Oral Thrush Overview
Thrush (oropharyngeal candidiasis) is a superficial yeast infection that may involve the tongue, inner cheek (buccal mucosa), inner lip region, and occasionally the gums (gingiva). While it is most commonly seen in young infants, thrush may affect toddlers, and to a lesser degree, older children and occasionally adults. Oral thrush diagnosed in an adult should always lead to a search for an underlying medical condition (diabetes, use of immunosuppressive therapy, etc.).
Oral Thrush Causes
Thrush is caused by an overgrowth of the yeast Candida albicans, which is commonly found on skin surfaces, the oral cavity, and throughout the intestinal tract of healthy individuals. Newborn infants often are exposed during vaginal delivery and may develop oral evidence of thrush within 10 days post-delivery. Breastfeeding infants may infect their mother's nipple area during breastfeeding. In addition, an overgrowth of Candida in the stool may be associated with a characteristic diaper rash. Contamination of formula bottle nipples and pacifiers with Candida may also introduce the yeast into a child's oral cavity.
In older children and adults, oropharyngeal candidiasis is associated with several risk behaviors, including prolonged or repeated use of oral antibiotics, smoking, dentures, use of birth control pills, and diabetes (either type I or type II). Perhaps the most common association for developing thrush is improper technique during the use of inhalers containing corticosteroids for the control of asthma or COPD (chronic obstructive pulmonary disease). Such medications require rinsing your mouth with water and then spitting out the water to eliminate any non-inhaled medication. Patients using a metered dose inhaler (MDI) for administration of their steroids are recommended to use a "spacer" to lessen the amount of potential residual steroid left in the mouth.
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