Oral Thrush

Oral Thrush
Thrush is a fungal infection usually caused by Candida albicans or Candida tropicalis. In this condition, a patchy or solid white coating develops on the tongue, inner cheeks, and roof of the mouth and can extend from the back of the mouth down the esophagus towards the stomach. It may cause discomfort; and if it occurs in the esophagus, it can cause difficulty swallowing.

Thrush is usually treated with oral medicines such as fluconazole (Diflucan®) or itraconazole (Sporanox®), or with lozenges (e.g., clotrimazole [Mycelex®]). The white patches can be brushed off the tongue or the inside of the mouth with a toothbrush, but they come back without medical treatment.

Oral Hairy Leukoplakia
Hairy leukoplakia is a white coating on the tongue that is often confused with thrush. Unlike thrush, it cannot be scraped off with a toothbrush and does not appear on the inner cheeks or roof of the mouth. It gives the tongue a patchy, hairy appearance which is caused by the lengthening of the papillae, the small bumps that cover the surface of the tongue.

The cause of hairy leukoplakia is unknown and it may result from a herpesvirus infection. There is no specific treatment, but it usually resolves on its own after antiretroviral therapy.