Oral thrush is characterized by a thick white coating of the tongue, inner cheeks, inner lip region, or gums. This coating may be differentiated from the very common off-white discoloration of the tongue associated with breast milk or infant formula debris by several means: (1) an oral Candida infection is a very bright white color -- milk debris is an off-white color; (2) oral Candida infections may also involve the buccal surface, inner lip area, and gingiva, while milk debris is limited to the tongue; and (3) oral Candida is rather adherent to an involved skin surface while milk debris may more easily be wiped off with a damp facecloth. Neither thrush nor milk debris cause discomfort nor other symptoms when limited to the mouth.
In older children and adults, oropharyngeal candidiasis is associated with several risk behaviors, including prolonged or repeated use of oral antibiotics , prednisone (or other steroid medications), smoking , dentures , use of birth control pills, and medical conditions especially diabetes (either type I or type II) or any diseases that can suppress your immune system ( HIV/AIDS ). Perhaps the most common association for developing thrush is improper technique during the use of inhalers containing corticosteroids for the control of asthma or COPD ( chronic obstructive pulmonary disease ). Such medications require rinsing your mouth with water and then spitting out the water to eliminate any non-inhaled medication. Patients using a metered-dose inhaler (MDI) for administration of their steroids are recommended to use a "spacer" to lessen the amount of potential residual steroid left in the mouth.