Thrush and adults

Definition
Thrush is a yeast infection of the mouth.

Causes/associated factors
Thrush is typically caused by the fungus Candida albicans, a type of yeast that thrives on milk and in humid environments. Candida albicans is one of the many microbes normally present in small amounts in your mouth. It may multiply out of control if your natural resistance to infection is low due to an illness or the natural balance of microbes in your mouth is upset from antibiotics, corticosteroids or immunosuppressive drugs. Candida albicans is also the same microbe responsible for vaginal yeast infections.
Although thrush can occur at any age, it's most common among:

infants and young children
those on certain types of chemotherapy
those on long-term corticosteroid therapy, either through pills, inhalers or nasal sprays
elderly adults
people who have weak immune systems (For people who have HIV, the virus that causes AIDS, thrush is a significant sign that HIV is progressing to AIDS.)
people who wear dentures (Irritation to the gums may cause an imbalance in the normal organisms of the mouth.)
people who have diabetes
people who are not eating well or have anemia (a condition marked by a decreased number of red blood cells or hemoglobin, a protein in red blood cells that contains iron)

Transmission
Candida albicans is so widespread in the environment that it's nearly impossible to protect yourself from exposure. When you're exposed to someone who has thrush, simply practice good hygiene. No special precautions are necessary.

Signs/symptoms
If you have thrush, you will notice slightly raised, sore, creamy-white or creamy-yellow patches in your mouth or throat. If the patches are rubbed off while you eat or brush your teeth, the area may be painful, raw and bleed slightly. Other symptoms of thrush may include denture problems, dry mouth and a bad taste in the mouth.

Diagnosis
To diagnose thrush, your doctor or dentist will examine your mouth or throat. A sample of a patch may be taken for lab analysis. You may need blood tests to rule out the possibility of an underlying disease.

Treatment
Specific treatment measures vary, depending on your overall condition. Topical medications such as clotrimazole troche lozenges or nystatin oral mouth rinses are often used as the first measure. If these measures are ineffective, you may need oral (taken by mouth) or other types of antifungal medication. Any underlying disorders are typically treated at the same time.
During treatment, drink plenty of fluids and avoid foods that may irritate your mouth, such as hot or spicy foods or foods with sharp edges. Drinking with a straw may help you avoid the painful patches.


Complications
Thrush may lead to esophagitis (inflammation of the esophagus, the tube that connects the throat and stomach).

Pregnancy-specific information
Thrush can spread from mother to baby during childbirth, especially if you have a vaginal yeast infection (a common condition during the third trimester).

Senior-specific information
Thrush is common among elderly adults because their immune systems are not as strong and they're less able to fight infections. Older adults are also more likely to wear dentures, a common underlying cause of thrush.

Prevention
To prevent thrush, practice good oral hygiene. Avoid antibiotics unless they're essential -- they may lead to yeast infections. If you use a corticosteroid inhaler or nasal sprays for asthma or other medical conditions, be sure to rinse your mouth with water after each use of the inhaler.
If your dentures are causing thrush, talk with your doctor or dentist about preventive measures, such as applying a small amount of antifungal medication (such as nystatin) under them.