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If you’re having trouble swallowing and you notice tiny, white lesions on your tongue, around your mouth, or in the back of your throat, chances are you have oral thrush. This condition cause bad breath, and affect your tastebuds—preventing you from enjoying the foods that you love. To get your taste buds back to normal (and alleviate that pain in your throat), learn the best treatments and medications, and the natural remedies that work.
What is oral thrush (oral candidiasis)?
Oral thrush, also known as oral candidiasis or oropharyngeal candidiasis, is a fungal infection that develops on the mucous membranes of the mouth. Common symptoms of oral thrush include pain and difficulty swallowing, loss of taste, bad breath, dryness, redness, and a white tongue, according to the Centers for Disease Control and Prevention (CDC). Some treatment options are antifungal medications, topical antiseptics, and throat lozenges.
“When oral thrush takes hold, Candida bacteria become very active in the mouth and crowds out healthy, important bacteria within the oral microbiome,” says Mark Burhenne, DDS, founder of AsktheDentist.com. Dr. Burhenne goes on to say, “Candida is also high when you have high rates of dental caries—cavities—and likes to coexist with the major cavity-causing bacteria, S. mutans.”
Oral thrush is a relatively common condition, with more than 200,000 cases occurring in the U.S. every year. Because of how prevalent it is, there are ongoing clinical trials and research to find additional cures. Recently, a new drug called Diflucan (fluconazole) has been approved by the FDA and found effective against oral thrush.
How is oral thrush diagnosed?
Oral thrush is most commonly caused by the fungus, Candida albicans, but it can also be caused by Candida glabrata or Candida tropicalis. It’s very rare for healthy adults to contract oral thrush. Those at risk include babies, especially those who are younger than one month old, people who wear dentures, those who have diabetes or HIV/AIDS, cancer patients, those with a weakened immune system, people who smoke, and those who take antibiotics or corticosteroids.
One of the easiest ways to tell if you or your child has oral thrush is visible white patches on the inner cheek, tongue, and roof of the mouth, in addition to pain while swallowing.
If you’re not sure whether you or your child have oral thrush, schedule an appointment with your primary healthcare provider right away, as he or she can help diagnose the issue and provide further medical advice. Here’s what you can expect at your appointment:
- Your doctor may examine your mouth and look for lesions, white spots, and redness.
- Your doctor may perform a biopsy or take a small scraping of the lesions to determine which bacteria or fungi, if any, are causing your symptoms.
- If you have an oral thrush infection in your esophagus, your doctor may perform an endoscopy to examine your tonsils, esophagus, stomach, and upper part of your small intestine.
- If needed, your doctor may perform a physical exam and do some blood tests to identify underlying medical conditions that could be causing oral thrush.
Questions your doctor may ask you
During your appointment, your doctor may ask the following questions to better inform the diagnosis of oral candidiasis:
- When did you start noticing symptoms?
- Have you recently taken antibiotics?
- Do you have asthma and use a steroid inhaler?
- Do you have any long-term health conditions?
- Did you have a vaginal yeast infection when you gave birth (if you’re a new mother)?
- Are you breastfeeding?
- Do you wear dentures?
Questions you should ask your doctor
If you do have oral thrush, it’s important to understand its causes and course of action over the short- and long-term. Here are some of the more important questions to ask your doctor during your appointment:
- What causes thrush?
- Is oral thrush contagious?
- What treatments are available to help treat this condition?
- How long do I have to take the medicine for?
- Can I give my children certain medicine to help with the pain?
- How can I breastfeed my newborn who has thrush?
- How can I lower the risk of my newborn getting thrush?
Though primary care physicians, pediatricians, and dentists can usually treat oral thrush, they may refer you to an infectious-disease specialist or immunologist in severe cases.
Oral thrush treatment options
After you receive a diagnosis, your doctor should provide you with a variety of options to treat oral thrush. In most cases, treatment will consist of antifungal medications, lozenges, or topical medications. The most popular antifungal medications are clotrimazole, miconazole, and nystatin. For more severe oral thrush cases, the most common treatment is fluconazole.
According to Dr. Andrea Santa, DMD, the best treatment options for oral thrush will typically include topical treatments. “The most common is oral troches, which I tend to describe as a sort of lozenge that you suck on for about 30 minutes, oral suspensions, which have medical agents mixed with a liquid to be a delivery vehicle, and topical creams.” Dr. Santa goes on to say, “For chronic cases of oral thrush, some patients will be prescribed a systemic treatment, which is delivered in pill form.”
To prevent candidiasis, practice good oral hygiene, rinse your mouth after using inhaled corticosteroids, clean your dentures after every use, and change your toothbrush every three months. Nursing mothers should avoid using damp nursing pads, routinely clean pacifiers, and consider air-drying their nipples if their infant routinely develops thrush. For those who need to take daily-inhaled corticosteroids for asthma, consider rinsing and spitting following the use of a metered-dose inhaler (MDI).
Oral thrush medications
There are two main types of medications used to treat oral candidiasis. They are antifungals and antiseptics.
Antifungals
Antifungal medicines work by killing fungal cells. They do this by damaging the cell walls of the fungus and preventing the cells from growing and reproducing. Antifungals can come in the form of creams, sprays, tablets, and injections. Some popular antifungals include Diflucan, Mycelex Troche, Nystop, Ketoconazole, and Nyata.
Common side effects of these drugs include itching and burning, redness, abdominal pain, and a rash.
Antiseptics
Topical antiseptics can destroy or prevent the growth of microorganisms on the skin that are causing infection. For oral thrush treatment, the most popular brand is Paroex Oral Rinse. This type of antiseptic has powerful antibacterial properties that can help maintain a healthy mouth and control and kill bacteria in your mouth. Some side effects include tooth and tongue staining, increased tartar, throat irritation, dry mouth, and tongue swelling.
What is the best medication for oral thrush?
The best medication for oral thrush depends on the patient’s medical condition, medical history, and medications they may already be taking that could interact with oral thrush medication as well as the patient’s response to treatment.
This table will act as a comparison chart for the most commonly prescribed oral thrush medications.
| Best medications for oral thrush | ||||
|---|---|---|---|---|
| Drug name | Drug class | Administration route | Standard dosage | Common side effects |
| Diflucan (fluconazole) | Antifungal | Oral | One 15 mg tablet taken once a day | Headache, upset stomach, dizziness |
| Oravig (miconazole) | Antifungal | Topical | Apply one 50 mg buccal tablet to the upper gum region once a day for 14 days. | Mouth discomfort, unpleasant taste, nausea |
| Nystop (nystatin) | Antifungal | Topical | Apply powder to candidal lesions two or three times daily until healing is complete. | Skin irritation, redness, burning |
| Periogard (paroex) | Antiseptic | Topical | Use twice daily, rinsing for 30 seconds, morning and evening after brushing your teeth. The usual dosage is 15 ml. | Staining of teeth, oral irritation, loss of taste |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of oral thrush medication?
The most common side effects of oral thrush medication include mouth irritation, upset stomach, nausea, vomiting, or a skin rash. For antifungals, the most common side effects are abdominal pain and nausea.
Note: This is not a full list of side effects. Talk to a healthcare professional for a complete list of possible adverse events and drug interactions.
What are the best oral thrush home remedies?
In addition to medications, there are a few natural remedies that can treat oral thrush and prevent episodes of oral thrush from recurring. Some include:
- Gargle with saltwater: Saltwater has antiseptic and pain-relieving properties that can relieve symptoms of oral thrush. Simply mix ½ teaspoon of salt in a cup of warm water, swish the solution in your mouth, and spit it out after a minute.
- Rinse your mouth with baking soda: Similar to saltwater, baking soda may also help treat oral thrush. Mix ½ teaspoon of baking soda in a cup of warm water and gargle the solution in your mouth.
- Eat probiotic yogurt: This type of yogurt contains “good” bacteria that can restore the balance of good to bad bacteria in your mouth.
- Use gentian violet: You can apply gentian violet, a violet-colored dye with antifungal properties, to the affected areas in your mouth two to three times a day. You can buy gentian violet without a prescription at most pharmacies.
- Put clove oil or oregano oil on sores: Dab a Q-tip in clove oil and apply to the lesions in your mouth. Oregano oil has antimicrobial and antifungal properties and can also help reduce soreness and alleviate symptoms of oral thrush.
- Take vitamin C: Vitamin C can encourage white blood cell production and protect your body against infection. Increasing your intake of this vitamin may help boost your body’s ability to beat the infection.
Frequently asked questions about oral thrush
How can I get rid of oral thrush fast?
To address oral thrush, rinse your mouth with salt water to relieve some of the pain you’re experiencing. You can also eat unsweetened yogurt to restore healthy bacteria levels.
Can you treat oral thrush over-the-counter?
If you or your child has a mild case of oral thrush, you can take over-the-counter medications, like acidophilus pills, that can help restore a healthy balance of germs in your mouth. You may also try gentian violet, an over-the-counter natural treatment that kills bacteria and fungi. Talk to your doctor before taking gentian violet.
How long does oral thrush last without treatment?
If left untreated, oral thrush will resolve in three to eight weeks. However, most thrush cases will clear up within 14 days with oral antifungal medicine, antifungal mouthwash, or lozenges. Very mild cases of oral thrush will clear up without any medical treatment.
Note: medical care should be sought for children and infants when over-the-counter remedies aren’t helping or the infection causes pain.
What are the best ways to treat thrush?
The best ways to treat oral thrush are with antifungal medicine or topical antiseptics. It’s also important to maintain your oral health and practice preventative habits, like brushing your teeth twice a day and gargling with an antiseptic mouthwash.
Can you get rid of oral thrush naturally?
Yes, you can get rid of oral thrush naturally. Salt has antiseptic, cleansing, and soothing properties, so gargling with salt water every night can help reduce the bacteria in your mouth and relieve pain symptoms. Additionally, eating probiotic yogurt can help rebalance good bacteria levels in your mouth, applying apple cider vinegar to the affected areas can relieve pain, and gargling with a baking soda solution may help kill the bacteria that caused the yeast infection.
What causes oral thrush?
Most people, including infants, have Candida in their mouths and digestive tracts, which is considered normal. However, the main cause of oral thrush is the overgrowth of Candida albicans, which causes creamy white lesions on the tongue, lining of the mouth, and even the throat and esophagus.