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 department should I go to for thrush?

Thrush is a lesion caused by a Candida albicans infection of the oral mucosa, so the choice of clinic should be based on the specific situation. If it is neonatal thrush, it is usually appropriate to visit a neonatal clinic or a general pediatric clinic. If it is an older child with thrush, then it’s typically seen by a pediatric clinic during normal working hours, or it can also be seen at a dental clinic. During non-working hours, such as at noon, in the evening, on weekends, or holidays, it is generally appropriate to visit pediatric emergency or dental emergency services. Of course, for specialized children's hospitals and dental hospitals, there might be clinics available for pediatric dental medicine, in which case one would visit a pediatric dental clinic.

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Written by Zhang Xian Hua
Pediatrics
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Thrush should be seen by the Department of Stomatology.

Thrush is a mucosal lesion in the mouth caused by an infection of Candida albicans. Which department to visit depends on the child's age, the specific condition of the disease, and whether there are any underlying diseases. Usually, if it is a newborn, they should visit the neonatology clinic. For infants and young children, it is generally appropriate to visit the pediatric clinic or pediatric emergency department during normal working hours. During non-working hours, which means noon, night, weekends, and holidays, the pediatric emergency department should be visited. Of course, if the child has an underlying disease or is taking immunosuppressants that lead to a decrease in immunity, causing thrush, the department treating the primary disease should be consulted.

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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.

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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 Xian Hua
Pediatrics
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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.)