Thrush is a fungal infection that occurs inside the mouth, causing painful white patches on the tongue and cheeks. The fungus that causes thrush is called candida and is commonly found on our skin and in the environment. Thrush is most likely to affect infants and small children and is rarer in adults. It can be a side effect of corticosteroid inhalers used for asthma and other respiratory conditions.

This article discusses the causes, signs, and treatment of thrush, as well as ways to prevent thrush when using a corticosteroid inhaler.

Signs and Symptoms of Oral Thrush

Common signs and symptoms of oral thrush include:

• Redness inside the mouth
• White patches on the tongue, cheeks, gums, tonsils, roof of the mouth, or back of the throat
• Mouth discomfort, soreness, or pain
• Loss of taste
• Difficulty swallowing
• In severe cases, fever (could indicate that the infection has spread beyond the esophagus)

Oral Thrush and Inhalers

Inhaled corticosteroids are frequently prescribed to treat asthma or chronic obstructive pulmonary disease (COPD). A side effect of these medications is decreased immune function, which can increase your likelihood of developing certain infections, like thrush.

Approximately 3% of people who use inhaled corticosteroids get thrush.

Other Causes of Oral Thrush

In addition to corticosteroids, certain other medications may make you more likely to develop thrush, including hormonal birth control pills and antibiotics.

Other medical conditions that may make you prone to thrush include:

• Diabetes
• Cancer
• Human immunodeficiency virus (HIV)
• Dry mouth
• Pregnancy

People who smoke and people who do not maintain proper oral hygiene may also be more likely to get thrush.

Infants with underdeveloped immune systems are prone to getting thrush while breastfeeding.

Preventing Oral Thrush From an Inhaler

Practicing good oral hygiene is essential to preventing thrush. Here are some tips to prevent it while using an inhaler:

• Rinse your mouth out with water or brush your teeth after every inhaler use
• Brush and floss regularly
• Avoid high sugar foods or foods that contain yeast
• Stop smoking

Treating Oral Thrush

Oral thrush can be treated with oral medications, such as flucanazole, or topically with antifungal rinses, such as nystatin, which are usually swished around the mouth and then spit out.

Topical medications are often chosen because they are less likely to be absorbed into the bloodstream and cause side effects.

Summary

Using inhaled corticosteroids can increase your risk of developing thrush, a fungal infection in the mouth. This is due to the lack of immune response in chronic health conditions like asthma and COPD. It can also be due to a lack of proper oral hygiene.

You can decrease your chances of getting thrush by rinsing your mouth out or brushing your teeth after using your inhaler. If you do develop thrush, it can be treated with oral or topical medications.

A Word From Verywell

While using inhaled corticosteroids can increase your chances of getting thrush, it's not common. It's more important to use your inhaler to manage your chronic respiratory condition, as necessary. If you experience frequent bouts of thrush, talk to your healthcare provider about underlying health conditions that could be causing it.