White patchy tongue? You may be suffering from oral thrush


Oral candidiasis is also known as oral candidosis or oral thrush. It is a type of candidiasis that affects the mouth or throat. As explained by Dr. Johnson Wambugu, a dentist, oral candidiasis is a fungal infection of mucus membranes of the mouth.

It is caused by a fungus called Candida albicans. Candida is usually a normal organism occurring in the mouth. However, at times when the environment in the mouth is altered, it can overgrow hence causing symptoms such as creamy, white lesions in the mouth usually on the tongue, palate, gums, tonsils, and the inner parts of the mouth.

In severe cases, the infection can spread to the liver, lungs, heart valves, and digestive system.

Dear doc,

Who gets oral candidiasis?


Dear Jeremiah,

Anyone can get oral candidiasis. However, there are some risk factors that can increase chances of developing the condition. Children, elderly, people with suppressed immunity such as those with diabetes, cancer or HIV/AIDS, and those undergoing chemotherapy are at a greater risk of getting oral thrush.

Other risk factors include conditions that can cause dry mouth and use of certain medications like steroids. Wearing dentures also increases risk of oral thrush as they create a good incubation place for fungus. The risk of getting oral thrush mostly depends on a person’s immunity. The immune system normally works to get rid of harmful organisms like bacteria, viruses and fungi hence maintaining equilibrium between good and bad microorganisms in the body.


Dear doc,

Do white lesions in the mouth always mean one has oral thrush?

Paul G

Dear Paul G,

Oral candidiasis can manifest in different ways. Usually, the most common symptom of oral candidiasis is the appearance of characteristic white patches on the tongue and other mucous membranes of the mouth.

Other accompanying symptoms may include inflammation of the affected areas, difficulty eating due to inflammation, cracks on the corners of the mouth, loss of taste, and lesions may bleed slightly if they are rubbed.

In severe cases of oral candidiasis, the lesions can extend down into the oesophagus and cause Candida oesophagitis. This may cause one to experience difficulties when swallowing food. Besides characteristic white mouth lesions, infants with oral thrush may appear irritable, fussy and have trouble with feeding.

Women can have their breasts infected with candida which can result in cracked, red, and sensitive nipples. The skin around the areola (area surrounding the nipple) may appear flaky and shiny.

Breast feeding mothers with candida may have unusual pain when breast feeding or the nipples may feel painful between feedings. It important to seek medical attention if you one or more of these symptoms.


Dear doc,

I noticed some white patches on my baby’s tongue a few days after birth. The doctor said it was oral candidiasis. How could he have contracted the infection?


Dear Peris,

It is common for newborn babies to get infected with oral thrush. An infant can get the infection through birth canal during birth if the mother has vaginal candidiasis.

Also, the new born can catch the infection through breast feeding. Treatment involves use of oral antifungal medication or creams.


Dear doc,

I was recently diagnosed with oral candidiasis. What can I do to feel better?


First you need to start treatment with antifungal medication either in form of tablets or lozenges. In addition:

Observe good oral hygiene

Do not use mouthwashes — unless a dentist recommends a specific one — as they can change the normal flora in the mouth.

Replace toothbrush regularly to avoid re-infection.

Do not share your toothbrush with another person as this can spread infection.

Use warm, salty water to rinse your mouth. Do not swallow the rinsing water, instead spit it out.

If you are breast feeding, use nursing pads to prevent fungus from getting into contact with clothes. However, avoid nursing pads which have plastic barrier as they are a good habitat for fungal growth. Ensure to wash nursing pads and bras with hot water that contains bleach.


Oral hygiene is no doubt an important area of personal hygiene. Poor oral hygiene can greatly affect your social life. If you have good oral hygiene, you are likely to have confidence as compared to when you have poor oral hygiene. Therefore maintaining good oral hygiene is as important as maintaining body hygiene. There are several measures that one can undertake to maintain good oral health.

Brushing teeth properly: Teeth occupy a larger part of the mouth. It harbours food particles and bacteria which cause bad breath or can even damage teeth. Brushing properly that is at least twice daily and using the right brush helps eliminate food particles and bacteria keeping the mouth clean and fresh. Apart from brushing teeth, it is important to clean the tongue to remove bacteria and food particles. If you are in a place you are not able to brush after a meal, rinsing your mouth with water reduces the amount of food that would otherwise serve as substrate for bacteria.

Floss: Flossing is an activity that most people avoid. However, brushing alone cannot keep the mouth clean. Flossing help remove food elements and other substances between the teeth which cannot be achieved by brushing. It is recommended that flossing be undertaken at least once in a day.

Use mouth wash: mouth wash provides a quick remedy to oral hygiene. They can be used alongside brushing and flossing to improve oral hygiene. Mouthwashes help reach places between the teeth where brushing may not. Although not all mouthwashes are useful, there are some that help to kill harmful bacteria in the mouth keeping it clean and fresh. Talk to a dentist about the right mouth wash for you.

Clean your tongue: the surface of your tongue harbours food particles and bacteria which can lead to bad odours if not cleaned. It is therefore important to clean your tongue. Tongue cleaning can be done using a toothbrush, a teaspoon or a professional tongue scrapper. This helps remove bacteria living on the rough surface of the tongue which contribute to halitosis (bad breath).

Get treated for any underlying medical problems: oral hygiene is not all about the teeth. It also includes other parts of the mouth including tonsils. Tonsillitis leads to bad breath if not treated. Hence having the problem treated can improve oral health.

Visit a dentist regularly: there is need to visit a dentist at least every six months in order to have your mouth or teeth examined. A dentist is able to identify any issues that may need to be countered before they worsen such as tooth decay. If treated on time, such problems can prevent poor oral hygiene.

Avoid cigarette smoking and tobacco products: smoking has serious effects on the human body. The smoke builds up in the lungs and more so in the mouth leaving a foul smell. Even brushing may not be enough to get rid of tobacco smell. As such smokers are forced to use other substances like candies, mints, coffee or tea to mask this odour. Unfortunately, this does not help the situation as it is only a short term measure. Quitting smoking can help improve your overall oral health.

Avoid sugary substances: most people have a sweet tooth! Well sugary stuff like cakes, sweets, candies and even soda create a favourable environment for bacteria activities. This in turn accelerates damage to teeth and leads to bad breath. To stay safe, chew sugarless gums or go healthy options like water or milk to quench your thirst in place of sugary products.

Your mouth says a lot about you so take care of your oral health!