Oral Thrush Treatments and Medications

If you’re having trouble swallowing and you notice tiny, white lesions on your tongue, around your mouth, or in the back of your throat, chances are you have oral thrush. Not only can this condition cause bad breath, but it can also affect your tastebuds and prevent you from enjoying the foods that you love. To get your taste buds back to normal (and alleviate that pain in your throat), keep reading to learn about oral thrush, what the best treatments and medications are, and which natural remedies we recommend.

What is oral thrush (oral candidiasis)?

Oral thrush, also known as oral candidiasis or oropharyngeal candidiasis, is a fungal infection that develops on the mucous membranes of the mouth. According to the Centers for Disease Control and Prevention (CDC), common symptoms of oral thrush include pain and difficulty swallowing, loss of taste, bad breath, dryness, redness, and a white tongue. Some treatment options are antifungal medications, topical antiseptics, and throat lozenges.

“When oral thrush takes hold, Candida bacteria become very active in the mouth and crowds out healthy, important bacteria within the oral microbiome,” says Dr. Mark Burhenne, DDS, founder of AsktheDentist.com. Dr. Burhenne goes on to say, “Candida is also high when you have high rates of dental caries—cavities—and likes to coexist with the major cavity-causing bacteria, S. mutans.” 

Oral thrush is a relatively common condition, with more than 200,000 cases occurring in the U.S. every year. Because of how prevalent it is, there are ongoing clinical trials and research to find additional cures. Diflucan (fluconazole) is approved by the FDA and found to be effective against oral thrush.

How is oral thrush diagnosed?

Oral thrush is most commonly caused by the fungus, Candida albicans, but it can also be caused by Candida glabrata or Candida tropicalis. It’s very rare for healthy adults to contract oral thrush. Those at risk include babies, especially those who are younger than one month old, people who wear dentures, those who have diabetes or HIV/AIDS, cancer patients, those with a weakened immune system, people who smoke, and those who take antibiotics or corticosteroids.

One of the easiest ways to tell if you or your child has oral thrush is visible white patches on the inner cheek, tongue, and roof of the mouth, in addition to pain while swallowing.

If you’re not sure whether you or your child have oral thrush, schedule an appointment with your primary healthcare provider right away, as he or she can help diagnose the issue and provide further medical advice. Here’s what you can expect at your appointment:

• Your doctor may examine your mouth and look for lesions, white spots, and redness.

• Your doctor may perform a biopsy or take a small scraping of the lesions to determine which bacteria or fungi, if any, are causing your symptoms.

• If you have an oral thrush infection in your esophagus, your doctor may perform an endoscopy to examine your tonsils, esophagus, stomach, and upper part of your small intestine.

• If needed, your doctor may perform a physical exam and do some blood tests to identify underlying medical conditions that could be causing oral thrush.

Questions your doctor may ask you

During your appointment, your doctor may ask the following questions to better confirm the diagnosis of oral candidiasis:

• When did you start noticing symptoms?

• Have you recently taken antibiotics?

• Do you have asthma and use a steroid inhaler?

• Do you have any long-term health conditions?

• Did you have a vaginal yeast infection when you gave birth (if you’re a new mother)?

• Are you breastfeeding?

• Do you wear dentures?

Questions you should ask your doctor

If you do have oral thrush, it’s important to understand its causes and course of action over the short- and long-term. Here are some of the more important questions to ask your doctor during your appointment:

• What causes oral thrush?

• Is oral thrush contagious?

• What treatments are available to help treat this condition?

• How long do I have to take the medicine for?

• Can I give my children certain medicine to help with the pain?

• How can I breastfeed my newborn who has oral thrush?

• How can I lower the risk of my newborn getting oral thrush?

Though primary care physicians, pediatricians, and dentists can usually treat oral thrush, they may refer you to an infectious disease specialist or immunologist in severe cases.

Oral thrush treatment options

After you receive a diagnosis, your doctor should provide you with a variety of options to treat oral thrush. In most cases, treatment will consist of antifungal medications, lozenges, or topical medications. The most popular antifungal medications are clotrimazole, miconazole, and nystatin. For more severe oral thrush cases, the most common treatment is fluconazole.

According to Dr. Andrea Santa, DMD, the best treatment options for oral thrush will typically include topical treatments. “The most common are oral troches, which I tend to describe as a sort of lozenge that you suck on for about 30 minutes, oral suspensions, which have medical agents mixed with a liquid to be a delivery vehicle, and topical creams.” Dr. Santa goes on to say, “For chronic cases of oral thrush, some patients will be prescribed a systemic treatment, which is delivered in pill form.”

To prevent candidiasis, practice good oral hygiene, rinse your mouth after using inhaled corticosteroids, clean your dentures after every use, and change your toothbrush every three months. Nursing mothers should avoid using damp nursing pads, routinely clean pacifiers, and consider air-drying their nipples if their infant routinely develops thrush. For those who need to take daily-inhaled corticosteroids for asthma, consider rinsing and spitting following the use of a metered-dose inhaler (MDI).

Oral thrush medications

There are two main types of medications used to treat oral candidiasis. They are antifungals and antiseptics.

Antifungals

Antifungal medicines work by killing fungal cells. They do this by damaging the cell walls of the fungus and preventing the cells from growing and reproducing. Antifungals can come in the form of creams, sprays, tablets, and injections. Some popular antifungals include Diflucan, Mycelex Troche, Nystop, Ketoconazole, and Nyata. Common side effects of these drugs include itching and burning, redness, abdominal pain, and a rash.

Antiseptics

Topical antiseptics can destroy or prevent the growth of microorganisms on the skin or in the mouth that are causing infection. For oral thrush treatment, the most popular brand is Periogard. This type of antiseptic oral rinse has powerful antibacterial properties that can help maintain a healthy mouth and control and kill bacteria in your mouth. Some side effects include tooth and tongue staining, increased tartar, throat irritation, dry mouth, and tongue swelling.

What is the best medication for oral thrush?

The best medication for oral thrush depends on the patient’s medical condition, medical history, and medications they may already be taking that could interact with oral thrush medication as well as the patient’s response to treatment.

This table will act as a comparison chart for the most commonly prescribed oral thrush medications.

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Best medications for oral thrush