Oral Thrush Treatment: Over The Counter & Medication

By Robynn Lowe
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September 1, 2022

If you notice a white rash in your mouth, don’t be alarmed. You may have a fungal infection known as oral thrush. Although it’s more common in babies, people who have an immune deficiency, and those who use steroid sprays to treat asthma, oral thrush also occasionally occurs in healthy individuals. 

The good news is, oral thrush is typically easy to treat. To help you determine if you have oral thrush and how to remedy this condition, in this article, I will explain the symptoms of oral thrush, how it is diagnosed, and the treatment options for adults and infants.

I’ll also share how, by practicing good oral hygiene, you can prevent your chances of contracting the infection or having it recur.

Oral Thrush Prescription Treatment Options

The best treatment for oral thrush depends on your age, overall health, and the cause of the infection. Your provider will consider these factors to select the right treatment and measures to prevent recurrence.

Doctors commonly prescribe one of the following medications to treat oral thrush:

Fluconazole (Diflucan)

Fluconazole is an oral antifungal medication that can be taken with or without food. Take as prescribed by your doctor until the full course is finished. 

Clotrimazole (Mycelex Troche) 

Clotrimazole is an antifungal medication that’s available as a lozenge, as well as a topical medication. 

Itraconazole (Sporanox)

Itraconazole is an oral antifungal medication suitable for people with HIV and those who do not respond to other treatments. It is available in capsule or solution forms. 

Nystatin (Nystop, Nyata)

Nystatin is an oral antifungal medication used for infants and those with weakened immune systems.

Amphotericin B (AmBisome, Fungizone)

Amphotericin B is an injection that’s used for more severe cases of oral thrush. It is given to a patient intravenously over a time period of around 2 to 6 hours by a healthcare provider to stop the spreading of a fungal infection.

This medication is usually taken once a day, though sometimes every other day at the discretion of your doctor. 

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Treatment for Different Types of Oral Thrush

Mild oral thrush

The treatment for mild oral thrush is typically clotrimazole, miconazole, or nystatin, which are all antifungal medications, often applied inside the mouth for a period of 7-14 days. 

Always take prescribed medications for the full duration of time your healthcare provider prescribes them, even if your condition is improving. 

Moderate oral thrush

Moderate oral thrush is treated similarly to mild oral thrush, with antifungal medications applied inside the mouth or via capsule or solution.

Severe oral thrush

If a case of oral thrush is more severe and hasn’t responded to other forms of treatment, a healthcare provider may prescribe amphotericin B, a prescription injection. 

Over-the-Counter Oral Thrush Treatment

Prescription medications are safer and more effective than over-the-counter options.

Always speak with a healthcare professional before trying these OTC treatments, especially when treating a baby:

  • Probiotics: Some research suggests probiotics may help treat oral thrush in adults who have normal immune systems by restoring a healthy balance of bacteria in the mouth. However, more research is needed to confirm how effective probiotics are.
  • Gentian violet: Sometimes used to treat mild cases of oral thrush in healthy adults, infants, and breastfeeding mothers, gentian violet is an antifungal. However, it can be irritating or toxic at some doses, stains skin and clothing, and is not regulated for use as a treatment by the FDA. 

Preventing Oral Thrush

The easiest way to help prevent oral thrush is to practice good oral hygiene:

  • Use an alcohol-free antiseptic mouthwash twice a day or as directed by your dentist or healthcare provider.
  • Brush your teeth twice a day and floss daily.
  • Remove your dentures at night and clean them daily. You may want to check with your dentist that your dentures fit properly and aren’t causing irritation.
  • If you experience dry mouth, discuss treatment options with your healthcare provider.
  • Limit the amount of sugary foods that you eat. These foods may promote the growth of candida.
  • Keep your blood sugar levels in check. This will help control the amount of sugar in your saliva, which is known to encourage the growth of candida.

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When to See a Medical Provider

Normally your immune system works well to fight off fungi that can be harmful to your health and, with the right treatments, oral thrush will resolve within two weeks.

However, this is not always the case, especially if you have a compromised immune system.

Visit your healthcare provider if:

  • You have a medical condition (such as HIV or cancer) that causes a weak immune system.
  • Your child shows symptoms of oral thrush.
  • You are generally healthy but the sores won’t go away with at-home treatments.

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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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Robynn Lowe

Robynn Lowe is a board certified Family Nurse Practitioner with over 15 years in the medical field. Robynn received her Bachelor's and Master's degrees from Florida Atlantic University and has been practicing in rural family medicine since. Robynn is married to her college sweetheart, Raymond and they have three awesome children. When Robynn isn't with patients you can find her shopping, coaching her kids sports teams, or spending time on the water.