Patient information from BMJ

Oral thrush: what treatments work?

Last published:Sep 14, 2022

Oral thrush is an infection some people get in their mouth and throat. It's caused by a fungus called Candida. Thrush can make your mouth sore, but it can usually be easily treated with drugs. There are also things you can do to reduce your chances of getting it again.

You can use our information to talk to your doctor about the best treatments for you. 

Treating mild to moderate oral thrush

Oral thrush is usually treated with antifungal medicines. If your symptoms are mild and you don’t have any pain you will probably be offered antifungals in the form of liquid to swirl around your mouth or tablets to suck or put in your cheek.

These are called topical medicines. This type of antifungal works to clear up the infection in most children and adults.

Treating more severe oral thrush

Some people get more severe symptoms, including pain and a burning feeling in their mouth. People with these symptoms usually need antifungal tablets.

These tablets are more powerful than the topical treatments, but doctors are unlikely to prescribe them unless your symptoms are severe. This is because they are more likely than the topical medicines to cause side effects. These can include vomiting, diarrhoea, headaches, and rashes. 

In some people, these drugs can cause more serious side effects, such as liver damage. If you need to take antifungals for more than a few weeks, your doctor should make sure that you have regular check-ups to make sure this isn’t happening. 

Treating stubborn infections

People whose infections don’t respond to the usual antifungal tablets can be treated with other drugs, and sometimes with antifungals given by a drip (an intravenous or ‘IV’ treatment).

This is usually only used for the most serious infections, because these treatments can cause side effects in some people, including headache, fever, nausea, vomiting, and diarrhoea. 

Prevention in people whose immune systems are severely weakened

Some people, such as those with HIV or who are having treatment for cancer, may need treatment with antifungals to prevent oral thrush infection. This is because these people’s immune systems are so weak that an infection would be more serious for them than for most people.

Babies born prematurely, or who have a very low birth weight, may also sometimes need treatment to make sure they don’t get a thrush infection that could become serious.