Thrush is a fungal infection of the mouth. It usually begins on the tongue and inside of the cheeks. It may also spread to the palate, gums, tonsils, and throat.
Severe, untreated thrush can spread to the: EsophagusUrinary tractWhole body—systemic infection causes multiple organ failure and death
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Thrush is caused by a fungus. There are many microorganisms that normally live in the mouth. When these organisms become imbalanced, the fungus can grow and cause thrush. The imbalance of organisms may be caused by a medical condition or medication.
Factors that may increase your baby's chance of getting thrush include: Contamination from caregiversContamination during breastfeedingBirth complications, such as preterm birth, premature rupture of membranes, or perinatal asphyxiaVery low birth weight babies admitted to neonatal intensive careVaginal yeast infection in the mother at the time of birth
Factors that may increase your child's chance of getting thrush include: Use of antibioticsHealth conditions that suppress the immune system, such as: HIV infection
or medical treatments for cancer, such as
chemotherapyCongenital immune deficiencies
Prolonged illnessConditions that cause a dry mouthUse of medications that treat psychiatric conditions
Thrush may cause the following in infants: IrritabilityDecreased interest in feedingWhite, lacy patches on the inside of the cheeks or tongue that don't come off when rubbed
Thrush may cause the following in children: Sore mouth and throatDifficulty swallowingDifferences in tasteWhite or red patches on the inside of the cheeks or tongue that may or may not come off when rubbedFissures or cracks in the mouth
You will be asked about your child's symptoms and medical history. A physical exam will be done, including an inspection of the mouth. Diagnosis can usually be done after physical exam. The doctor may take a sample of cells from the affected area. The sample will be examined under a microscope to confirm thrush or look for other infections.
The goal of treatment is to restore the normal balance of bacteria and yeast in the mouth. If any underlying conditions contribute to thrush, they will also be treated.
In infants, antifungal medications may be a gel or a rinse that is swished around your baby's mouth. Systemic medications may be used if: Your baby is at risk for developing a systemic infectionYour baby can't tolerate other treatmentsYour baby doesn't respond to other treatments
Breastfeeding mothers of babies with thrush can use a topical antifungal medication on their nipples to reduce the baby's infection.
Antifungal medications for children may include oral tablets, rinses, or lozenges that dissolve in the mouth.
Oral hygiene practices that may aid in healing include: Clean your baby's mouth with a clean, moist gauze pad as soon as baby teeth appear.Have your child rinse his or her mouth with warm salt waterGently scrape patches off your child's mouth with a toothbrushGently brush any newly appearing teeth with a child-size toothbrush and water.Start to clean your baby’s teeth regularly as soon as they come in. Use an amount of fluoride toothpaste that is about the size of a grain of rice. Progress to an amount that is about the size of a pea by the time your child is 3 years of age. This will reduce the risk of your child swallowing it.If your child has 2 teeth that touch, you can start to use dental floss.
To help reduce your child's chance of getting thrush, take these steps: Maintain proper oral hygiene after treatment.Thoroughly clean your baby's pacifier and toothbrush.If your baby is prone to thrush and drinks from a bottle, use disposable nipples.Avoid mouthwashes and mouth sprays. These can upset the normal balance of yeast and bacteria in the mouth.If your child uses a corticosteroid inhaler, make sure they rinse their mouth thoroughly after each use.If your child is at risk, ask your child's doctor about antifungal medication.
Babies and kids healthy habits. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/babies-and-kids/healthy-habits. Accessed February 23, 2016.
Oral candidiasis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/fungal/diseases/candidiasis/thrush/. Updated February 13, 2014. Accessed February 23, 2016.
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http://www.ebscohost.com/dynamed: American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014 Feb;145(2):190-191.
Last reviewed February 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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