Thrush — the White Stuff Growing in Your Mouth (and How to Get Rid of it)

What’s that white stuff on your tongue? And why does your mouth feel “funny” — maybe a little bit like sandpaper? Well, my friend, you may have a case of thrush.

Thrush can strike anyone, but some people are far more vulnerable: “We usually see thrush in children whose immune systems are developing, or older adults, whose immune systems are starting to fail,” says otolaryngologist Tony Reisman, MD. “People who have conditions that affect the immune system are also more susceptible.”

Do I have thrush?

It can be challenging to know if your mouth woes are related to the Candida fungus that causes thrush. Common signs include:

• A white, cottage cheese-like coating.
• Redness, burning or soreness.
• A change in the ability to taste.
• Cracking of the tongue or corners of the lips.
• A dry, cotton- or sandpaper-like feeling.

Is thrush treatment necessary?

“You may not even need a diagnosis because thrush often goes away on its own once you stop whatever caused the problem,” says Dr. Reisman. “For example, if antibiotics led to thrush, just waiting a few weeks may give the body time to return to a natural yeast balance.”

Dr. Reisman recommends using good oral hygiene for three to four weeks to see if thrush resolves on its own.

When oral thrush just won’t go away

Well, it’s been a few weeks. You’ve been dutifully rinsing your mouth twice a day. But the white stuff is still there. It’s time to call your primary care provider.

Your provider will want to look at your mouth to rule out other causes, including:

• Burning mouth syndrome (a burning sensation in the mouth that has no obvious cause).
• Geographic tongue (harmless patches on the top and sides of the tongue with no known cause).
• Precancerous or cancerous lesions.

If it is thrush, your provider will likely order an antifungal rinse. You’ll swish, swish, swish for 10 to 14 days, which will help the body regain the natural yeast balance.

But if your symptoms still don’t improve, or you have recurrent episodes of thrush, visit an ear, nose and throat specialist (otolaryngologist) to discuss the diagnosis and treatment.

Prevent thrush from creating chaos in your mouth

People who are prone to thrush — whether from dentures, immune system-suppressing drugs or a condition such as HIV — can take steps to avoid it (because you can’t be on an antifungal medication forever).

Dr. Reisman recommends these behaviors to prevent thrush:

• See the dentist: Practice good oral hygiene, including a professional dental cleaning twice a year.
• Rinse: If you need steroid inhalers, make sure to rinse your mouth after using them.
• Drink water: Keep yourself hydrated so your mouth doesn’t get dry.
• Watch your sugar: Limit the sugary foods yeast feeds on, and maintain good blood sugar levels, especially if you have diabetes.
• Quit smoking: No explanation needed!