Everything You Need to Know About Oral Thrush

DISCLOSURE: Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.

Oral Thrush can happen when the normal candida fungus that lives in the mouth gets imbalanced and then proliferates into an infection. Thrush presents as white, thick patches on the tongue, gums, and tissues that won’t rub off. Fungus and bacteria live in the oral environment naturally and usually stay pretty balanced, both contributing to the overall health of the mouth and its micro environments. When negatively affecting external stimuli become ingested, side effects can tip the balance of this ecosystem. Read on to learn about some of the triggers that can lead to thrush.

• Weakened Immune system
  When the immune system is compromised, either purposefully or unintentionally, the reaction and ability of the body’s immune cells are slowed or altered completely. This allows seemingly regular shifts in balance to become more difficult to redirect. Small overgrowths of fungi in the mouth can then lead to dysbiosis. Dysbiosis can happen in the gut microbiome, urogenital microbiome, and the skin’s microbiome simultaneously.

• Chemotherapy and radiation
  Chemo and radiation therapies target cancer cells, but these therapies also affect normal healthy cells in the process. When the health-promoting cells are killed at the same time as the cancer-promoting cells, the immune system is vulnerable. This is a form of intentionally weakening the immune system in the hopes of destroying all the cancer-causing cells while preserving some of the immune cells.
• Regular corticosteroid use
  Steroids disrupt the natural balance of microorganisms in the mouth, especially inhaled steroids like albuterol. Inhalers can lower the immune system in the mouth and the throat, contributing to an overgrowth of fungi leading to thrush.
• Denture wearers
  Denture wearers are especially prone to thrush because the denture itself can trap and harbor the fungus that causes thrush. Dentures need to be removed at night to allow the tissues of the mouth to breathe. Dentures also need to be regularly cleaned, brushed, and soaked to help remove the pathogens that can lead to infections in the mouth tissues.
• Diabetics
  Since sugar helps candida (thrush) grow, people with diabetes are innately prone to suffering from thrush and angular cheilitis. High levels of sugar in the blood also mean high levels of sugar in the saliva, sweat, and urine. With high sugar levels in these systems, yeast can overgrow and become a candida infection more rapidly and more often than what non-diabetics experience. Most diabetics struggle with xerostomia or dry mouth due to the effects of diabetes itself and the medications they take. When there isn’t enough saliva in the mouth to flush the tissues and move around the fluids, plaque accumulates and harbors the bacteria and fungi that lead to oral candidiasis.
• Antibiotic use
  Antibiotics have a direct link to the overgrowth of yeast within the body. Antibiotics destroy the bacteria that help to prevent candida from getting out of control. Sometimes a single course of a broad-spectrum antibiotic can wipe out the beneficial gut flora, including the balance of the oral microbiome that helps to prevent things like thrush. Other times, the overuse or chronic usage of antibiotics has the most damming effect on the body’s ability to fight infections.

Treatment for Oral thrush

Xylitol is one of my favorite treatments for mild cases of thrush, and as a preventative measurement when you know you will be exposed to stimuli that may cause this type of infection. Xylitol reduces the levels of decay-causing bacteria in saliva and acts against some bacteria that cause ear infections and yeast overgrowth. Research into the effects of xylitol shows that xylitol can inhibit pathogenic bacteria from attaching to the teeth or gums and enhance the mineral structure and strength of the teeth. Xylitol helps fight the yeast by reducing its ability to stick to a surface and cause an infection, the same way it helps fight acute otitis media (the dreaded ear infection). Xylitol can reduce adherence of Streptococcus pneumonia.

• Antifungal rinses
• Oral medications
• Good hygiene
• Probiotics/Prebiotics
• Saltwater rinses
• Baking soda rinse
• Vitamin C

Signs of Oral Thrush

Symptoms range in severity and duration but often include the following:

• White raised lesions on the tongue, inner cheeks, gums, the roof of the mouth, and back of the throat. Often resembling a coagulated cottage cheese appearance on the tissues and back of the throat, the tongue will have a thick white or yellowish coating that cannot be wiped off or brushed away.
• Redness in the mouth, especially on the cheeks or the sides of the tongue and throat.
• Bleeding in the mouth.
• Loss of taste.
• What is often described as a “Cotton Mouth,” feeling dry and full.
• Difficulty eating and swallowing, often painful as it progresses and spreads.

Contact your doctor right away if you have the signs or symptoms of thrush and you are immunocompromised. Most mild cases can be treated at home but may need the help of a doctor or dentist to identify.

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Noelle Copeland

Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.