What to do about thrush?

Written by Zhang Xian Hua
Pediatrics
Updated on January 26, 2025
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Thrush is a local lesion caused by the infection of oral mucosa by Candida albicans. Comprehensive treatment measures should be adopted for treatment, starting with addressing the cause. Nystatin and baking soda water can be used to rinse the mouth three to four times daily. Additionally, good oral hygiene must be maintained. All items that come into contact with the mouth should be sterilized before and after eating or feeding, not just daily, as sterilizing only once a day is insufficient. Thirdly, children and patients can consume probiotics to regulate gastrointestinal function and enhance immunity; appropriate medication to boost immune strength can also be taken. Of course, if there are underlying diseases, treatment should still continue. (Medication should be used under the guidance of a professional doctor.)

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Does thrush hurt?

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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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.

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Does thrush need treatment?

Oral thrush is a white Candida infection of the oral mucosa, which certainly requires timely treatment. Firstly, oral thrush causes discomfort in the mouth; secondly, if left untreated for an extended period, it may also spread to the pharyngeal area. Thirdly, recurrent episodes of oral thrush can lead to decreased immunity and may facilitate subsequent infections. Therefore, active treatment is necessary. Treatment primarily involves using 2% baking soda solution to rinse the mouth. In severe cases, adding nystatin for oral rinsing might be required. Of course, maintaining good oral hygiene is crucial, and all tools that come into contact with the mouth must be thoroughly disinfected.

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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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How to treat thrush?

Thrush is an oral mucosal lesion caused by an infection of Candida albicans, commonly seen in infants and young children, especially those with low immunity or those taking steroids and other immunosuppressants. The treatment mainly involves symptomatic and supportive care, which may include topical medication. Diet management is also important; it is advisable to provide rice soup, glucose, and vitamin-rich foods, while avoiding high-sugar, stimulative, and greasy foods to prevent worsening the symptoms and discomfort in children. Lastly, hygiene related to the child’s feeding equipment, including pacifiers, bottles, and spoons, should be maintained by timely sterilization. Breastfeeding mothers should also pay attention to the hygiene of the breasts and nipples to prevent recurrent episodes of thrush. (Please follow the guidance of a professional physician for medication usage and do not self-medicate.)