Does thrush hurt?

Written by Li Jiao Yan
Neonatology
Updated on September 06, 2024
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Thrush is caused by an infection of Candida albicans, forming white plaques on the surface of oral mucosa. Typically, it presents as small dots or patches on the oral mucous membranes that resemble curdled milk and can gradually merge into larger patches. They are not easily wiped off, without surrounding inflammatory response. Forceful removal might result in local mucosal redness, roughness, and possible bleeding. Generally, it is painless, does not cause drooling, and does not affect feeding. In severe cases of thrush, the white mucosal coating can extend to the pharynx, esophagus, trachea, and lungs, leading to symptoms like refusal to eat, low-grade fever, difficulty in breathing, and even life-threatening conditions. Typical thrush does not involve significant pain.

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Written by Zhang Xian Hua
Pediatrics
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What is thrush?

Thrush is a fungal infection that commonly occurs in infants and young children, especially those with weakened immunity due to prolonged use of immunosuppressants or steroids. It is caused by the infection of oral mucous membranes by Candida albicans. Commonly affected areas include the oral cavity, mucous membranes, gums, and tongue. It appears as white patches on the mucosa that generally cannot be wiped off with a cotton swab. Forceful wiping may lead to bleeding. Treatment mainly involves topical medication, a light diet, and maintaining good oral hygiene, which is very important.

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Written by Zhang Xian Hua
Pediatrics
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How to completely eradicate recurrent thrush?

Thrush is inherently prone to recurrence, and the difficulty in eradication is primarily due to poor hygiene, so figuring out how to effectively treat it is crucial. Firstly, active treatment should be implemented. The mouth should be rinsed with 2% baking soda solution at least four times a day. In severe cases, an antifungal agent can be added to the 2% baking soda solution for mouth rinsing. This is the primary step. Secondly, proper hygiene must be maintained. In principle, all items that come into contact with the baby's mouth, including pacifiers and bottles, need to be disinfected promptly. Of course, if breastfeeding, the cleanliness of the nipples and breasts is also very important.

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Written by Zhang Xian Hua
Pediatrics
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Is thrush easy to scrape off?

Oral thrush is caused by an infection with Candida albicans, resulting in localized lesions on the oral mucosa. Typically, a white membranous layer appears on the affected mucosa, which is difficult to wipe off. Forceful removal can lead to submucosal bleeding, which means it is not advisable to scrub the area. Instead, rinsing the mouth with about 2% baking soda solution is the correct approach, and this can relieve most symptoms. Additionally, it is important to maintain proper disinfection and hygiene. All tools that come into contact with the child's mouth during the period of oral thrush should be disinfected before and after each use. Consuming probiotics can also help manage the condition, reducing the likelihood of recurrence.

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Written by Li Jiao Yan
Neonatology
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Can thrush heal by itself?

Thrush is generally caused by a fungal infection due to an imbalance in the microbial flora, primarily involving the formation of a white plaque membrane by Candida albicans on the surface of the oral mucosa. It is mainly seen in individuals with lowered immunity, such as those with long-term malnutrition, repeated use of antibiotics, diarrhea, or the use of certain medications like corticosteroids. Additionally, unsanitary conditions during breastfeeding, fungal contamination on the mother's nipples, or fungal infection from nursing equipment can also lead to thrush. Typically, thrush does not require special antimicrobial medication. If the baby's immunity improves and their intestinal flora are properly established, thrush can heal spontaneously. It is generally recommended to orally take some probiotics and enhance oral care, which can include cleaning the oral cavity with 2% sodium bicarbonate before and after breastfeeding, or locally applying antifungal agents to suppress the fungal growth in the mouth.

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Written by Zhang Ai Min
Pediatrics
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How to treat thrush?

Thrush is a fungal infection, so its treatment is relatively simple. Generally, the approach involves maintaining an alkaline environment in the affected area, such as using 2% baking soda solution to cleanse and apply to the mouth. This 2% baking soda solution is made by diluting the 5% baking soda solution commonly available in pharmacies or hospitals by half, resulting in a 2%-2.5% solution. This can be used to rinse the mouth three to four times a day. After three to four days of cleaning, if there is no improvement, antifungal tablets such as miconazole or fluconazole dissolved in water can be applied to the affected area, typically yielding very good treatment outcomes. If there is no improvement after applying the baking soda solution and the antifungal solution, oral antifungal medication may be considered. In addition to these treatments, I believe prevention is most important. Preventing fungal infections involves maintaining cleanliness of the mouth and hands, ensuring the cleanliness of items such as baby bottles, pacifiers, and spoons, especially ensuring that adults' hands are free of fungal presence.