Oropharyngeal Candidiasis (Oral Thrush)

INTRODUCTION 

Oropharyngeal candidiasis—commonly known as oral thrush—is a fungal infection of the mouth and throat caused by Candida albicans. Although Candida normally lives in the mouth harmlessly, certain conditions allow it to overgrow, leading to white patches, irritation, and difficulty eating.

NOTE:-

This condition is common in infants, elderly people, denture users, diabetics, and those with weak immunity.

What is Oropharyngeal Candidiasis?

It is a fungal infection affecting the tongue, inner cheeks, palate, gums, and sometimes the throat (pharynx).
It appears as white, creamy patches that may be painful or leave a red surface when scraped.

OROPHARYNGEAL CANDIDIASIS

Causes

Oropharyngeal candidiasis develops when the balance of microorganisms in the mouth is disturbed. Common causes include:

1. Weakened Immunity

• HIV/AIDS
• Cancer patients on chemotherapy
• Long-term steroid use
• Organ transplant patients (immunosuppressants)

2. Diabetes Mellitus

High sugar levels promote rapid fungal growth.

3. Antibiotic Use

Broad-spectrum antibiotics kill good bacteria, allowing Candida to multiply.

4. Denture Use

Ill-fitting or unclean dentures create a moist environment for fungal growth.

5. Dry Mouth (Xerostomia)

Due to dehydration, salivary gland problems, radiation therapy, or certain medications.

6. Smoking

Weakens oral mucosa and increases fungal colonization.

Signs & Symptoms

Common symptoms include:

• White, creamy patches on the tongue, inner cheeks, palate, or throat
• Redness or soreness in the mouth
• Burning sensation
• Pain while swallowing
• Loss of taste or unpleasant taste
• Cracks at the corners of the mouth (angular cheilitis)
• Dry mouth feeling

In severe cases, the infection may spread to the esophagus, causing difficulty swallowing.

Who Is at Higher Risk?

• Infants & elderly
• Diabetics (poorly controlled)
• HIV/AIDS patients
• Cancer patients
• Denture wearers
• Asthma patients using steroid inhalers
• People on long-term antibiotics
• Smokers
• Organ transplant recipients

Diagnosis

Diagnosis is usually clinical.
A doctor may check:

• Characteristic white plaques
• Red patches after wiping
• Swab culture (in severe or recurrent cases)
• Blood sugar levels (if diabetes suspected)

Treatment

1. Antifungal Medications

Topical antifungals (mild cases):

• Clotrimazole mouth paint / lozenges
• Nystatin oral suspension
• Miconazole oral gel

Systemic antifungals (moderate/severe cases):

• Fluconazole tablets
• Itraconazole (if resistant)
• Amphotericin B (rare, severe cases)

2. Treat Underlying Cause

• Control diabetes
• Improve mouth hygiene
• Replace or clean dentures
• Adjust antibiotics if needed

3. For Inhaler Users

• Rinse mouth after using steroid inhalers
• Use a spacer device

Home Remedies

These do not replace medical treatment, but help recovery:

• Warm salt-water gargles
• Maintain good oral hygiene
• Limit sugar intake
• Keep dentures clean
• Drink adequate water
• Quit smoking
• Eat probiotic-rich foods (curd, yogurt)

Prevention

• Brush twice daily
• Clean tongue regularly
• Rinse mouth after meals and inhaler use
• Control diabetes
• Avoid excessive antibiotics
• Keep dentures clean and remove at night
• Stop smoking
• Maintain hydration

Complications

If untreated, infection may:

• Spread to esophagus (esophageal candidiasis)
• Cause difficulty eating and dehydration
• Recur frequently in diabetics and immunocompromised patients
• Spread systemically (rare, in very weak immunity)

FAQs