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Oral Thrush (Candidiasis):
A Candida albicans Infection

Thrush (candidiasis) is a yeast infection caused by the fungus Candida albicans. This yeast infection can occur in various parts of the body, including the mouth, the gastrointestinal tract, the vagina, the skin and even the bloodstream. Oral thrush, or oral candidiasis, is one of the more common types of thrush infection.

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Causes of Oral Thrush

Like many other microscopic organisms, Candida albicans can be found virtually everywhere. Normally, a small amount of the fungus is already present in the mouth. The reason nothing happens is because the body's immune system and the other normal bacteria in the mouth keep the growth of Candida in check. But when the immune system is impaired or when the balance of bacteria in the mouth is disturbed, Candida can grow unrestricted.

Most of the time, oral thrush occurs because of antibiotics or medications that lower the immune system's effectiveness, but various diseases and conditions may also lead to oral thrush. Some of those conditions include:

HIV/AIDS: HIV/AIDS greatly inhibits the immune system's ability to protect the body, opening the way for Candida albicans and a variety of other dangerous microorganisms to grow unchecked.
cancer: The disease itself and the treatments for cancer tend to lower the immune system's effectiveness.
diabetes: Some people with diabetes (including those who don't know that they have it yet) may have abnormally high levels of sugar in their saliva. This extra sugar may disrupt the balance of bacteria in the mouth and allow Candida to grow.
xerostomia: A dry mouth means lower amounts of saliva present in the mouth. Lower levels of saliva decrease protection from various problems, including oral thrush.

Who Is Most Likely to Develop Candidiasis?
Oral thrush is more common in babies/infants and the elderly due to their weaker immune systems.

Symptoms of Oral Thrush

People with oral thrush often develop creamy white lesions that may look like cottage cheese in the mouth, usually on the tongue or on the inner cheeks. These lesions are painful when they come into contact with irritants and may bleed if rubbed or scraped.

Attention: Breastfeeding Mothers
Babies may develop oral thrush in their first weeks of life. They develop the lesions in the mouth and may appear to be irritable, especially when feeding. Breastfeeding mothers should check whether their babies have oral thrush because Candida albicans can infect the mother's breasts. Some symptoms include:

red, sensitive nipples
pain while nursing
pain in the nipples between nursing sessions
deep pain within the breast.

Treatments for Oral Thrush

Treatment depends on the age of the patient.

Newborns and Nursing Mothers: Infants and nursing mothers are treated together, to prevent the infection from passing back and forth between mother and child. The infant is often prescribed oral antifungal medication while the mother is prescribed a topical antifungal cream for her nipples.

Young Children: Doctors generally recommend adding unsweetened yogurt to a child's diet in order to restore the balance of bacteria in the mouth. If symptoms are severe, antifungal medication may be prescribed.

Adults: Unsweetened yogurt may be enough to restore the balance of bacteria in the mouth. If not, antifungal medication may be prescribed. Antifungal medication is prescribed for adults with weakened immune systems.

Resources

Aetna InteliHealth Inc. (updated 2003). Candidiasis.

Mayo Foundation for Medical Education and Research. (updated 2003). Oral thrush.

National Library of Medicine. (updated 2002). Oral thrush. MedlinePlus Medical Encyclopedia.

Nemours Foundation. (2005). Candidiasis.