Oral thrush - Diagnosis and treatment (2024)

Diagnosis

Diagnosis of thrush depends on the location and identifying whether there is an underlying cause.

If thrush is limited to your mouth

To diagnose oral thrush, your doctor or dentist may:

  • Examine your mouth to look at the lesions
  • Take a small scraping of the lesions to examine under a microscope
  • If needed, do a physical exam and certain blood tests to identify any possible underlying medical condition that may be the cause of oral thrush

If thrush is in your esophagus

To help diagnose thrush in your esophagus, your doctor may recommend any or all of these:

  • Biopsy. The tissue sample is cultured on a special medium to help determine which bacteria or fungi, if any, are causing your symptoms.
  • Endoscopic exam. In this procedure, your doctor examines your esophagus, stomach and upper part of your small intestine (duodenum) using a lighted, flexible tube with a camera on the tip (endoscope).
  • Physical exam. If needed, a physical exam and certain blood tests may be done to try to identify any possible underlying medical condition that could cause thrush in the esophagus.

More Information

  • Upper endoscopy

Treatment

The goal of any oral thrush treatment is to stop the rapid spread of the fungus, but the best approach may depend on your age, your overall health and the cause of the infection. Eliminating underlying causes, when possible, can prevent recurrence.

  • Healthy adults and children. Your doctor may recommend antifungal medication. This comes in several forms, including lozenges, tablets, or a liquid that you swish in your mouth and then swallow. If these topical medications are not effective, medication may be given that works throughout your body.
  • Infants and nursing mothers. If you're breast-feeding and your infant has oral thrush, you and your baby could pass the infection back and forth. Your doctor may prescribe a mild antifungal medication for your baby and an antifungal cream for your breasts.
  • Adults with weakened immune systems. Most often your doctor will recommend antifungal medication.

Thrush may return even after it's been treated if the underlying cause, such as poorly disinfected dentures or inhaled steroid use, isn't addressed.

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Lifestyle and home remedies

These suggestions may help during an outbreak of oral thrush:

  • Practice good oral hygiene. Brush and floss regularly. Replace your toothbrush often until your infection clears up. Don't share toothbrushes.
  • Disinfect dentures. Ask your dentist for the best way to disinfect your dentures to avoid reinfection.
  • Try warm saltwater rinses. Dissolve about 1/2 teaspoon (2.5 milliliters) of salt in 1 cup (237 milliliters) of warm water. Swish the rinse and then spit it out, but don't swallow.
  • Use nursing pads. If you're breast-feeding and develop a fungal infection, use pads to help prevent the fungus from spreading to your clothes. Look for pads that don't have a plastic barrier, which can encourage the growth of candida. Wear a clean bra every day. Ask your doctor about the best way to clean your breast nipples, bottle nipples, pacifiers and any detachable parts of a breast pump if you use one.

Preparing for your appointment

You're likely to start by seeing your family doctor or pediatrician. However, if you have an underlying condition that's contributing to the problem, you may be referred to a specialist for treatment.

Here's some information to help you get ready for your appointment.

What you can do

The doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Have you recently taken antibiotics for an infection?
  • Do you have asthma? If so, do you use a steroid inhaler?
  • Do you have any long-term health conditions?
  • Do you have any other new symptoms of illness?

What to expect from your doctor

The doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Have you recently taken antibiotics for an infection?
  • Do you have asthma? If so, do you use a steroid inhaler?
  • Do you have any long-term health conditions?
  • Do you have any other new symptoms of illness?

By Mayo Clinic Staff

Oral thrush - Diagnosis and treatment (2024)

FAQs

What is the strongest treatment for oral thrush? ›

Antifungal medications

Healthcare providers usually prescribe antifungals (like nystatin) to treat thrush. These medicines are available in tablets, lozenges or liquids that are “swished” around in your mouth before swallowing. Usually, you need to take these medications for 10 to 14 days.

How do you get rid of thrush on your tongue fast? ›

Oral thrush can usually be successfully treated with antifungal medicines. These usually come in the form of gels or liquid that you apply directly inside your mouth (topical medication), although tablets or capsules are sometimes used.

How do you self diagnose oral thrush? ›

Oral thrush causes white patches in the mouth that can be wiped away, leaving red and bleeding areas. Other symptoms may include: pain or burning in the mouth. an unpleasant taste.

What happens if oral thrush is left untreated? ›

A pharmacist can help with oral thrush

The gel is suitable for adults, children and babies over the age of 4 months. Ask your pharmacist for advice. Always follow the instructions on the medicine packet. If you leave oral thrush untreated, the infection can spread to other parts of the body.

What can be mistaken for oral thrush? ›

Hairy leukoplakia causes fuzzy, white patches that look like folds or ridges. The patches usually form on the sides of the tongue. Hairy leukoplakia is often mistaken as oral thrush, an infection that causes creamy white patches that can be wiped away.

Why won't my oral thrush go away? ›

Oral thrush clears up within a few weeks with the proper antifungal treatment. The condition may be harder to treat if you have a weakened immune system from HIV infection, cancer, or diabetes. Treatment is designed to stop the fungus from spreading, but it's also important to determine the underlying causes.

What mouthwash kills thrush? ›

Several over-the-counter mouthwashes are available to help treat thrush. Look for one that contains hydrogen peroxide, such as Colgate Peroxyl. Hydrogen peroxide can help treat oral thrush, but it can also kill helpful bacteria in your mouth, so discontinue using it once your symptoms have resolved.

Can salt water heal oral thrush? ›

Home remedies for oral thrush (oral candidiasis) include probiotics, vitamin C, or mouth rinses made with salt water, baking soda, apple cider vinegar, lemon essential oil, lemongrass, oil of oregano, clove oil, and other essential oils. Good oral hygiene is also essential.

Can I treat oral thrush on my own? ›

Oral thrush is treated with antifungal medication, but you can also ease uncomfortable symptoms with home remedies such as salt water, yogurt, clove oil, apple cider vinegar, and more. Oral thrush, also called oral candidiasis, is a yeast infection of the mouth.

Should I go to urgent care for oral thrush? ›

Oral thrush is often a mild infection that usually doesn't require a trip to the doctor or urgent care. However, you should seek medical advice as soon as you develop signs and symptoms of the condition.

Is it better to spit or swallow Nystatin? ›

Put the medicine in your mouth. Keep it in your mouth for at least 30 seconds if possible, swilling it around your mouth like a mouthwash before you swallow it. Do not eat or drink anything for 30 minutes after taking it. This stops you washing the medicine out of your mouth too soon.

What are two signs and symptoms of oral thrush you may see? ›

Symptoms
  • Creamy white lesions on your tongue, inner cheeks, and sometimes on the roof of your mouth, gums and tonsils.
  • Slightly raised lesions with a cottage cheese-like appearance.
  • Redness, burning or soreness that may be severe enough to cause difficulty eating or swallowing.
Apr 23, 2021

What is the best treatment for thrush that won't go away? ›

You'll usually need antifungal medicine to get rid of thrush. This can be a tablet you take, a tablet you insert into your vagin* (pessary) or a cream to relieve the irritation.

What if nystatin doesn't work for oral thrush? ›

Your doctor may prescribe fluconazole if miconazole or nystatin have not worked to treat your oral thrush, or if your infection is severe. Fluconazole comes as a capsule or liquid that you swallow. Your body absorbs it for it to work. This means that it affects more of your body and has a stronger effect.

Why is my oral thrush so bad? ›

Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the natural balance of microorganisms in your body can increase your risk of oral thrush. Other oral conditions. Wearing dentures, especially upper dentures, or having conditions that cause dry mouth can increase the risk of oral thrush.

References

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