Childhood Diseases – On a Mission to Educate: Oral Thrush

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In my last article, ”Childhood Diseases – On a Mission to Educate: Infectious Mononucleosis” we learned that Infectious Mononucleosis is a contagious disease. “Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, but other viruses can also cause this disease. It is common among teenagers and young adults, especially college students. At least one out of four teenagers and young adults who get infected with EBV will develop infectious mononucleosis” according to the Centers for Disease Control & Prevention (CDC).

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Symptoms of mononucleosis are similar to the flu: Severe fatigue, headache, sore throat, which sometimes can be very severe, chills, followed by a fever, muscle aches. Other symptoms include: Swollen lymph nodes, jaundice, a measles-like skin rash anywhere on the face or body, severe sore throat, tiny red spots or bruise-like areas inside the mouth, especially on the roof of the mouth (palate), soreness in the upper-left abdomen, from an enlarged spleen.Mono symptoms may last for 2 to 4 months but most people will recover without any long-term problems. Today I would like to move onto another childhood illness called Oral Thrush.

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What Is Oral Thrush?

Oral Thrush is a yeast infection that is caused by Candida which is a fungus, that in small amounts, thrives in the mouth and intestines. It helps with digestion and nutrient absorption. But when this fungus overproduces, it can then penetrate the intestinal wall to enter the bloodstream, where it then releases toxic by-products causing candidiasis which is a candida infection. According to Health Line (https://www.healthline.com/health/is-thrush-contagious#overview1), this fungus can turn into Thrush “when the natural bacteria in the mouth are out of balance. This makes your mouth a breeding area for Candida to spread and cause infection.”

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What Are the Causes of Thrush?

Causes of thrush, according to Health Line, are:

Antibiotic use

Chemotherapy

Dentures

Diabetes

Dry mouth

HIV

Immune system deficiencies

Inhaled corticosteroid use

Smoking

Use of steroid medications

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According to Web MD (https://www.webmd.com/oral-health/guide/what-is-thrush#1) Thrush can also be triggered by a dry mouth, hormonal changes that happen with pregnancy, cancer, & stress. Thrush is common in newborns due to the exposure to yeast in the mother’s birth canal. The baby in turn can pass the infection to his/her mother while breastfeeding.

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What Are the Symptoms of Thrush?

According to the CDC (https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html) Candidiasis in the mouth & throat is also called “thrush”. Candidiasis in the mouth can have many different symptoms including:

White patches on the inner cheeks, tongue, roof of the mouth, and throat

Redness or soreness

Cottony feeling in the mouth

Loss of taste

Pain while eating or swallowing

Cracking and redness at the corners of the mouth

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In babies with oral thrush, according to Kids Health (http://kidshealth.org/en/parents/thrush.html), generally exhibit cracked skin in the corners of their mouths and have white patches on their tongues, lips or inside the cheeks.
These white patches look like cottage cheese and can’t be wiped away. Some babies may have difficulty when sucking due to the soreness of their mouths while others don’t exhibit any discomfort or pain.

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How Is Thrush Diagnosed?

The doctor will usually diagnoses oral thrush by the symptoms you exhibit and by the typical appearance in your mouth according to Patient (https://patient.info/health/oral-thrush-yeast-infection). There can be situations where the doctor may want to do a blood test to explore the possibility of certain conditions that may make you more likely to develop oral thrush. Other procedures can include a swab of the inside of your mouth which is sent to a lab or a biopsy where a small sample is taken from the white patches in your mouth which can be examined under a microscope.

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How Is Thrush Treated?

According to the Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/oral-thrush/diagnosis-treatment/drc-20353539) the primary goal for treating oral thrush is to stop the rapid spread of the fungus. The best way to do this is to approach it on the basis of the age of the patient, his/her overall health and what is actually causing the infection. It will be best to try to eliminate the underlying causes of thrush in an effort to prevent a reoccurrence of it. The following is a list of treatment approaches per the Mayo Clinic:

Healthy adults and children: Your doctor may recommend antifungal medication. This comes in several forms, including lozenges, tablets, or a liquid that you swish in your mouth and then swallow. If these topical medications are not effective, medication may be given that works throughout your body.

Infants and nursing mothers: If you're breast-feeding and your infant has oral thrush, you and your baby could pass the infection back and forth. Your doctor may prescribe a mild antifungal medication for your baby and an antifungal cream for your breasts.

Adults with weakened immune systems: Most often your doctor will recommend antifungal medication.

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How Can Thrush Be Prevented?

Thrush can be prevented by following these recommended practices by Cleveland clinic (https://my.clevelandclinic.org/health/articles/thrush):

Follow good oral hygiene practices: Brush your teeth at least twice a day and floss at least once a day.

Avoid mouthwashes or sprays: These products can destroy the normal balance of microorganisms in your mouth.

See your dentist regularly: This is especially important if you have diabetes or wear dentures.

Limit the amount of sugar and yeast-containing foods you eat: Foods such as bread, beer, and wine encourage Candida growth.

If you smoke, quit: Ask your doctor or dentist about ways to help you kick the habit.

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Patient (https://patient.info/health/oral-thrush-yeast-infection) has provided excellent additional information to help prevent oral thrush which can be helpful for certain situations:

If you have diabetes - good control of your blood sugar level reduces the risk of thrush and other infections.

If you use steroid inhalers - having a good inhaler technique and using a spacer device may reduce the risk of thrush. Also, rinse your mouth after using the inhaler, to help remove any medicine particles left in your mouth. Ask your doctor about reducing your dose of steroid in your inhaler to the lowest level needed to control your asthma.

If you take medication which causes a dry mouth - take frequent sips of water.

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If you wear dentures:

Leave your dentures out overnight, or for at least six hours daily. Constant wearing of dentures, and not taking them out at night, is thought to be one of the most common causes of oral thrush.

Clean and disinfect dentures daily. To clean, use soapy water and scrub the dentures with a soft nailbrush on the fitting surface - that is, the non-polished side. Then soak them in a disinfecting solution. The type of solution and the time they should be soaked for will be advised by your dentist. Rinse the dentures after disinfecting them, and then allow the dentures to air dry before wearing them again. Drying like this helps to kill any Candida that might be stuck to the dentures.

Clean the inside of your mouth (where the dentures sit) with a soft brush.

See a dentist if the dentures do not fit well.

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Kids Health stated that Oral Thrush is a common infection in babies but mothers can help prevent it by the following:

If you formula-feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. That way, if there's yeast on the bottle nipple or pacifier, your baby won't be re-infected. Store milk and prepared bottles in the refrigerator to prevent yeast from growing.

If you breastfeed and your nipples are red and sore, you might have a yeast infection on your nipples, which you and your baby can pass back and forth. Talk to your doctor, who might recommend using an antifungal ointment on your nipples while your baby is treated with the antifungal solution.

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Are There Complications of Oral Thrush?

According to the Mayo Clinic oral thrush is seldom a problem for healthy adults and children however for people with HIV/AIDS and cancer, who have a lowered immunity, thrush can be more serious. Untreated oral thrush can result in more serious systemic candida infection. Sometimes thrush can spread to the esophagus or other parts of the body.

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In conclusion we learned that Oral Thrush is a condition in which a fungus called Candida overgrows in the mouth and throat which can be triggered by various factors like illness, pregnancy, medication, smoking or dentures. It is common in newborns and infants but it is not usually harmful. Oral thrush looks like white patches in the mouth causing soreness and pain. Overall prognosis for thrush is good but it is important to find the underlying cause to prevent re-occurrence of it. It is also important to see the doctor to get a diagnosis, medical guidance and intervention as needed.

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I hope you learned something from this article about Oral Thrush. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on ”Childhood Diseases – On a Mission to Educate: Oral Thrush”. If you would like to follow me, please check HERE

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