Candida albicans is a yeast (a kind of fungus) that everyone has in the gut. Under certain conditions, it invades the skin or mucous membranes. When it affects the mouth, it is called oral thrush.

Cause


Babies with thrush have usually contracted it during delivery, when they passed through a vagina infected with Candida albicans. Symptoms appear as oral thrush within seven to 10 days after birth.

Oral thrush may develop after a viral upper respiratory infection, infectious mononucleosis (glandular fever) or irritation caused by dentures.

The condition may also occur after treatment with antibiotics. During the treatment, the antibiotics kill all the normal bacteria in the mouth, giving the fungus the opportunity to flourish.

People are more prone to thrush if they are chronically ill, malnourished or have severely impaired immunity.

Candida can sometimes lead to infection of the skin in other areas of the body.

Symptoms



    • Curd-like white patches inside the mouth, on the tongue, palate and around the lips

    • Red, inflamed areas underneath the white surface, with slight bleeding when one attempts to scrape off the white patches

    • Cracked, red, moist areas of skin at the corners of the mouth

    • Fussiness, irritability, and poor feeding in infants if the infection is painful (rare)

    • In babies, a nappy rash, caused by the same fungus, may be present.



Prevalence


Thrush infects two to five percent of newborn babies.

Course


Thrush may recur in people with chronic illnesses and those with impaired immunity. The oral thrush fungus may also spread to other parts of the body, such as the oesophagus, causing candida oesophagitis.

Risk Factors



    • Newborn babies

    • People using antibiotic medication

    • The chronically ill (such as diabetics)

    • The elderly

    • People using corticosteroid drugs or other medications that suppress the immune system

    • Those with weak immune defences (such as people with AIDS)



When to see a doctor


Call your doctor if:

    • Curd-like white patches appear inside the mouth.

    • Mouth irritation prevents a baby from feeding.

    • In addition to the above, there is difficulty swallowing.



Diagnosis


Diagnosis is based on a medical history and specific information about:

    • Diabetes

    • HIV

    • Chronic illnesses

    • Recent respiratory infections

    • Infectious mononucleosis (glandular fever)

    • Diet

    • Recent use of antibiotics

    • Recent use of medications that suppress the immune system



Examining the mouth and scraping the surface of the thrush to see if there is bleeding are usually sufficient to make a diagnosis. In addition, the following tests may be done:

    • A scraping of the mucosa for a fungal culture

    • Blood and other tests to determine undiagnosed medical conditions such as diabetes, cancer and HIV infection



Treatment


The naturopathic approach to treating thrush is to boost immune function and return bacterial balance:

    • Probiotic supplements containing Lactobacillus acidophilus, Lactobacillus reuteri and Bifidobacterium animalis help maintain bacterial balance. They may help address the bacterial imbalance caused by candida / thrush.

    • Garlic has anti-fungal properties that may also help fight minor fungal infections such as thrush. Echinacea, zinc, vitamin C, vitamin E and betacarotene support immune function, and may be effective in helping chronic cases of thrush.



We recommend combining any natural supplement with anti-fungal medications. Nystatin, clotrimazole, ketoconazole and fluconazole are also effective for treating thrush.

    • Nystatin is a suspension that is swished around the mouth and then swallowed.

    • Clotrimazole can be taken in lozenge form.

    • Ketoconazole or fluconazole must be taken orally for seven to 10 days.

    • Gentian violet may be used to paint an infected area.



Prevention



    • Follow a healthy diet.

    • Use antibiotics only as prescribed by a doctor. As mentioned above, taking probiotics or eating yoghurt may help to prevent thrush and provide bacterial balance.

    • Visit the dentist if you have an irritation caused by dentures.

    • Pregnant women should be checked for vaginal thrush to prevent oral thrush infection of their newborn babies.



Image via Thinkstock