A white tongue is often a harmless condition that can resolve on its own. However, in some cases it may indicate an underlying health issue. Here we explore the causes, symptoms, and treatments for white tongue.
What is a white tongue?
A white tongue refers to a buildup of debris, bacteria and dead cells on the surface of the tongue. It appears as a white, yellow or cream color coating over parts or all of the tongue.
What causes a white tongue?
A number of factors can cause a white tongue:
- Poor oral hygiene: Not brushing or scraping your tongue regularly can allow dead cells and bacteria to build up.
- Dehydration: A lack of fluids can make the tongue appear white and coated.
- Dry mouth: Reduced saliva flow from medications, mouth breathing, dehydration or certain illnesses can cause dry mouth, allowing debris to accumulate on the tongue.
- Oral thrush: A fungal infection in the mouth can cause creamy white lesions on the tongue.
- Leukoplakia: Thick, white patches on the tongue may indicate this pre-cancerous condition.
- Oral lichen planus: An inflammatory condition that can cause a lacy white pattern on the tongue.
- Strep throat: White bumps or patches along with sore throat and fever may indicate a streptococcal infection.
- Oral hairy leukoplakia: White, fuzzy patches on the side of the tongue, often due to weakened immune system.
Is a white tongue normal?
A thin white tongue coating is very common and harmless in most cases. It often develops after eating or drinking and resolves with brushing.
A thicker white layer may also be normal if it comes and goes. Permanent white patches should be checked by a dentist.
White tongue symptoms
Signs and symptoms of a white tongue can include:
- A white or yellow coating on the tongue
- Debris built up in the cracks and crevices of the tongue
- A furry or hairy texture to the coating
- White or cream-colored lesions or patches
- Red or inflamed bumps under the coating
- Bad breath
- Metallic, bitter or unpleasant taste in the mouth
- Sensitivity or burning sensation of the tongue
- Cracked, sore or smooth tongue
- Loss of taste
- Dry mouth or reduced saliva
Where does a white tongue normally occur?
The location of white patches or coating can help identify the cause:
- All over the tongue – Often due to oral hygiene, dry mouth or dehydration.
- Back of the tongue – Associated with oral hygiene issues.
- Side of the tongue – May indicate oral thrush or oral hairy leukoplakia.
- Under the tongue – Can be normal but may point to oral thrush.
- Top of the tongue – Can occur with many different causes.
- Specific patches – May be leukoplakia, lichen planus or geographic tongue.
- Bumps or lesions – Could be lie bumps, canker sores or inflamed papillae.
What diseases can cause a white tongue?
In some cases, a white tongue can arise from certain illnesses:
Oral thrush
Oral thrush is a yeast infection caused by an overgrowth of Candida fungi in the mouth. It appears as creamy white lesions on the tongue, inner cheeks and sometimes the roof of the mouth and gums.
Strep throat
Strep throat is a bacterial throat infection causing sore throat, fever, swollen lymph nodes and white spots on the tonsils and back of the throat. White patches may also occur on the tongue.
Leukoplakia
Leukoplakia is characterized by thick, white patches that form on the gums, insides of the cheeks or bottom of the mouth. It can sometimes develop on the top or sides of the tongue as well.
Oral lichen planus
Oral lichen planus is an inflammatory condition that can cause a lacy, white pattern on the insides of the cheeks as well as the tongue.
Oral hairy leukoplakia
Often due to weakened immune system, this causes white, hair-like projections to grow on the side edges of the tongue.
Geographic tongue
Geographic tongue is a harmless but patchy red and white condition of the tongue surface that can sometimes be mistaken for thrush.
When to see a doctor
See your doctor or dentist if:
- White patches last longer than 2 weeks
- The coating is thick, wart-like or hard to scrape off
- Red spots or ulcerations are present
- You have pain, tingling or burning of the tongue
- There are other symptoms like sore throat or mouth pain
- You have an immune system deficiency
Prompt evaluation is recommended as some white lesions may be precancerous or indicate an underlying condition needing treatment.
How to get rid of a white tongue
A number of home remedies may help get rid of a white tongue:
Brush your tongue
Gently brushing the tongue with a soft toothbrush can remove debris and bacteria buildup. Focus on the back of the tongue where the coating often accumulates.
Use a tongue scraper
Using a tongue scraper is one of the most effective ways to remove white tongue. Scraping the tongue gets deeper into the crevices than brushing.
Drink more water
Staying hydrated helps thin saliva so it flows better, keeping the tongue surface clear.Aim for eight 8-ounce glasses daily.
Avoid irritants
Reduce intake of alcohol, tobacco, coffee, sodas and acidic or spicy foods that can irritate the tongue.
Improve oral hygiene
Brush and floss thoroughly twice a day and see your dentist regularly to prevent plaque buildup.
Treat dry mouth
Use saliva substitutes, humidifier at night, sip water and avoid antihistamines and decongestants that reduce saliva flow.
Rinse with baking soda
A baking soda mouth rinse helps balance pH levels in the mouth, reducing fungal or bacterial growth.
Eat probiotic yogurt
Consuming probiotic yogurt can help establish healthy bacteria levels in the mouth to prevent overgrowth of harmful microbes.
Rinse with hydrogen peroxide
Dilute peroxide may have an anti-fungal effect and help temporarily whiten the tongue. Rinse and spit out after 30 seconds.
When to see your doctor for white tongue treatment
See your doctor if home remedies and improved oral hygiene don’t clear up a white tongue within 1-2 weeks. Medical treatment may be needed if the cause is:
- Oral thrush – Antifungal medication is used to treat thrush.
- Strep throat – Antibiotics are given to treat the bacterial infection.
- Underlying illness – Treatment focuses on managing diabetes, nutrient deficiencies or immunodeficiency disorders contributing to thrush.
- Allergies – Altering medications that cause dry mouth or treating environmental allergies may help.
- Geographic tongue – Corticosteroid oral rinses or ointments can reduce discomfort.
- Leukoplakia – Surgery may be done to remove affected tissue and regular monitoring is required.
- Oral cancer – Early treatment is critical and may involve surgery, radiation or chemotherapy.
Home remedies for a white tongue
A number of simple home treatments may help get rid of a temporary white tongue:
Baking soda and lemon rinse
Mix 1/2 teaspoon baking soda with juice from 1/2 lemon in 1 cup warm water. Rinse your mouth with this solution for 30 seconds, 2-3 times daily. The acidic lemon balances the pH in your mouth while the baking soda gently scrubs the tongue.
Hydrogen peroxide rinse
Dilute 3% hydrogen peroxide solution with equal parts water. Swish this around your mouth for 30 seconds before spitting out. Use once daily. Peroxide can help whiten your tongue but don’t swallow it.
Salt water rinse
Dissolve 1/2 teaspoon salt in a cup of warm water and rinse your mouth with it. Saltwater helps draw out excess moisture from the tongue.
Aloe vera gel
Apply pure aloe vera gel directly on the white patches on your tongue using a cotton swab. Aloe vera has antibacterial and antifungal properties to fight infection.
Probiotic yogurt
Eating a few spoonfuls of plain yogurt with live cultures daily can introduce good bacteria to promote a healthy oral microbiome and prevent fungal overgrowth. Look for words like Lactobacillus or Bifidobacterium on the label.
Fenugreek tea
Rinsing with fenugreek tea may help remove white coating due to its antimicrobial and anti-inflammatory effects. Boil 1-2 teaspoons of fenugreek seeds in a cup of water, strain and use to rinse your mouth when it cools.
Prevention tips for white tongue
Here are some tips to help prevent white tongue:
- Brush your teeth and tongue thoroughly twice daily.
- Scrape your tongue daily with a tongue scraper or brush.
- Floss between teeth daily.
- See your dentist for regular cleanings and exams.
- Drink plenty of water to stay hydrated.
- Avoid irritants like smoking, alcohol, spicy, acidic or sugary foods.
- Rinse mouth after using inhaled corticosteroids.
- Practice good oral hygiene if you wear dentures.
- Treat dry mouth from medications, breathing issues or dehydration.
When to see a doctor
Consult your doctor or dentist if:
- White patches last longer than 2 weeks
- You have sore throat or mouth pain
- You feel burning or tingling sensation of the tongue
- You have an immune system deficiency
- You have diabetes, nutrient deficiency or GI issues
- You use medications that reduce saliva flow
- You use inhaled corticosteroids
- White lesions are thick, hard or raised
A white tongue that doesn’t go away with improved oral hygiene may need evaluation to rule out underlying conditions like oral thrush or leukoplakia.
What does a white tongue indicate?
A white tongue can indicate the following:
- Poor oral hygiene allowing debris buildup
- Lack of hydration and dry mouth
- Harmless buildup from eating, smoking or sleeping
- Oral thrush due to Candida overgrowth
- Strep bacterial infection
- Canker sores
- Leukoplakia, a precancerous lesion
- Oral lichen planus, an inflammatory condition
- HIV/AIDS or weakened immune system
- Allergies causing dry mouth and thick saliva
While often harmless, white tongue should be evaluated by a doctor or dentist when it persists to rule out any underlying conditions.
Key points
- A harmless white tongue often goes away with brushing or scraping.
- Persistent thick coating may be due to thrush, oral cancer or illness.
- Practice good oral hygiene and hydration to prevent white tongue.
- See your dentist if white patches last more than 2 weeks.
- Treatments include antifungals, antibiotics, oral rinses or surgery if precancerous.
Conclusion
A white or coated tongue is typically a harmless condition that arises from a buildup of debris, bacteria and dead cells. Proper oral hygiene, hydration and avoiding irritants can usually resolve temporary white coating.
However, a thick white layer that persists longer than 2 weeks may need evaluation to rule out oral thrush, oral cancer or other underlying illness. Seeking prompt treatment can help manage these more serious causes of white tongue.
