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Medical News Today: What causes a white tongue?

White tongue is a term used to describe any area of the tongue that has a grayish-white coating on it. The entire tongue may be coated, or the coating may appear in patches.

There are a few 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 a serious condition.


In this article, we look at common causes of a white tongue and home remedies to get rid of the problem.





Causes of white tongue


Doctor examining tongue and throat.
Maintaining good oral hygeine is important for preventing problems from ocurring with the tongue.


The most common cause of a white tongue is poor oral hygiene. Small bumps on the tongue called papillae can start to swell up and become inflamed in a mouth that is not cared for well.


Plenty of germs, debris, food particles, and dead cells can get stuck in between these papillae. This causes the tongue to appear white as the particles build.


Oral and hygiene issues that can lead to a white tongue include:


  • dry mouth caused by mouth-breathing or sleeping with the mouth open

  • not brushing or flossing the teeth correctly

  • not cleaning the tongue

  • dehydration

  • irritation from sharp edges inside the mouth, such as teeth, braces, or dentures

  • regular alcohol consumption

  • smoking, chewing, or dipping tobacco

Basic oral hygiene is essential for everyone, but there are some conditions that cause a white tongue even in people who take great care of their mouths. These include:


Oral lichen planus


Oral lichen planus is an inflammatory condition that can affect the mouth and cause thick, white patches of skin to appear in the mouth and tongue.


These white patches may appear alongside other symptoms, including ulcers or painful cheeks and gums.


Leukoplakia


Leukoplakia causes thick white patches to form on the tongue and mouth. Leukoplakia is usually caused by irritants such as tobacco and alcohol, but may also result from inflammatory conditions and irritation from dentures.


The patches that leukoplakia causes are harmless by themselves. Rare cases can have serious complications, so a doctor should always diagnose leukoplakia.


Oral thrush


White tongue.<!--mce:protected %0A--> <br>Image credit: Grook da oger, (2012, April 6)</br>
White tongue can be caused by various fungal infections.
Image credit: Grook da oger, (2012, April 6)


Oral thrush is one condition that may cause the tongue to appear white. Oral thrush is a fungal infection caused by the Candida yeast.


Oral thrush causes patches to develop in the mouth and on the tongue. These patches usually have a white or off-white color and may have an unpleasant taste.


Oral thrush can also be painful, especially when eating or drinking.


People who have a weakened immune system may be more likely to develop oral thrush. This includes people who have recently taken antibiotics or undergone chemotherapy. Poor oral hygiene or wearing poorly fitting dentures are other risk factors.


Oral thrush can be caused by the use of inhaled corticosteroids for asthma. Certain conditions also increase the risk of infection, including diabetes.



Syphilis


Syphilis is a commonly-known sexually transmitted infection (STI) that can cause symptoms in the mouth.


Untreated syphilis can cause white patches to appear on the tongue and sores in the mouth. Syphilis requires medical treatment.


Other conditions


Rarer but sometimes serious conditions can lead to white patches on the tongue.


Mouth or tongue cancer may cause a white tongue, and other mouth conditions may also make the symptoms worse.


Underlying chronic inflammatory disorders may influence a white tongue as well.




When to see a doctor


Most appearances of a white tongue will clear up easily, although this is not always the case.


If the symptoms do not respond to basic oral care or are experienced alongside other symptoms, a person should speak to a doctor.



Medical treatment


A white tongue caused by a certain disorder may need a specific medical treatment.


Oral thrush is treated with antifungal medicines, most likely in the form of an oral drop, for 1 to 2 weeks until it has run its course.


Oral lichen planus is treated with corticosteroids if it is severe, but in many cases, it is simply monitored by a doctor or dentist.


Leukoplakia will also be monitored by a healthcare professional to make sure it is not getting worse.


Syphilis is treated with the antibiotic penicillin that kills the bacteria that cause the disease. Reducing irritants in the mouth, such as alcohol and tobacco, may help clear up the white patches.




Home remedies


Some home remedies and habits may also help with getting rid of a white tongue.


Probiotics


a range of fermented foods that contain probiotics, including pickles, kimchi, kombucha, and yoghurt.
Probiotics can be found in fermented foods and drinks, such as kimchi, pickles, and kombucha. Yogurt also often contains probiotics.


Probiotics are another way to influence oral symptoms such as a white tongue. Probiotics are strains of bacteria that are good for the digestive system.


While lots of research on probiotics focuses on improving gut health, probiotics may also be helpful for the mouth and tongue.


A review in the European Journal of Dentistry noted that probiotic bacteria can occupy the mouth as well as the gut. In some cases, these bacteria can help fight off infectious yeasts and other bad strains of bacteria.


While the evidence is not conclusive, probiotics may still help balance the environment in the mouth and avoid a white tongue.


Baking soda scrub


Adding food-grade baking soda to a toothbrush and scrubbing the tongue, teeth, and gums may help reduce the bacteria that cause a white tongue.


One study found that baking soda kills harmful bacteria that commonly cause infections in the mouth, such as Streptococcus and Candida.


Raw garlic


Eating raw garlic may help the body fight off infections caused by Candida. Research noted that a compound in garlic called allicin was effective at fighting off the harmful strain Candida albicans.


People can eat a clove of raw garlic whole each day or chop it up and eat it with a little olive oil to reduce the risk of white tongue.


Tongue scraping


Gently scraping the tongue from back to front may also help reduce and remove the bacteria and debris that settle in the mouth.


Many companies make specific tools for tongue scraping, but the edge of a spoon can be used just as easily.



Prevention


While it is not always possible to avoid getting a white tongue, basic oral hygiene can help prevent many cases. This includes brushing the teeth twice a day and flossing at least once a day.


Many people also benefit from using a tongue scraper every day or brushing the tongue with a toothbrush.


Lifestyle choices may also help prevent a white tongue at times. Avoiding tobacco products and alcoholic drinks may help, as well as eating a varied and nutritious diet.


Going to a dentist every 6 months for a checkup will help keep the mouth as clean as possible. People should report any worrying symptoms to a doctor for proper diagnosis and treatment.




Outlook


The outlook for a white tongue is typically very good. In many cases, it is harmless, even if it may be distressing to see.


Symptoms may not always respond to improved hygiene or lifestyle choices right away, but improved oral health is suggested for anyone with a white tongue.


In rare cases, a white tongue is an indication of a serious underlying condition. Following the treatment plan set out by a doctor is the best way of relieving symptoms.