Oral Thrush and Inhalers: What You Should Know

I get along really well with my primary healthcare provider, and most of our visits are light and filled with laughter. But there’s one part of my annual wellness exam that my healthcare provider always gets very serious about - whether or not I’ve been gargling with water for five seconds after taking my inhaled steroid inhaler.

Of all the details that we discuss during my wellness visits, it’s easy to think that gargling after taking my inhaler is a minor detail. But not only does my healthcare provider ask if I’ve been doing it, but she also takes her little flashlight and looks down my throat. She’s looking for signs of oral thrush.

What is oral thrush?

Everyone has an organism called Candida in their mouths, but sometimes it can overgrow and cause creamy, white lesions on the tongue and inner cheeks. This fungal overgrowth can also affect the roof of the mouth, tonsils, gums, and the back of the throat. ¹

Also called oral candidiasis, oral thrush is more common in babies, small children, and older adults due to their reduced immunity, but it can also affect adults who have certain health conditions or who are taking certain medications. ¹

What are the symptoms of oral thrush?

Part of why my doctor looks down my throat for early signs of oral thrush is because this fungal infection can develop without me even noticing it. But once the overgrowth of the Candida fungus has started, it can result in:³

• Slightly raised lesions that look like cottage cheese in appearance
• Redness, burning, or soreness in the mouth and throat area that may make if difficult to eat or swallow
• Light bleeding if the lesions are scraped or rubbed
• Redness and cracking at the corners of the mouth
• A dry or cottony sensation in the mouth
• Decreased taste sensation

Can you get oral thrush from an inhaler?

One of the risk factors for developing oral thrush is taking an inhaled corticosteroid, which I and many other asthmatics do as part of our long-term treatment plan. While my inhaled corticosteroid inhaler works well for managing my asthma symptoms, studies have shown that there is an increased amount of Candida in people who take an inhaled corticosteroid versus people who do not. ^2,3

Many inhaled corticosteroids contain a spray or powder that helps deliver the medicine to the lungs, but if these residues are not rinsed away after inhaler use, they can build up and eventually lead to an oral thrush infection.¹

How to prevent getting oral thrush from an inhaler

I’ve been using an inhaled corticosteroid inhaler for about five years now and have never developed oral thrush. Gargling with water for five seconds after I use my inhaler, just as my doctor prescribed, has been successfully keeping my throat clear.

I also brush my teeth, floss, and use mouth wash on a daily basis, just to make sure everything stays fresh and clean in there.

When does oral thrush clear up?

Should asthmatics ever develop oral thrush, a form of antifungal medication will be prescribed to bring the Candida levels back down to normal levels and alleviate symptoms. The primary healthcare provider may also look into alternative inhaler types to lessen the chance of developing oral thrush in the future since not all asthma inhalers increase the risk of developing oral thrush.^2,3

Although no one wants to develop oral thrush as a result of using their asthma medications, it’s possible to prevent an oral thrush infection with a little bit of daily maintenance. And if your doctor is anything like mine, she’ll keep a close on you just to make sure your mouth and throat stay healthy.