Oral thrush treatment over the counter for adults

What are the symptoms of oral thrush?

Oral thrush refers to the infection of the oral cavity with the Candida fungus. This is a very common condition in babies, especially in the first few months of life, when it is often passed on by the mother during childbirth; it may also occur in adults.

The condition presents with slightly raised white or yellow patches on the tongue, cheeks, and roof of the mouth, which looks similar to milk curd but does not wipe off as easily. If removed, the area underneath will be sore and red and may bleed slightly. It is often painful and uncomfortable; in babies, this will be evident at feed time.

What are the causes of oral thrush?

The Candida fungus is responsible for the infection; whilst this is present in the mouths of around 50% of the population, it will only multiply enough to cause a noticeable thrush infection when the conditions are right - there are a number of factors which can influence this. In babies and small children, the immune system is still developing and the first time that the fungus is presented to the mouth will more than likely cause oral thrush. Recurrent oral thrush in children is uncommon, but may be caused either by the presence of Candida on the mother's nipples whilst breast feeding, or inadequately sterilised bottle teats in bottle fed babies.

In adults, the immune system should prevent the onset of oral thrush by controlling the population of Candida in the mouth, if present, however there are situations in which the balance may be disturbed. The most common causes of oral thrush in adults are the use of steroid inhalers ("preventer" inhalers) and the use of dentures; other possible causes are a previous course of antibiotics, diabetes, malnutrition, or a compromise of the immune system by some other factor, in which case the doctor should be consulted.

Also, the over-use of strong mouthwashes and mouth sprays may upset the balance of micro-organisms in the mouth, making oral thrush more likely.

What complications might occur?

Complications arising from oral thrush in children or adults are rare, however if an infection fails to respond to treatment, or if the child or adult falls into any of the categories listed above, you should talk to your pharmacist or doctor for further advice.

How can I treat Oral Thrush?

For babies and children, ensure that feeding equipment and dummies are properly sterilised to avoid reinfection, or if breast-feeding, a small amount of an antifungal gel may be applied to the nipple. Further advice about treatment using an antifungal gel is given below.

In adults, where the cause is thought to be related to the use of an asthma inhaler, you should rinse the mouth with water after use, to remove particles of powdered medication remaining in the oral cavity. Ask your pharmacist if you are unsure about the correct way to use your inhaler, as correct use can minimise the amount of powder deposited in the mouth; there are also devices which can be used alongside common inhalers to prevent this effect if necessary.

If oral hygiene is difficult because of soreness in the mouth, consider using a soft toothbrush until the condition is under control.

What treatments are available for me to purchase?

Over-the-counter treatment miconazole gel (Daktarin Oral Gel) is used to treat oral thrush for adults and children over 4 months old. Treatment should be continued for two days after symptoms clear and should work within one week. Treatment is not suitable for people taking anticoagulants such as warfarin.

Other products which are suitable for the treatment of oral thrush include Nystatin mouthwash or Fluconazole when the oral gel is not suitable.

The most effective treatment available without a prescription is miconazole gel (Daktarin Oral Gel). This is an orange flavoured antifungal gel, which can be used for all ages, and may be applied to the mouth of a young child using a cotton bud or the handle of a teaspoon. It's important that the gel is retained in the mouth for as long as possible after application, and treatment should be continued for two days after the symptoms have cleared, to ensure complete eradication of the infection. Treatment should work within one week. However, this gel is not suitable for people taking anticoagulants, such as warfarin tablets.

Other products which are suitable for the treatment of oral thrush include Corsodyl mouthwash, Corsodyl dental gel, and Oraldene mouthwash, all of which are based on a strong oral antiseptic.

What treatments are available from my doctor?

Other antifungal preparations based on an ingredient called nystatin can be prescribed by a doctor for oral thrush which is resistant to non-prescription treatments. This is available in a dropper form for adults and children, or as a pastille for adults. This is usually used four times a day and treatment is continued for two days after all symptoms have cleared, as for the miconazole gel, above. Nystatin preparations should also be held in the mouth for as long as possible - they are broken down as soon as they reach the stomach.

The doctor may recommend other courses of action if necessary, depending on the underlying cause of the condition, such as recommending better fitting dentures, a modification of medicines for diabetes, or referral for further investigation.

What additional investigations might be needed?

The doctor should be consulted in the following circumstances:

· The patient is an adult, and there is no obvious underlying cause
· Non-prescription treatments have been tried, and have failed
· Oral thrush is a recurring problem
· The patient has a compromised immune system
· Your pharmacist has referred you

If the doctor is unsure of the nature of the infection, a scraping from the mouth can be sent for analysis, to confirm the diagnosis if necessary.

Any other information I should have?

Oral thrush is a common condition in babies and young children, and can usually be treated quickly and successfully using a non-prescription oral antifungal gel. It commonly occurs at the same time as nappy rash; this can be treated using an antifungal cream such as Canesten or Daktarin Cream. Ask your pharmacist if you need more advice.

However, it's not as common in adults, and may be painful but it is rarely serious. If oral thrush appears for no apparent reason, then talk to your pharmacist or doctor for the best advice.

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