Where There Is No Dentist 2012 105
Thrush is an infection caused by a yeast fungus called Candida. It often
appears when a person is weak and poorly nourished, or sick and taking
medicine like tetracycline or ampicillin. In a baby, thrush usually appears
on the tongue or top of the mouth. It can stop the baby from sucking. ln
an adult, thrush often occurs under a denture. Thrush is a very common
problem for people living with HIV (see pages 186 to 187).
• White patches on the tongue, cheek, or
top of the mouth. Wipe the white area: If
there is no bleeding it is old milk. If there
is bleeding, it is thrush.
• The child may not want to suck or eat.
There is usually something else present which is helping thrush to grow.
Try to find what it is and deal with it. For example, treat the malnutrition,
diabetes, or anemia, change or stop the antibiotic medicine, or clean the
denture and leave it out of the mouth for a while. Then:
1. Cover the white patches with nystatin drops. Use a full dropper 4 or 5
times a day until the patches are gone. If you do not have nystatin you
can soak a piece of cotton in gentian violet and use it to paint the white
patches 2 times a day.
If the baby’s mother has sore, painful nipples, she may also have thrush
in her breasts. She should treat her nipples the same way she treats
the baby’s mouth.
Do not use penicillin or any other antibiotic unless you need to
treat something different. Thrush can get worse when a person uses
an antibiotic for a long time.
2. For children, continue breastfeeding. For older persons, make their
food soft and easy to chew.
IMPORTANT: Sometimes white lines appear on the inside of an adult’s
cheek or on the roof of the mouth. If these lines become sore and do not
get better with treatment, they can change into a cancer (page 125). To
prevent this cancer, ask the person to stop smoking (especially pipes), stop
chewing betel nut, and get dentures adjusted if they do not fit properly.