By Medicover Hospitals / 20 Feb 2021
A white tongue is a term used to describe any area of the tongue covered with a grayish-white coating. The entire tongue may be coated or the coating may appear in patches. There are several different reasons for a white tongue, and each has a specific treatment. A white tongue is usually a harmless symptom but, in rare cases, it can indicate serious illness.
- What is a White Tongue?
- When to visit a Doctor?
- Home Remedies
What is a White Tongue?
Whitening of the tongue can occur when there is a buildup or layer of bacteria and debris on the surface of the tongue due to mild dehydration, disease, or a dry mouth. Whitening of the top layer of the tongue or the presence of white spots or patches on the tongue can also be seen with infection, irritation, or chronic inflammation of the surface of the tongue. Some oral infections, including Candida yeast infection, are characterized by a white tongue. These yeast infections can be seen in many different circumstances, but are common in people with immune suppression due to conditions such as cancer or HIV infection. On the other hand, some infections, like scarlet fever, can produce red spots on the tongue. Inflammation and whitening of the tongue can also occur due to dryness or environmental irritants such as smoking or other tobacco use and can be associated with bad breath. Inflammation of the tongue is known as glossitis. Some white spots on the tongue, known as leukoplakia, can be precancerous lesions. Geographic tongue is a condition in which certain areas of the tongue do not have the papillae normally present on the surface of the tongue, resulting in irregular red spots on the tongue with a white border.
A white tongue is usually caused when bacteria, debris (like food and sugar), and dead cells get trapped between the taste buds on the surface of your tongue. These string-like papillae then become large and swell, sometimes becoming inflamed. This creates the white spot that you see on your tongue.
Having a white tongue can also be caused by several different conditions:
- Leukoplakia: Leukoplakia is a common condition caused by an overgrowth of cells in the lining of the mouth. These cells combine with the keratin protein (found in your hair) to form a raised white patch on your tongue. In many cases, you can get this disease by irritating your mouth and tongue when you drink alcohol or smoke tobacco. Sometimes there is no obvious cause. Leukoplakia is usually not serious, but it can sometimes become cancerous (oral cancer) years or even decades after it starts.
- Oral Lichen Planus: Oral lichen planus is a chronic (long-term) inflammatory oral disease. It is caused by a disorder in your immune system (your body's defense against germs) and other microscopic threats. You cannot pass this condition on to others.
- Geographic tongue: Geographic tongue occurs as the skin on your tongue grows back. Parts of the top layer of skin on your tongue fall off too quickly, leaving tender red areas that are often infected. During this time, other parts of your tongue stay in place for too long and take on a white color. You cannot pass the geographic language on to anyone.
- Oral thrush: Oral thrush is an infection of the mouth caused by the yeast Candida (fungus). Although Candida is normally found in your mouth, it becomes a problem when it grows too much.
- Syphilis: Syphilis is a bacterial infection and a sexually transmitted infection (STI). It is a serious illness with many symptoms, including a white tongue.
The doctor or dentist may scrape a small amount of white matter from the mouth or throat and look at it under a microscope and look at the characteristic yeast-like fungi. Candidiasis lower down the throat or esophagus is usually found through a procedure called endoscopy. In this procedure, the doctor passes a small camera down the back of the throat into the esophagus and stomach to view the tissue and take samples. If white lesions are found, they can be biopsied or scraped to confirm the diagnosis of thrush. This procedure is usually done by a gastroenterologist.
You might not need treatment for your white tongue. Usually, it should go away on its own within a few weeks. But be treated if it lasts longer or you want to get rid of it sooner. Treatments for common white tongue symptoms include:
- Hairy Tongue: Your provider likely won't treat your hairy tongue directly. Instead, they'll focus on treating your weakened immune system. In rare cases, they may prescribe antiviral drugs such as valacyclovir or famciclovir. Or they can apply a treatment (like podophyllin resin or retinoic acid) directly to your white spot.
- Tongue rash: You shouldn't need treatment for a tongue rash (oral lichen planus). But sometimes it can last for several years in the mouth. Your healthcare professional may prescribe steroid mouthwashes (steroid pills dissolved in water) and steroid sprays which may reduce your discomfort caused by symptoms like burning or sore gums.
- Mouth fungus: If you have mouth fungus (oral thrush), your healthcare professional will prescribe anti-fungal medicines such as Diflucan. These come as tablets that you can take or gels or liquids that you can apply to the patches inside your mouth. You will usually need several applications per day for a week or two.
- White Patches: There is no special treatment to have multiple white tongue patches (called geographic tongue because it looks like a map outline). Avoid any food and drink that causes you discomfort. Topical applications used to treat mouth fungus can provide relief from any discomfort you are experiencing. There is no risk that this condition will become cancerous.
- Syphilis: If syphilis is the cause of your white tongue, it will not go away on its own. If you don't get it treated, it can eventually damage your nervous system and cause serious long-term health problems. Syphilis is treated with a single injection of antibiotics (penicillin). If you have had syphilis for more than a year, you may need three injections.
- Oral cancer: If your healthcare professional tells you that you are at high risk for oral cancer, your white spot will likely be removed with surgery. Your surgeon may use a scalpel, a laser, or (rarely) another method like cryotherapy (freezing it with liquid nitrogen). This surgery will help make sure that the cells in your tongue do not become cancerous. You can choose to be numb or asleep for this operation. Usually, you will recover soon after this procedure.
When to visit a Doctor?
If a white tongue is your only symptom, you don't necessarily need to see your doctor. But if it doesn't go away in two weeks, you may want to consider making an appointment.
Call earlier if you have these more serious symptoms:
- Your tongue is sore or you feel like you are burning
- You have open sores in your mouth
- You have difficulty chewing, swallowing, or speaking
- You have other symptoms, such as fever, weight loss, or a rash
Some home remedies and habits may also help with getting rid of a white tongue.
- Another way to influence oral symptoms such as a white tongue is probiotics. Probiotics are strains of bacteria that are good for the digestive system.
- While a lot of research on probiotics focuses on improving gut health, probiotics can also be helpful for the mouth and tongue.
- A review from the European Journal of Dentistry noted that probiotic bacteria can occupy the mouth as well as the intestine. In some cases, these bacteria can help fight infectious yeasts and other bad strains of bacteria.
- Although the evidence is inconclusive, probiotics can still help balance the environment in the mouth and prevent a white tongue.
Baking Soda Scrub:
- Adding food-grade baking soda to a toothbrush and rubbing your tongue, teeth, and gums together can help reduce the bacteria that cause a white tongue.
- One study found that baking soda kills harmful bacteria that usually cause infections in the mouth, such as Streptococcus and Candida.
- Eating raw garlic can help the body fight off infections caused by Candida. The researchers noted that a compound in garlic called allicin was effective in combating the harmful strain Candida albicans.
- People can eat a whole raw garlic clove every day or chop it and eat it with a little olive oil to reduce the risk of white tongue.
- Gently scratching the tongue from back to front can also help reduce and remove bacteria and debris that collect in the mouth.
- Many companies offer specific tools for tongue scraping, which are available for purchase online. However, the edge of a spoon can be used just as easily.
Frequently Asked Questions:
A white tongue is usually not a cause for concern. But on rare occasions, this symptom can warn of a more serious illness, such as infection or early cancer. That's why it's important to keep an eye out for your other symptoms and call your doctor if the white coating doesn't go away in a few weeks.
A white tongue is the result of excessive growth and swelling of finger-like projections on the surface of your tongue. The appearance of a white layer is due to debris, bacteria, and dead cells that lodge between the enlarged and sometimes inflamed papillae.
Salt has antiseptic, cleansing, and soothing properties. This makes it a common home remedy for many oral problems. Rinsing your mouth with salt water can help relieve the symptoms of oral thrush.
Using a mouthwash that destroys bacteria and plaque can also help reduce and prevent the buildup that is causing your white tongue. Be careful, however, not to frequently use an alcohol-based mouthwash as this can dry out your mouth and make the problem worse.
Different tongue coatings - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092577/