Smoking and oral thrush

Preventing a yeast infection from antibiotics

If you have strep throat, a sinus infection, or another bacterial infection, your doctor might prescribe antibiotics to cure it. Antibiotics are very useful drugs that kill off the harmful bacteria that causes illness. Unfortunately, they can also destroy your body’s so-called “good” bacteria in the process.

Because of this, antibiotics often come with some unpleasant side effects, including nausea, dizziness, diarrhea, and yes, yeast infections. If you’ve experienced them, you’ve probably wondered, “Is there any way to prevent a yeast infection from antibiotics?” Read on to learn how.

What is a yeast infection?

Vaginal yeast infections, or candidiasis, are fungal infections of the vagina. They are caused by a fungus called Candida. This fungus is always present in the vagina, and usually it exists happily among the many good bacteria that balance it out. However, when a woman takes antibiotics that kill off all that natural biome, the Candida might start to grow out of control. When that happens, you get a yeast infection.

If you are not already familiar with the symptoms of yeast infection, consider yourself lucky. They are very uncomfortable and can include:

  • Intense itching in and around the vagina, including the vulva
  • Irritation
  • Burning
  • Pain or discomfort when urinating
  • Pain during intercourse
  • White, clumpy discharge that smells like bread

In extreme cases, yeast infections can cause redness, swelling, and cracks in the vaginal wall.

Why do you get a yeast infection from antibiotics?

A woman’s vagina maintains its own balanced mix of yeast and bacteria. “Antibiotics can destroy bacteria that protect the vagina, or may alter the balance of bacteria present,” says Dr. Janelle Luk, medical director and co-founder of Generation Next Fertility in New York City.

She explains that a type of bacteria called Lactobacillus keeps the vagina slightly acidic, which keeps the yeast at bay. But broad-spectrum antibiotics change all that. They destroy the bad bacteria causing your illness. But they also wipe out beneficial bacteria, including Lactobacillus. When there is less Lactobacillus in your vagina, it becomes less acidic, and therefore a perfect environment for yeast.

Which antibiotics cause yeast infections?

Do all antibiotics cause yeast infections? It’s a good question—especially if there are multiple options available to treat your condition. Broad-spectrum antibiotics are most likely to throw off your body’s natural bacterial balance, such as:

  • Amoxicillin
  • Carbapenems (like imipenem)
  • Tetracyclines
  • Quinolones (like ciprofloxacin)

Some inhaled steroidal treatments for asthma can increase risk of an oral yeast infection.

First and foremost, you should know that the benefits of antibiotics far outweigh the risk of side effects. Even though antibiotics might cause yeast infections, it is still important to take the medication as your doctor prescribed to fully treat a bacterial infection. Failure to finish an antibiotic prescription can cause something called antibiotic resistance. This means that your bacterial infection might become resistant to the drug and much more difficult to cure.

RELATED: What happens if you don’t finish antibiotics?

However, it is possible to prevent some side effects, including yeast infection. “To help prevent yeast infections, make sure to avoid wearing wet bathing suits or underwear, as moisture will allow yeast to grow,” Dr. Luk says. “Also, be sure to avoid hot tubs or hot baths, since yeast also forms in warm environments. Be sure to wear loose-fitting clothing, and avoid vaginal deodorant products such as sprays, powders, or scented pads and tampons.”

Rebecca Berens, MD, assistant professor of Family and Community Medicine at Baylor College of Medicine in Houston, says your doctor can also prescribe “an antifungal pill called Diflucan to take concurrently with your antibiotic prescription.”

Dr. Luk says it’s good to preemptively speak with your doctor about a Diflucan prescription if you experience yeast infections often. And she says that if Diflucan doesn’t work, another solution could be to use an over-the-counter antifungal cream, such as Monistat. “You may also try eating yogurt, as this will replenish the good bacteria in your vagina,” says Dr. Luk.

6 tips to prevent yeast infection from antibiotics

Antibiotics have a lot of uses. They treat dangerous bacterial infections, and the benefits far outweigh the risks. But it is possible to prevent some of the side effects, including yeast infection, by:

  1. Avoiding hot tubs or hot baths
  2. Wearing loose clothing
  3. Changing out of wet bathing suits or underwear
  4. Skipping feminine hygiene products, like douches
  5. Avoiding vaginal deodorant products such as sprays, powders, or scented pads and tampons
  6. Wearing breathable underwear and fabrics, like cotton

And, if your doctor prescribes an antibiotic, be sure to ask about prevention and treatment options, such as Diflucan and Monistat.

Antibiotics might clear up an infection, but they can disrupt the beneficial bacteria in your system, leaving you feeling a little off in unexpected places. We had a board-certified physician weigh in on the matter, and here is her advice.

Dear DrSugar,

I am on antibiotics (Clindamycin) to clear up an infected tooth before having a root canal. Good times, I know. I haven’t taken antibiotics in years, but know that they give me a serious yeast infection. I have upped my yogurt intake to twice daily and have been taking a probiotics pill twice a day too. Is that overkill? Should I be doing more? And if so, what do you recommend to keep the secondary yeast problem at bay? Thanks!
— Possibly Over-proactive

First off, I’d like to give you well wishes on a speedy recovery from your recent root canal! I’m really glad you asked this question, because antibiotics are some of the most commonly prescribed medications, and for women, taking antibiotics can definitely lead to yeast infections. To see why antibiotics can lead to yeast infections and what you can do to try to prevent it, keep reading.


Vaginal yeast infections, aka vaginal candidiasis, are caused by an overgrowth of the fungus Candida albicans. Candida albicans is commonly present in the vagina, mouth, and digestive tract and on the skin. Usually it does not cause disease or symptoms. There are other “good” bacteria that live normally in the vagina with Candida albicans and together they keep each other in balance. However, when the vagina has certain favorable conditions, the amount of Candida albicans increases, leading to a yeast infection. One of the most common of these favorable conditions is when a person takes antibiotics. Antibiotics are used to treat or prevent infections if a person is sick or has had a procedure/surgery that can increase the chances of having an infection (root canal!). The reason that the use of antibiotics can lead to an increased risk of yeast infections is that antibiotics tend to kill the “good” and protective bacteria along with the “bad” bacteria. This disrupts the normal balance of Candida albicans and the “good” protective bacteria in the vagina, thus leading to an overgrowth of Candida albicans.

Just for review, the symptoms of a yeast infection may include change in color, odor, or amount of discharge from your vagina; vaginal itching or burning; pain with intercourse; painful urination; or light vaginal bleeding. Typically, for vaginal yeast infections, the more common symptoms are itching and a white, thick discharge.

Some experts recommend eating yogurt with live cultures or taking probiotics containing Lactobacillus acidophilus when taking antibiotics to try to prevent a vaginal yeast infection. Lactobacillus acidophilus is an organism that normally lives in the vagina. Eating yogurt with Lactobacillus acidophilus or taking probiotics with this “good” bacteria will help to replenish the vagina with protective bacteria species and will help keep the balance of organisms in the vagina in check, thus hopefully preventing a yeast infection.

In terms of the amount of probiotics and yogurt you are taking daily, unfortunately there is no research that gives appropriate recommendations on how much to take of each while on antibiotics to prevent yeast infections. Also, the Food and Drug Administration (FDA) does not regulate Lactobacillus acidophilus (in over-the-counter probiotics), thus its safety, efficacy, and purity may not be known. Web MD suggests the typical doses range between one to 10 billion living organisms taken daily in three to four divided doses. However, directions may vary among the different manufacturers of probiotics. Also, antibiotics may reduce the effectiveness of probiotics or yogurt and thus should be taken two hours prior to taking the antibiotics to be most effective. It is hard to say whether you are overdoing it, but what I can recommend is only taking the recommended dosage that is printed on the directions of the probiotics bottle. One serving of yogurt a day should be plenty, however, given that you are also taking probiotics, I would recommend you check with your primary care physician regarding taking multiple servings of live-culture yogurts as well as multiple doses of probiotics daily. Your primary care physician will be able to tell you if they feel you are taking in too much Lactobacillus acidophilus and will be able to tell you what amount of it is appropriate for you.

DrSugar’s posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. for more details.

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Candida albicans. Also known as “thrush” when referring to baby and “yeast infection” when referring to moms. No matter what you call it, and we’ve called it almost every name in the book, it can be stubborn and painful. But we have some relief – and a few possible ways to prevent thrush altogether.

What is Thrush and How Do You Get It?

Thrush happens when there is an overgrowth of the fungus Candida albicans (yeast) in the body, either yours or baby’s. The resulting yeast infection can be easily transferred between a breastfeeding mom and baby.

You’re at a higher risk of being patient zero if you recently took antibiotics because, as many women are familiar with, antibiotics can deplete good bacteria that controls naturally occurring yeast in our bodies. Other breastfeeding moms at higher risk of developing a yeast infection are those who have diabetes or are anemic.

Baby can also be the carrier, though it’s not as clear what activates the infection in some babies’ mouths and not others. One way they can pass it to you is through cracked nipples. Wearing damp breast pads or bras also offers an introductory breeding ground.

The Blush of Thrush: Signs and Symptoms

For mom, the signs of a yeast infection on the nipple may be subtle or very painful. Look for the any of the following symptoms:

  • Bright pink nipples with a reddened areola
  • Tender, itchy, damp, or burning nipples
  • Shooting pain in nipple and breast during or right after feeding*
  • Deep pain in the breast
  • Cracked nipples that are slow to, or won’t, heal
  • Vaginal yeast infection

*Research has not definitively shown that the shooting pain is associated with yeast infection. Talk to your doctor if you have pain during breastfeeding – it may be from other causes.

For baby, it’s more consistent. Symptoms of thrush in babies include:

  • White patches on baby’s tongue, roof of their mouth, or inside cheeks that don’t rub off easily
  • Diaper rash that doesn’t go away after topical cream treatment
  • Skin rash with small, red spots near the edge appearing anywhere on baby’s body
  • Fussy baby during and after feeding
  • Baby slipping off breast or clicking during feeding

Preventing Thrush Infection or Reinfection

You and baby may both need to be seen by a doctor to be treated for thrush; sometimes it goes away with at-home treatment but left improperly treated or untreated altogether, thrush could turn into a worse infection such as plugged ducts and mastitis. Thus, it’s best for your doctor to diagnose and treat. However, preventing reinfection – or infection in the first place – is something you can do right at home.

Wash Everything

Wash all clothes and linens that came into contact with your nipples or with baby. Use hot water with bleach and let them air dry in the sun or set the dryer on hot. Make sure you’ve sterilized and washed all parts of your breast pump that touch your nipples or breastmilk.

Toys, teethers, bottles, nipples, pacifiers – anything that baby puts in their mouth need to be washed. Sterilize what is safe to do so, put those that aren’t in the dishwasher (or in washer or hand wash).

Use Dr. Brown’s® Rachel’s Remedy® Antimicrobial Washable Breast Pads

Dr. Brown’s® Rachel’s Remedy® Antimicrobial Washable Breast Pads feature a nifty technology that helps prevent bacterial growth. The cotton Sherpa on the breast pad secures silver molecules to the surface that only “turn on” when in the presence of unwanted bacteria, yeast, and other fungi. It’s safe for baby and won’t interfere with your skin’s good bacteria.

Our breast pads are proven to reduce bacterial growth by more than 90 percent and remain just as effective through 50 or more launderings. That’s 300 uses between the six-pad pack. While any mom who needs preventative protection can use these pads, moms dealing with thrush will especially appreciate them.

Consider Your Diet

And baby’s diet. While you can still breastfeed baby during a thrush infection, you can’t store or freeze your milk. Cold temperatures do not kill the yeast cells you carry in your milk during a thrush infection, so it’s possible to reinfect your baby – and yourself – with stored milk pumped during infection.

For mom, adding in probiotics to your diet may help build good bacteria that manages the growth of yeast. Some moms also lower yeast and sugar intake to help maintain the body’s inner balance. Before making any changes to your diet – always check with your doctor.

Helpful Everyday Practices

Thoroughly wash your hands with hot water and soap after every diaper change and topical treatment application. It’s good practice to wash and sterilize bottle nipples and pacifiers daily but extra important when dealing with thrush.

Change your bra and breast pads if-and-when they get wet and always keep your nipples as dry as possible. Avoid breast pads made with plastic liners that don’t allow air around your breasts, as they hold in moisture. Using Dr. Brown’s Breast Shells can also help with keeping you dry; small holes in the top of the shell air everything out and keep moisture from leaking onto your clothing.

Thrush infections are flat-out difficult to deal with. But with a little diligence, lots of self-care, and some technologically savvy breast pads – you’ll get through to the other side of thrush. For any questions about how Dr. Brown’s® Rachel’s Remedy® Antimicrobial Washable Breast Pads help thrush and other infections, we’re here with answers.

What Is Thrush?

A common mouth infection, thrush can be treated by anti-fungals and probiotics.

Thrush is an oral infection that occurs when the natural balance of microorganisms inside your mouth is disturbed.

It’s rarely serious, but you’ll want to get it treated right away to relieve the symptoms.

A thrush infection is caused by a type of fungus, or yeast, known as Candida albicans.

Normally, Candida exists in the mouth in small numbers along with various kinds of good bacteria, with each type of organism keeping the other in check.

An upset in this balance clears the way for the yeast to grow, ultimately resulting in thrush.

The infection affects 5 to 7 percent of newborns, 9 to 31 percent of AIDS patients, and about 20 percent of cancer patients, the Centers for Disease Control and Prevention (CDC) notes.

Thrush Symptoms

Symptoms of a thrush infection include:

  • White patches in the mouth or on the tongue that may bleed when rubbed
  • Redness or soreness inside the mouth
  • Cracking at the corner of the mouth (known as angular cheilitis)

The risk of contracting thrush may be increased by:

  • Having cancer, HIV or AIDS, or any other condition that weakens the immune system
  • Undergoing chemotherapy
  • Using antibiotics, corticosteroids, or immunosuppressive drugs
  • Using inhaled corticosteroids for asthma
  • Being very old or very young
  • Having diabetes that is not well controlled
  • Wearing dentures
  • Having oral sexual contact with someone who has a yeast infection

Thrush and Babies

It’s not unusual for newborns and infants to develop thrush, and it’s not considered serious unless the infection persists for more than a week or two.

Thrush usually clears up on its own in infants.

In adults, thrush has been associated with poor oral hygiene, but only in very extreme cases, says Orli Etingin, MD, professor of clinical medicine at Weill Cornell Medical College and medical director of the Iris Cantor Women’s Health Center at NewYork–Presbyterian Hospital in New York City.

“You really have to have massive decay and neglect in order to see thrush,” said Dr. Etingin. “In cases like that, bacterial infection is much more common, and it can be severe.”

Heavy tobacco smoking is also sometimes associated with thrush because smoke can irritate the tissue lining the mouth, making it easier for yeast as well as other organisms to invade and grow.

Thrush on Nipples

Thrush is a common infection on a breastfeeding mother’s nipples and in breast milk ducts.

This infection often occurs after recent antibiotic use, and can cause considerable breast tenderness, pain, and irritation.

Even though the mother’s breasts might appear normal, babies often have white thrush plaques in their mouth.

Both mother and child will need treatment if a thrush infection is diagnosed.

Thrush Treatment

Your doctor or dentist usually will be able to diagnose an oral yeast infection simply by looking for the characteristic velvety white lesions in your mouth or on your tongue.

If there is any doubt, the diagnosis can be confirmed by gently scraping off some of this material, examining it with a microscope, or sending it to a laboratory where it can be cultured.

Treatment consists of using an anti-fungal mouthwash or lozenges for 5 to 10 days.

Probiotics for Thrush

Dr. Etingin also recommends consuming probiotics to restore the mouth’s healthy balance of bacteria to yeast.

Probiotics are “good” bacteria similar to the bacteria normally found in the body.

They can be found in certain dietary supplements and some brands of yogurt that contain live bacterial cultures.

The amount and type of bacteria in probiotic products varies widely, so compare the labels carefully before you buy.

Thrush Complications

In otherwise healthy people, thrush has few serious or lasting consequences.

But if your immune system is weak, the infection may also involve the esophagus and spread through the bloodstream to other organs, so prompt and effective treatment is important.

Left untreated, a serious case of thrush can lead to a deadly C. albicans infection called invasive candidiasis.

Intravenous (IV) catheters and other medical equipment contaminated with Candida species can also cause invasive candidiasis.

In fact, the yeast causes up to 10 percent of all bloodstream infections acquired in the hospital (nosocomial infections), according to a report in the journal Clinical Microbiology Reviews.

Symptoms of invasive candidiasis can include fever and chills, but are not specific and depend on which organs the infection spreads to in the body.

Treatment requires several weeks of oral or intravenous antifungal medication.

Thrush may also signal a previously undetected medical condition such as diabetes or, rarely, infection with the human immunodeficiency virus (HIV).

How to Prevent Thrush

The American Dental Association offers these tips for minimizing your risk of oral thrush:

  • Good oral hygiene is essential. If you wear dentures, clean them regularly and remove them at bedtime.
  • Sometimes a saliva substitute may help, as a dry mouth presents a good growth medium for yeast.
  • If you have an underlying medical condition associated with thrush, such as diabetes, do your best to keep it under control.
  • Don’t smoke, or if you do, quit smoking.
  • Take any anti-fungal medication you’re prescribed exactly as your dentist or doctor tells you to.

If you see any signs or experience any symptoms of thrush, see your doctor right away so that you can get treatment and quickly restore the natural balance to your system.

How Smoking Affects the Mouth

  • Introduction to the effect of smoking on the mouth
  • Gum disease and smoking
    • How does smoking contribute to gum disease?
      • Bacteria
      • Blood vessels in gums
      • The way our body responds to bacteria
    • Effects of smoking on treatment for gum disease
    • Effects of stopping smoking on gum disease
  • Dental implants and smoking
  • Smoking, saliva and tooth decay
  • Oral cancer
    • Oral precancer
  • Other effects of smoking on the mouth
    • Aesthetics, smell and taste
    • Smoker’s melanosis
    • Nicotinic stomatitis (smoker’s palate)
    • Hairy tongue

Introduction to the effect of smoking on the mouth

The role of smoking in the development of lung cancer and cardiovascular disease is well known. It also has a part to play in several diseases and lesions in the mouth; the most common being gum disease. The chance of dental implant failure is more common among smokers than among non-smokers, and gum disease around these implants in those who smoke is also more prevalent.

The following oral diseases and conditions are caused by, or can be attributed to smoking:

  • Staining of teeth and dental fillings;
  • Reduction of the ability to smell and taste;
  • Bad breath;
  • Smoker’s palate, where the palate becomes white and a number of little spots project from the surface, each bearing a small red spot at the centre that marks the opening of the duct of the gland;
  • Smoker’s melanosis, which is associated with cigarette and pipe smoking, and is seen as brown spots inside the mouth;
  • Coated tongue, which is the condition wherethere is a coloured layer composed of mainly food particles, bacteria, and debris from epithelium in the mouth;
  • Oral thrush, which is a type of fungal infection that occurs in the mouth;
  • Gum disease;
  • Tooth decay (dental caries);
  • The failure of dental implants; and/or
  • Oral precancer and cancer.

These lesions most likely result from the:

  • Irritants, and toxic and cancer causing compounds found in the smoke;
  • Dryness in the mouth following high temperatures of inhaling smoke;
  • pH change;
  • Change in immune response; and/or
  • Change in ability to handle viral and fungal infections.

Have you quit smoking? Or are thinking about trying to quit? Use this tool to see what health benefits you have already achieved and what benefits you can expect in the future if you stick with it. For more information, see Health Benefits of Quitting Smoking Tool.

Gum disease and smoking

Cigarette smoking and its relationship with gum disease has been the topic of interest in the last 10-15 years.

Smokers have a 2.5 to 3.5 times greater risk of severe gum disease, which is recognised by the amount of bone lost around a particular tooth due to gum disease. Smokers also tend to lose more teeth than non-smokers.

The effect of smoking on gum disease is also dependent on the amount of cigarettes or cigars consumed (both quantity and duration of smoking).

Some research in previous decades thought that severe gum disease in smokers was caused by poor dental hygiene, and was made worse by smoking. It is now known that smoking, when adjusted for poor dental hygiene still causes more gum disease than in non-smokers.

How does smoking contribute to gum disease?


Three common bacteria are involved in gum disease. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia, are all present in higher amounts in smokers than non-smokers.

Although we do not know if there is a greater amount of bacteria in total, there is a lot of research that indicates the type of bacteria in smokers is more likely to cause gum disease. This is due to a higher quantity of “bad” bacteria that is present in smokers.

Blood vessels in gums

There is less inflammation and bleeding in smokers than in non-smokers. The reason for this is due to a constriction in blood vessels in the facial area. This constriction does not simply go away once people stop smoking but lasts for a while after smoking has stopped. The reduction in inflammation around the gums may also lead to a false sense of security that the gums are healthy, as one of the indicators dentists use to measure gum health is the amount of inflammation around the gums.

The way our body responds to bacteria

Smoking alters the way the body responds to the bacteria that is in plaque. It reduces the ability of the body to respond well to the bacteria and thus causes gum disease.

There are many compounds in smoke that can cause a reduction in the immune system (e.g. nicotine).

The main way our body responds to bacteria is through inflammation, and neutrophils are the most critical cell in protection against gum disease. Smokers have more neutrophils in the body in total; however fewer neutrophils reach the gums mainly due to the effects of nicotine. As neutrophils cannot control the bacteria as well as usual (due to the fewer amount reaching the gums), there is a much higher chance gum disease will occur.

The destruction of the gums also occurs much faster in smokers due to the presence of a higher number of matrixmetalloproteinases (MMPs), elastase, interleukin-1 and prostanglandin-2. These are components of the body’s immune response that are involved in inflammation, loss of collagen, and loss of bone.

It is clear that nicotine and various compounds in tobacco may impose detrimental effects on the blood system, inflammatory process and immune system. This results in a progression of gum disease, and a poor response to treatment.

Effects of smoking on gum treatment

Smokers respond less favourably than non-smokers to treatment of any kind to try and control the progression of gum disease. Heavy smokers (smoking > 10 cigarettes per day) in general exhibit a lower degree of healing following treatment for gum disease than ex-smokers and nonsmokers.

Effects of stopping smoking on treatment for gum disease

The effect of smoking on the gums is reversible to some extent when people stop smoking. Stopping smoking will allow for normal healing and repair of the gum tissues when bacteria are introduced to the area (usually in the form of dental plaque).

Dental implants and smoking

Significantly greater proportions of implant failures occur in smokers (failure rate 11%) than in non-smokers (failure rate 5%).

We are not sure exactly why there is a poorer rate of success in smokers compared to non-smokers. However, it has recently been suggested that the increase in the number of implant failures in smokers is not the result of poor healing during the surgical part of the implant, but is due to the exposure of tobacco smoke to the gums around the implant. Peri-implantitis is the name given to gum disease around an implant, and chronic peri-implantitis results in implant failure when left untreated.

Programs designed to stop smoking show considerable promise in improving the success rate of dental implants in smokers, with significant differences in failure rates between:

  • Non-smokers and smokers; and
  • Smokers who adopted the smoking cessation protocol and those who continue smoking.

Smoking, saliva and tooth decay

Smoking tobacco has the following effects on saliva. Smoking:

  • Immediately stimulates salivary flow;
  • Does not affect saliva flow rates in the long term;
  • In the long-term, slightly reduces pH (makes the mouth more acidic) and buffering power, which means that the chance of getting tooth decay and dental erosion is slightly higher; and
  • Is associated with lower amounts of salivary cystatin (thought to contribute to maintaining good dental health).

Research shows there are higher counts of two bacteria that are linked with tooth decay in smokers than non-smokers, namely, Lactobacillus spp. and Streptococcus mutans.

It is interesting to note that smoking during pregnancy is also associated with a higher chance of tooth decay in preschool children.

Oral cancer

Numerous studies in various populations have shown that smokers have a substantially higher risk of oral cancer than nonsmokers. The risk is higher when a greater amount of tobacco smoke is consumed. There is also a clear benefit in cancer risk reduction when people stop smoking.

Although we do not know exactly how smoking causes cancer, the toxic elements of smoking do cause harm to cells, which could easily lead to cancer.

Combining smoking and excessive alcohol intake increases the risk of getting oral cancer, and it has been estimated that 75-90% of all cases of oral cancer are explained by the combined effect of smoking and alcohol use. This could be because:

  • Alcohol dissolves certain toxic compounds in tobacco smoke which are linked to cancer; and/or
  • Alcohol increases the permeability of the epithelium inside the mouth.

Oral precancer

Oral leukoplakia, which can be regarded as “pre-cancer” is far more common in smokers than in non-smokers. Leukoplakia is essentially any white lesion whose cause is not known, and there is a chance that these lesions can become cancer.

For more information, see Oral Cancer.

Other effects of smoking on the mouth

Aesthetics, smell and taste

Smoking causes discolouration of the teeth (more than from the consumption of coffee and tea), dental fillings and dentures. This affects the appearance of the mouth.

Smoking is also a common cause of bad breath and affects the ability for us to be able to taste and smell.

Smoker’s melanosis

Smoker’s melanosis is associated with cigarette and pipe smoking, and is seen as brown spots inside the mouth. Smoker’s melanosis occurs in 5-21.5% of smokers. The pigmentation in the mouth is a result of tobacco smoke causing:

  • Stimulation of melanin production (brown pigment in our skin and mouth); or
  • The binding of the melanin to the compounds in tobacco smoke.

The amount of pigmentation is increased in heavy smokers.

Nicotinic stomatitis (smoker’s palate)

Nicotinic stomatitis is seen in the mouth as a number of bumps, which may have red centres, and occurs on the top of the mouth, which looks whitish in appearance overall.

This appearance is due to irritated salivary glands with inflamed ducts, which enter into the mouth. Nicotinic stomatitis is a response to heat (not the chemicals in tobacco); thus, there is no chance of cancer as a direct result of this lesion. Nicotinic stomatitis usually goes away once the person stops smoking. The top of the mouth returns to how it should look within 1-2 weeks of stopping smoking.

Hairy tongue

Hairy tongue is characterised by an overgrowth of little “hairs” on the tongue known as papillae. The papillae may be stained white, yellow, brown, green, or black depending on the source of the staining. With tobacco use, the color is generally brown or black. This condition is of concern as it does not look very nice, and also may contribute to bad breath.

Kindly written by Dr Akhil Chandra BDSc. (Hons UWA)

Dentist, Whitfords Dental Centre and Editorial Advisory Board Member of the Virtual Dental Centre

Smoking is positively associated with oral thrush – in fact, it’s one of the main oral thrush causes in healthy adults. Tobacco smoke will dry your mouth, cause lesions to appear, and destroy the bacterial balance, thereby favoring nasty organisms such as candida albicans.

To better understand how smoking causes thrush, you first need to know how oral thrush appears.

How does thrush appear?

The reason why smoking causes oral thrush are easy to understand, once you know how candida albicans grows and develops.

Candida Albicans accounts for more than 50% of the oral candidiasis, and it’s the main pathogen – the infecting organism – involved in oral thrush.

The fungi is often part of the intestinal gut. So often, in fact, that about 70% of the population carries it in their intestinal flora. Though this figure may seem high, most of the time this type of candida is harmless, since it’s kept in check by the rest of the bacterial flora.

Aside from the gut, candida albicans is also present in the mouth. About 50% of the world’s population carries it and, again, it’s not usually dangerous.

The real problem comes when this organism grows to disproportionate numbers – a process known as candida overgrowth. This may be caused by a variety of factors, from a course of antibiotics to an imbalanced diet to bad oral hygiene. Several diseases also cause an increase in the population of candida albicans, such as AIDS, cancer, vaginal yeast infections and diabetes mellitus.

How does smoking cause thrush?

Tobacco smoke kills the beneficial bacteria in your mouth, thereby allowing the candida colonies to grow freely.

In fact, studies have shown that smoking causes a considerable amount of damage to the mouth tissue, while encouraging the candida colonies to grow, as a result of destroying much of the rest of the mouth flora.

Smoking is so closely associated with smoking, that it’s actually a stand-alone risk factor in patients suffering from HIV.

What can I do?

Stop smoking. If you’ve got oral thrush, smoking is the worst thing you could do.

As soon as you experience the first symptoms, consult your doctor and start treating your infection. Drugs such as Diflucan or Nystatin are pretty successful when it comes to treating thrush, and home remedies are also quite efficient.

Whatever you do, pay attention to your diet – you want to avoid sugar and yeast-rich foods, and eat plenty of probiotics, such as unsweetened yogurt.


Smoking is a serious risk factor for oral thrush: it damages the oral tissue, kills the beneficial organisms in your mouth, and helps spread the candida infection.

If possible, avoid smoking at all costs, especially if you’re experiencing thrush symptoms. Consult your doctor and start the treatment as soon as possible.


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