Oral thrush, which is due to an accumulation of the fungus Candida albicans, is the most common type of oral fungal infection. Oral thrush occurs when the fungus Candida albicans over-accumulates in the mouth and causes a white coating on the tongue. This fungus is often present in a healthy mouth but can cause oral thrush if it is not managed by the body’s normal immune response.  It is especially common in infants and elderly patients and in those who have compromised immune systems due to an underlying disease. The primary treatment for oral thrush is an antifungal mouthwash used daily for one to two weeks.

Symptoms and Diagnosis of Oral Thrush

When given the opportunity due to a compromised immune system, the Candida fungus will start to reproduce rapidly leading to visible symptoms. A diagnosis for oral thrush can usually be determined through an oral examination. Symptoms include:

• White coating on the tongue and cheeks
• Pain in areas with white bumps
• Drying of the skin around the mouth
• Impaired taste and difficulty eating

Oral thrush can be transmitted from an infant to a mother through breastfeeding, which is why the All-Purpose Nipple Ointment (APNO) we compound includes an antifungal. Oral thrush is also common for patients undergoing cancer treatments. These patients may benefit from an antifungal mouthwash with additional ingredients for treating mouth ulcers.

Ingredients in Antifungal Mouthwash for Thrush

In most cases oral thrush can be treated with an antifungal mouthwash prepared by a compounding pharmacy. There are many formulations we compound for the treatment of fungal infection along with oral inflammation and pain. These sometimes are called “magic mouthwashes” – a broad term used for many kinds of compounded mouthwashes. Other ingredients that can be added to an antifungal mouthwash to reduce pain and inflammation include antihistamines, corticosteroids, and antibiotics.

Lidocaine, which is found in many of our topical anesthetics for dentists, can be added to a mouthwash to reduce pain while the infection is treated. Chlorhexidine, an antimicrobial ingredient used by periodontists and endodontists in multiple formulations, has also been shown to be an effective way to treat oral thrush. Various other non-prescription treatments have been discussed for treating oral thrush such as oil pulling and rinsing with essential oils. While combining these treatments with a prescription medication may be helpful, on their own they have not been proven to be effective.

Tips for Treating Oral Thrush

Antifungal mouthwash is most often prescribed to be swished and held in the mouth then swallowed 2-3 times per day. This allows the antifungal to work both locally and systemically and for the back of the mouth and throat to be treated. In addition to using a prescription antifungal mouthwash for oral thrush, other steps should be taken to help treat the infection. Other non-prescription mouthwashes should be avoided as these often contain alcohol and can make pain and inflammation worse. Regular tooth brushing should be done with a soft toothbrush to prevent further irritation. For patients with diabetes, it is important to maintain blood sugar levels.

External Links

• The prevention and treatment of oral thrush – PubMed Health
• Candida infections of the mouth, throat, and esophagus – Centers for Disease Control and Prevention