By Medicover Hospitals / 9 Feb 2021

The yellow tongue usually occurs because of a harmless accumulation of dead skin cells in the small projections (papillae) on the surface of the tongue.


What is the yellow tongue?

Oral yeast infection, or yellow tongue, occurs when an enormous amount of Candida fungi accumulates on the tongue. This buildup can make the tongue look yellow or orange. Oral yeast infection affects people of all ages. But in rare cases, the condition is a symptom of a more serious health condition that requires medical attention, usually jaundice. However, it is especially common in people who take steroid medications or have weakened immune systems.


Causes

Oral hygiene products with oxidizing agents:

Some oral hygiene products, inclusive of mouthwashes, rinses, and toothpaste, include chemical compounds or particles that cause dry mouth, aggravate pores and skin cells at the tongue, or cause them to extrude color.

Common compounds are known to cause yellow tongue discoloration to include:

  • Peroxides
  • Witch Hazel
  • Menthol
  • Alcohol
  • Thymol
  • Eucalyptus

Dry mouth or mouth breathing:

A dry mouth is the lack of enough saliva in the mouth. Saliva removes bacteria from the mouth, which helps prevent cavities. Saliva naturally helps remove excess bacteria and particles from the surface of the tongue. Dehydration reduces saliva production, so bacteria and food particles remain close to cells, increasing the risk of bacterial growth.

Poor Oral Hygiene:

Cleaning the teeth and tongue helps reduce bacteria on the surface of the tongue, reducing the risk of developing a yellow tongue. While you do not brush your enamel often and thoroughly, pores and skin cells, and bacteria can increase on the papillae of your tongue. Bacteria release pigments that can cause your tongue to turn yellow. Food, tobacco, and other substances can also get caught on your tongue and turn it yellow.

Black Hairy Tongue:

Black hairy tongue is a fairly common, non-cancerous condition in which bacteria or fungi cause an enlarged, elongated, hair-like mat to appear on the surface of the tongue. Although the tongue usually appears black, it can also turn yellow, blue, or green. This harmless condition occurs when the small bumps called papillae that line the tip and sides of the tongue become enlarged.

Mouthwashes that Contain Oxidizing Agents:

  • Using a mouthwash that contains peroxide, witch hazel, or menthol can change the color of your tongue
  • Foods with dyes, colors, or that stick to the tongue
  • Many foods comprise dyes or colorants that could stain the tongue yellow, or are sticky and stick with the tongue, discoloring its surface

Certain medications and drugs:

Many medications and drugs also contain staining particles, cause pigment discoloration, or weaken the immune system. Common substances and medicinal drugs that can increase the danger of developing a yellow tongue include:

  • diabetes and many diabetes control medications
  • blood-thinning medications
  • antibiotics
  • lansoprazole (Prevacid)
  • chlorhexidine (found in some disinfectant mouthwashes)
  • iron salts
  • minocycline
  • bismuth subsalicylate
  • anti-cancer and radiation drugs
  • antipsychotic medications
  • some illicit drugs, such as cocaine, can also make the tongue discolored

Oral candidiasis:

The overgrowth of Candida microorganism can cause white patches on the tongue that sooner or later broaden into a yellow hue.

Geographic Tongue:

Geographic tongue is a non-cancerous condition that causes red or white spots on the top and sides of the tongue that is often surrounded by a yellow border. This condition occurs when you have missing patches of papillae on your tongue. The spots are usually red, but they can also turn yellow. Sometimes they hurt. The condition has no known cause, but mainly affects children between the ages of 4 and 5. The patches tend to occur where skin cells are missing and are occasionally painful.

Jaundice:

In people with jaundice, bilirubin, a chemical created by the breakdown of red blood cells, accumulates abnormally in tissues. Sometimes only specific parts of the body turn yellow, like the whites of the eyes. Other times, the entire skin may turn a yellowish hue or glow. There are many causes of the yellow tongue, jaundice requires immediate medical attention, and often treated it could be a sign of life-threatening conditions such as liver failure.

Eczema and autoimmune diseases:

Some autoimmune conditions, such as eczema, weaken the body's immune system, allowing otherwise harmless bacteria to grow too large on the tongue.

Gastric diseases and infections:

Conditions that cause inflammation of the gastric lining are known to cause a yellow coating on the tongue. Much research has shown that a thickened, yellow tongue related to persistent gastritis or infection of the stomach lining, in particular while resulting from the Helicobacter pylori microorganism.


Diagnosis

The diagnosis of thrush depends on the location and identification of whether there is an underlying cause.
If the yeast infection is limited to the mouth:

To diagnose an oral yeast infection, your doctor or dentist may:

  • Examine your mouth for lesions.
  • Take a small scrap of the lesions to examine them under a microscope.
  • If it is very necessary to carry out a physical exam and blood tests to discover any viable underlying clinical conditions that can be the reason for oral yeast infection.

If there is a yeast infection in the esophagus:

To help diagnose yeast infection in your esophagus, your doctor may recommend any of these:

Biopsy

The tissue sample is grown in a special medium to help determine which bacteria or fungi, if any, are causing your symptoms.

Endoscopic examination

In this procedure, your doctor examines the esophagus, stomach, and upper part of the small intestine (duodenum) using a flexible, lighted tube with a camera at the end (endoscope).

Physical exam

A physical exam and certain blood tests may perform to identify any underlying medical conditions that may cause thrush in the esophagus.


Treatment

Oral hygiene is an essential factor. The identical habits and treatments that assist deal with the yellow tongue additionally assist to prevent it.

Common methods to deal with and save your yellow tongue include:

  • Increased frequency and thoroughness of tooth brushing.
  • Brush your tongue gently with a soft-bristle toothbrush.
  • Scrape the tongue gently every day.
  • Treat sinus infections.
  • Seeking treatment for jaw conditions.
  • Changing sleeping positions, pillows, or mattress.

When to visit a Doctor?

You do not need medical help if the yellow tongue is your only symptom. But if you have the following other symptoms, you need the doctor's help:

  • abdominal pain
  • blood in your stool
  • vomiting
  • fever
  • easy bruising and bleeding
  • the yellow color does not disappear after two weeks
  • your skin or the whites of your eyes are also yellow
  • your tongue hurts

Home Remedies

  • Practice good oral hygiene
  • Disinfect dentures
  • Try warm salt water, rinses
  • Limit your intake of starch or simple foods rich in carbohydrates
  • Avoid sugary drinks, alcohol, and caffeine
  • Stay hydrated
  • Use rinses and mouthwashes without alcohol or oxidants
  • Eat a healthy diet with enough fiber
  • Avoid colored or dyed drinks
  • Avoid hot or acidic foods and drinks

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Frequently Asked Questions

1. Is the yellow tongue serious?

A yellow tongue is often harmless and will go away on its own with time. Only a few situations that can cause yellow tongue, like jaundice, are more severe and need treatment.

2. Can oral yeast infection make you feel bad?

Candidiasis can cause a cottony mouthfeel or loss of taste. Antifungal medications can usually treat yeast infections. Sometimes untreated infection of yeast can become an extra severe infection, especially in those who are very sick.

3. How long does an oral yeast infection last without treatment?

If left untreated, the oral yeast infection will resolve in three to eight weeks. However, most cases of thrush clear up within 14 days with oral antifungal medications, antifungal mouthwashes, or pills. Very mild cases of oral yeast infection will go away without any medical treatment.

Citations

Altered oral microbiota in chronic hepatitis B patients with different tongue coatings -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092577/
Association between tongue appearance in Traditional Chinese Medicine and effective response in treatment of rheumatoid arthritis -
https://www.sciencedirect.com/science/article/abs/pii/S0965229911000562
Bacillus as a potential diagnostic marker for yellow tongue coating -
https://www.nature.com/articles/srep32496
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