Oral thrush

What is oral thrush?

Oral thrush is an infection in your mouth caused by a fungus called Candida albicans.

What are the symptoms of oral thrush?

There are many different types of oral thrush that are all slightly different.

Typically, your mouth will look red with white patches. You can easily wipe off these white patches to leave red spots underneath that may bleed. It can be painful. Oral thrush can also appear on your tongue or lips. 

Other symptoms of oral thrush include:

• Cracks at the corners of your mouth

• Sore tongue or gums, or other mouth pain

• Difficulty eating and drinking

• An unpleasant taste in your mouth

• Food tasting different than normal

How common is oral thrush?

Oral thrush can happen in anyone but it is more common in babies, older people and people with dentures. It is also more common in people who:

• Use asthma inhalers that contain steroids

• Are taking a prolonged course of antibiotics

• Are receiving chemotherapy or radiotherapy

• Have type 1 or type 2 diabetes

• Have a weakened immune system for example from diseases of the blood, chemotherapy, or HIV

• Smoke

• Have an unbalanced diet

• Are lacking some nutrients such as iron or B12 in their diet

Is oral thrush contagious?

Oral thrush is not contagious except rarely in breastfeeding, when the infection can be passed to the mother’s nipples.

How is oral thrush diagnosed?

A doctor can tell you if you have thrush by looking in your mouth and asking you questions about how it feels. If the doctor is unsure of the cause of your symptoms, they can send you for further testing.

How to treat oral thrush

Oral thrush treatment can be sold over the counter at a pharmacy, a gel is applied to the tongue that fights the fungal infection. The most common is a drug called miconazole oral gel. If treatment with this does not treat your oral thrush a doctor may give you a stronger medicine to try.

How long does oral thrush last?

If it goes untreated, oral thrush can last for months or years. Once you start treatment, it should clear after around 2 weeks.

Oral thrush in babies and children

It can be worrying to notice unexpected changes in your baby, but oral thrush is common in babies. It usually looks like a white cottage cheese coating on the tongue. They may also have white spots in their mouth. Sometimes they may get nappy rash or not want to feed as well.  

A doctor can give an oral gel or liquid which should easily treat it.

During breastfeeding, it’s possible for the infection to spread to the mother’s nipples.

Older children very rarely get oral thrush and should follow the same advice as adults.

How to prevent oral thrush

You can reduce your chance of getting oral thrush with a few regular habits. 

• Take care of your oral hygiene by brushing your teeth, gums and tongue twice a day, cleaning dentures if you have them, and see your dentist regularly

• Avoid wearing dentures at night

• Sterilise your baby’s dummies and bottles regularly

• Rinse your mouth after eating or taking medicines. This is even more important after you use steroid inhalers

• Avoid smoking

What else could my white tongue be?

There are other causes of a white tongue that may require medical attention. If you’re unsure or if the treatment is not working as expected, speak to a doctor. These other causes include:

• Lichen planus

• Leucoplakia

• Geographic tongue (also known as erythema migrans or benign migratory glossitis)

• Mouth ulcers

When should I speak to a doctor about oral thrush?

Although simple Candida can be managed by a pharmacist, seek help from a doctor if you’re unsure if it’s oral thrush or:

• Your baby is under 4 months and has oral thrush

• You are struggling or have pain when you swallow

• Your thrush doesn’t improve after 1 week of using a mouth gel given to you by a pharmacist

• You are immunosuppressed

Very rarely, Candida can spread to the blood, this is called candidaemia. This is a rare but serious infection that needs urgent medical attention. If you have oral thrush and feel unwell you should see a doctor.