A white tongue is a common condition that can happen to anyone. It occurs when the top surface of your tongue develops a thick, whitish coating. This coating is caused by changes in the normal bacteria and dead cells on your tongue. While a white tongue can look unappealing, it’s usually harmless and temporary. Understanding what causes a white tongue can help you find ways to prevent and get rid of it.
What is a white tongue?
A white tongue is when the top surface of your tongue turns white or yellowish-white in color. The texture of the coating may be thin or thick, and uniform or patchy. Often, the back part of the tongue has the heaviest coating.
A number of factors can cause a build-up of dead cells, bacteria, fungi, food debris and other substances on the tongue. This debris can lead to a visible discoloration.
Some people have naturally white tongues, while others develop white tongues from irritations like smoking or drinking alcohol. Conditions like oral thrush or leukoplakia can also cause white discoloration.
While alarming at first glance, a white tongue is usually harmless and often resolves on its own. Proper oral hygiene and adjusting your habits can help get rid of a white coating. Still, it’s wise to have your dentist examine any significant or persistent tongue changes.
What causes a white tongue?
The most common causes of a white tongue include:
Poor oral hygiene
Brushing and flossing helps remove bacteria, dead cells and debris from your mouth. When you don’t brush and floss adequately, these materials build up on the tongue, leading to discoloration. A gentle tongue scraping when you brush can help remove coatings.
Dry mouth
Saliva helps cleanse your mouth and wash away dead cells and food particles. A condition called dry mouth (xerostomia) reduces saliva flow, allowing debris to accumulate. Dry mouth can result from chronic dehydration, medications, illness, smoking or mouth breathing.
White tongue coating
Some people naturally have a white-coated tongue due to overgrowth of papillae – the small, nipple-like projections on the tongue’s surface. Enlarged papillae create grooves where debris easily gets trapped. While this white tongue is harmless, the coating is visually unappealing.
Oral thrush
Oral thrush is a fungal infection caused by an overgrowth of yeast called Candida albicans. It’s most common in babies, the elderly and immunocompromised people. Signs include creamy white lesions on the tongue or inner cheeks. It can cause a sore, white tongue.
Leukoplakia
Leukoplakia causes thickened, white patches on the gums, cheeks or tongue. It results from excess cell growth and commonly affects older adults. While usually benign, leukoplakia can sometimes become cancerous.
Lichen planus
This inflammatory condition can cause lace-like white patches on the gums, inner cheeks or tongue. It may produce a painful or burning sensation. The cause is unknown but may involve an immune response.
Hairy tongue
When papillae overgrow on the tongue surface, it looks furry and discolored. Bacteria and dead skin cells get trapped in the elongated papillae, causing a yellow, brown or black appearance. Hairy tongue is harmless but bothersome.
Tobacco use
Chewing tobacco or smoking can stain and coat the tongue’s surface. Quitting tobacco use often resolves associated white tongue.
Dehydration
A lack of fluids causes dry mouth. Without adequate saliva flow, dead cells and debris build up and discolor the tongue. Increasing your daily water intake can help restore moisture and a normal pink tongue.
Medications
Many medications reduce saliva, triggering temporary white tongue. Medications that can cause dry mouth include antihistamines, decongestants, diuretics, muscle relaxants and certain antidepressants.
Poor nutrition
Deficiencies in iron, folate or vitamin B12 may contribute to atrophic glossitis – smooth, red patches with partial loss of tongue papillae. Eating a balanced, nutritious diet can help improve this condition.
Canker sores
Canker sores are small, painful ulcers that can develop on the tongue. They appear white or yellow with a reddish border. Certain foods, stress or nutritional deficiencies can trigger outbreaks.
When to see a doctor
Schedule an appointment with your doctor or dentist if:
– The white coating persists longer than two weeks
– It worsens or spreads despite improved oral hygiene
– Discoloration is accompanied by pain, soreness or changes in texture
– You experience any difficulty eating, swallowing or talking
– White patches resemble oral thrush or leukoplakia
– Red spots or lesions develop, which may indicate tongue cancer
– You have other symptoms like fever, nausea or fatigue
Your dentist can examine your mouth and identify potential causes. Based on the evaluation, your dentist may collect a culture, order blood work or perform a biopsy. These tests can diagnose conditions like oral thrush or cancer.
Diagnosing white tongue
To diagnose a white tongue, your dentist will:
– Ask about your symptoms and medical history
– Inspect your tongue’s coating texture, location and color
– Check for soreness, redness, swelling or lesions
– Review any medications that could cause dry mouth
– Examine your gums for signs of gingivitis
– Collect a culture to test for oral thrush
– Order blood work to check for nutritional deficiencies
– Perform a biopsy to test suspicious lesions for cancer
– Take X-rays to help rule out conditions like leukoplakia
– Check the rest of your mouth for issues like gum disease, canker sores or ill-fitting dentures
Your dentist will identify potential causes based on your symptoms, risk factors and exam findings. Treatment will depend on the underlying condition.
Home remedies for white tongue
You can try these home remedies to get rid of a white tongue:
Brush your tongue
Gently brush your tongue using a soft toothbrush when you brush your teeth. Focus on areas with the heaviest coating. This helps loosen and sweep away debris.
Scrape your tongue
Using a plastic tongue scraper can remove built-up debris from the tongue’s surface. Avoid hard scrapers, which may injure the tongue. Scrape gently once or twice daily.
Rinse with salt water
A salt water rinse can help dislodge debris by drawing moisture to the tongue surface. Stir 1/2 teaspoon salt into a cup of warm water. Swish this mixture in your mouth for 30 seconds and spit it out.
Increase hydration
Drink plenty of water and limit diuretics like coffee to prevent dry mouth. Keeping your mouth moist makes it easier for your tongue to naturally cleanse itself.
Sip green tea
Green tea contains antioxidants that may inhibit the growth of the yeast and bacteria that cause white tongue. Drinking 1 or 2 cups of green tea daily may offer benefits.
Avoid irritants
Cut back on potential irritants like smoking, excessive alcohol, spicy foods and acidic drinks. Eliminating sources of irritation helps prevent a white coating.
Improve oral hygiene
Ensure you brush twice a day and floss thoroughly each day. Regular cleaning removes debris that can build up and cause white discoloration.
Increase nutrient intake
Eat a balanced diet rich in iron, folate, vitamin B12 and zinc. Supplements may help if deficiencies underlie your symptoms.
Medical treatments
If home care doesn’t work, your doctor may prescribe:
Antifungal medication
Oral antifungal medication can clear fungal overgrowth causing white tongue from oral thrush. Common antifungals are nystatin or fluconazole.
Steroid medication
Topical corticosteroid medications like dexamethasone may help manage leukoplakia. For severe cases, oral corticosteroids can be prescribed.
Medicated mouthwashes
Your dentist may recommend prescription mouthwashes containing ingredients like hydrogen peroxide, antifungals or corticosteroids to reduce debris and inflammation.
Saliva substitutes
Artificial saliva supplements help treat severe dry mouth. Sprays, gels, mouthwashes and lozenges moisturize and lubricate the tongue.
Tongue debridement
A dentist can use specialized tools to gently scrape off and thin thick white coatings. Removing debris rebalances bacteria levels.
Tips for prevention
You can help prevent white tongue by:
– Brushing twice daily and flossing once daily
– Rinsing with an antiseptic mouthwash at night
– Scrapping the tongue when you brush
– Drinking plenty of water
– Limiting caffeine and alcohol to avoid dehydration
– Quitting smoking and tobacco use
– Avoiding excessive spicy, acidic or sugary foods
– Managing stress levels with relaxation techniques
– Getting adequate sleep each night
Practicing excellent oral hygiene and staying hydrated are the best ways to keep your tongue pink and healthy. See your dentist regularly for checkups and cleanings. Report any unusual changes or persistent white discoloration.
When to see your doctor
Consult your dentist if:
– A white coating lasts longer than 2 weeks
– Discoloration worsens despite home remedies
– Red lesions, soreness or swelling develops
– White patches resemble thrush or leukoplakia
– You have difficulty chewing, swallowing or moving your tongue
– You smoke or use other tobacco products
– You suddenly experience extreme dry mouth
– You take medications that cause dry mouth
– You have symptoms like unexplained weight loss
Your dentist can determine if the cause is harmless, or related to a condition requiring treatment. Prompt evaluation is important, especially if cancer is suspected.
Takeaway
A white tongue usually results from buildup of dead cells, bacteria or fungi on the tongue’s surface. While harmless in most cases, treatment is often needed for appearance or comfort. Practicing good oral hygiene, staying hydrated and limiting irritants can help prevent white tongue. See your dentist if home care and remedies don’t restore your tongue’s normal pink color.