White Tongue - Causes, Symptoms, Risk, Treatment and Prevention

What Is a White Tongue?

A white tongue is a term used to describe a tongue with a white or grayish coat. The coating may be seen along the entire tongue surface or appear in patches. It is usually a harmless condition. However, it rarely suggests a serious condition like an infection or cancer. Hence, it is always recommended to look for other associated symptoms and get an opinion from the doctor if the coating remains the same or gets exaggerated in a couple of weeks.

What Are the Causes of White Tongue?

White tongue can occur for many reasons, and the treatment varies accordingly.

The common causes of a white tongue are,

• Poor oral hygiene is one of the most common reasons for a white tongue and is often related to inadequate brushing and flossing. The tongue has tiny bumps called papillae that can become swollen and inflamed when the bacteria, fungi, dirt, food, or dead cells get trapped.

• Dry mouth.

• Breathing through the mouth.

• Dehydration.

• Eating a lot of soft foods.

• Chronic irritation due to sharp edges of the teeth or dental restorations.

• Wearing ill-fitting dentures.

• Fever.

• Eating a soft diet or mashed foods mostly.

• Smoking or chewing tobacco.

• Alcohol use.

What Are the Conditions Associated With White Tongue?

Some conditions associated with white tongue include,

Leukoplakia is a condition in which there are one or more white patches or spotty lesions on the inner surface of the mouth. It is due to the overgrowth of the cells that line the mouth. They combine with protein keratin to form a raised white patch on the tongue.

In most cases, it is due to chronic irritation from smoking tobacco. Sometimes, there is no apparent cause. However, it is a potentially malignant disease (it can turn into cancer years later or even after a decade from when it first showed up). Unlike the thrush of candidiasis, the white or grayish patch cannot be scraped from the surface.

Oral lichen planus is a chronic inflammatory mouth condition of the mucous membrane of the mouth. The exact cause is unknown, but research reveals an autoimmune disorder. They appear white and lacy patches with swollen, red tissues and open ulcers. They are painful and cause burning sensations and discomfort for the patient. This is also a precancerous condition (it has the potential to develop into cancer).

Candida albicans, a common fungal inhabitant of various body parts, including the oral cavity, throat, and vagina, cause oral thrush. It does cause problems in normal people. However, it is seen more widely in children and adults with weakened immune systems.

Syphilis is a sexually transmitted bacterial infection that can cause a small, painless sore or ulcer on the tongue after exposure. If left untreated, it may lead to white plaques on the tongue, known as syphilitic leukoplakia. These symptoms typically arise 10 to 90 days after a person comes into contact with the bacteria.

What Are the Other Symptoms Associated With White Patches of the Tongue?

• The increased surface area due to the ridges on the tongue can harbor debris and micro-organisms. This can result in halitosis (foul smell), and the tongue may taste bad.

• It can also lead to poor gum health.

• Hairy tongue.

Who Is At Risk for White Tongue?

Some health issues, substances, and habits can leave one at an increased risk of getting a white tongue, which may include,

• Diabetes.

• Age factor: very young or old due to a weakened immune system.

• Taking antibiotic medications.

• Eating a less nutritious diet deficient in fruits and vegetables rich in iron and vitamin B12.

• Maintaining poor oral hygiene.

• Chronic exposure to sharp tooth surfaces or objects.

• Having a dry mouth or being dehydrated.

• Smoking or chewing tobacco.

• Undergoing cancer treatment.

• Hypothyroidism results in poor metabolism.

• Mouth breathing.

• It is also seen in individuals undergoing tongue piercings.

What Is the Treatment for White Tongue?

In most instances, the white tongue may not need any treatment. The symptoms often settle on their own. However, individuals may need to get an opinion from their doctor if it does not go away in two weeks or if they have more severe symptoms, like-

• Painful tongue.

• Open sores in the mouth.

• Difficulty in chewing, swallowing, or talking.

• Other symptoms include fever, weight loss, or skin rash.

The treatment is given according to the underlying condition causing the white tongue, and it varies in each case.

• Leukoplakia and lichen planus do not need any treatment. However, a regular visit to the dentist may be necessary to ensure the condition is not worsening. Other than that, it is advisable to stop smoking or reduce the amount of alcohol intake.

• Oral thrush is treated with antifungal medications. They may come in gel, lozenge, or pill.

• Syphilis is treated with a single dose of Penicillin. People allergic to syphilis are prescribed different antibiotics.

• Reducing the irritants in the mouth, such as sharp teeth or exposure to sharp instruments, may also help clear up the white patches.

How Can One Treat the White Tongue at Home?

Most people may eliminate white tongue by maintaining proper dental care and consuming enough fluids to avoid dehydration. The following are some home-based tips:

• Consuming eight glasses or more of water every day.

• Using a gentle toothbrush to brush the teeth.

• Use a tongue scraper or brush to remove the white coating from the tongue.

• Use mouthwash and toothpaste with less fluoride.

• Avoiding things like vape pens and cigarettes that may expose the tongue to harmful substances.

• Steer clear of anything irritating the oral cavity, such as acidic, spicy, salty, or extremely hot foods.

• Brushing in the morning and night and flossing regularly.

• Additionally, visiting the dentist every six months for a checkup and cleaning may be helpful.

What Difficulties or Problems Can Arise From Failing to Treat White Tongue?

If a white tongue is not treated on time, gum disease can result from the bacteria and debris that coat the tongue. The illness can spread to other bodily parts. Oral cancer may eventually develop from the white spots linked to leukoplakia.

Can White Tongue Result from Tongue Piercings?

One may experience a white tongue after a tongue piercing. This is because bacteria grow on the tongue, which can be lessened by using mouthwash containing antifungal agents (Nystatin).

One may also observe white rings around the piercing area; this is the tongue's natural healing process.

What Are the Home Remedies for White Tongue?

• Probiotics: Probiotics help improve some oral symptoms, including white tongue. They are bacteria that help maintain gut health and protect against harmful bacteria and yeast.

• Baking Soda: Adding safe baking soda to toothbrushes, brushing the teeth, and scraping the tongue and gums helps prevent white tongue.

• Raw Garlic: Consuming raw garlic prevents bacterial and fungal infections by improving the body’s defense mechanisms.

Conclusion

Bumps, patches, and spots in the mouth are usually harmless, even if they are distressing to see. However, some can give clues about underlying health conditions needing immediate attention. It is always good to know about these conditions, and when they last more than two weeks, one can consult an online doctor or visit the family physician to check on these conditions.