Thrush

Thrush is a fungal infection caused by the Candida species of yeast. It is also known as candidiasis or oral thrush when it occurs in the mouth.

Causes and Risk Factors

Thrush can occur when there is an imbalance in the normal bacteria and fungi that live in the body, allowing the Candida fungus to overgrow. This can happen due to various factors such as:

• Weakened immune system
• Antibiotic use, which can disrupt the balance of bacteria in the body
• Corticosteroid use
• Hormonal changes during pregnancy
• Dry mouth or reduced saliva flow
• Poor oral hygiene
• Diabetes, especially if not well-controlled
• Vitamin deficiencies, such as iron, folate, or vitamin B12 deficiency

Symptoms

The symptoms of thrush can vary depending on the location and severity of the infection. Common symptoms include:

• White patches or lesions in the mouth, tongue, or throat that can be painful and may bleed if scraped
• Redness and inflammation in the affected area
• Difficulty swallowing or eating due to pain or discomfort
• Cracking at the corners of the mouth
• Burning sensation in the mouth or throat
• Loss of taste or altered taste

Diagnosis

Thrush is typically diagnosed based on a physical examination and medical history. The healthcare provider may also perform:

• Oral examination to look for white patches or lesions
• Scraping of the lesions to examine under a microscope for fungal elements
• Culture test to confirm the presence of Candida fungus
• Endoscopy to visualize the esophagus and stomach if symptoms persist despite treatment

Treatment

Treatment for thrush usually involves antifungal medications, which can be topical or systemic. The goal is to reduce the fungal load and restore the balance of normal flora in the body.

• Topical antifungals such as clotrimazole, miconazole, or nystatin are applied directly to the affected area
• Systemic antifungals like fluconazole may be prescribed for more severe cases or when topical treatment is not effective
• Good oral hygiene practices, including brushing and flossing regularly, and rinsing with salt water or an antifungal mouthwash
• Avoiding irritants such as tobacco, spicy foods, and acidic beverages

Prevention

To prevent thrush, it is essential to maintain good oral hygiene, avoid antibiotics unless necessary, and manage underlying medical conditions. Additionally:

• Practicing good dental care, including regular brushing and flossing
• Rinsing the mouth with water or an antifungal mouthwash after meals and before bed
• Avoiding sharing utensils, toothbrushes, or other personal items
• Wearing dentures properly and cleaning them regularly
• Managing stress through relaxation techniques such as meditation or deep breathing exercises

Complications

If left untreated, thrush can lead to complications such as:

• Esophageal candidiasis, which is a fungal infection of the esophagus
• Invasive candidiasis, a serious and potentially life-threatening condition that occurs when the fungus enters the bloodstream
• Dental problems, such as tooth decay or gum disease, due to poor oral hygiene