Oral Thrush (Oropharyngeal Candidiasis)
Recognising and treating fungal mouth infections — from nystatin to fluconazole
Oral thrush is a fungal infection of the mouth caused by Candida albicans. It commonly presents as creamy white plaques or red patches on the oral mucosa, or as angular cheilitis at the corners of the mouth. It is prevalent in infants, the elderly, denture wearers, inhaled corticosteroid users, and immunocompromised patients, and is usually straightforward to treat with topical antifungals.
What is Oral Thrush?
Oral thrush is a fungal infection of the mouth caused by an overgrowth of Candida, a yeast that is normally present in small amounts. It typically appears as creamy white patches on the tongue, inner cheeks, or roof of the mouth, and can cause soreness or a burning sensation. It is common in babies, older adults, and people taking certain medicines.
Who Is At Risk?
People who use steroid inhalers, take antibiotics, or have a dry mouth are more prone to oral thrush. It is also more common in denture wearers, those with diabetes, and anyone with a weakened immune system. Using a spacer with an inhaler and rinsing the mouth after each dose can help prevent it.
How Is It Treated?
Oral thrush usually responds well to antifungal treatment such as miconazole gel or nystatin suspension, which are applied directly inside the mouth. A pharmacist can advise on suitable products and how to use them correctly. If thrush keeps coming back or does not clear up, a GP should be consulted to check for an underlying cause.