dry completely before putting a bra back on can help minimize risk.
When to see a doctor
It is recommended that a person sees a doctor if there are symptoms present for evaluation and possible treatment.
Outlook and takeaway
Typically speaking, thrush is not a concerning infection but can recur often. At times, the infection can spread into the esophagus or bloodstream of certain people including those with weakened immune systems.
However, if it is persistent or recurs outside of infancy it may be a sign of another underlying medical problem.