Why Is Your Tongue White

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Why Is Your Tongue White?
Here's What Dentists Want You to Know For the
most part, a white tongue is pretty benignbut
sometimes it can signal a bigger oral health
issue.
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INTRO
Unless you've just eaten a blue raspberry Jolly
Rancher, your tongue has a pretty steady
appearance Pink, with a thin whitish coating,
and devoid of any cracks or ulcerations. In a
healthy tongue, you may also see tiny bumps on
top of it that make it look roughthose are known
as papillae, and contain tastebuds and
temperature sensors. But sometimes, tongues can
look a little different than expectedlike, if it
has a whiter-than-usual appearanceand it could
signal a larger issue at hand. For the most part,
your tongue can look white for totally benign
reasons (maybe you're dehydrated or you skipped a
few brushings), but thicker white patches can
also be a sign of infection or, in rare cases,
mouth or oral cancer.
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Here, oral health experts weigh in on what a
"white tongue" can meanand when you should book
an appointment with your dentist. why is my
tongue white , Playful teenage girl sticking out
tongue while standing in studio
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WHAT IS A "WHITE TONGUE," EXACTLY?
Not all white tongues look exactly the same.
Sometimes a white tongue can look like a thick,
white coating on your tongue that stays put even
after brushing other times, it can form a thin
lace-like pattern. The whiteness can cover your
entire tongue, only the back of your tongue, or
it can appear in patches, bumps, or specks.
When your tongue has a distinct white appearance,
you may also notice other oral symptoms
According to the Cleveland Clinic, your white
tongue could be accompanied by a bad taste in
your mouth, bad breath, or some redness. Bad
breath or bad taste are commonly associated with
a white tongue because of the raised papillae,
per the Cleveland Clinicthose raised patches
create a larger surface area for food, plaque,
and bacteria to build up in your mouth, leading
to the less-than-pleasant symptoms.
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WHAT TYPICALLY CAUSES A WHITE TONGUE?
Just like all white tongues don't look exactly
the same, white tongues aren't always caused by
the same thing, either. "There are a variety of
reasons why you may have white lesions on your
tongue, and they can range from something fairly
benign and common to more serious and potentially
dangerous," Michael Nguyen, DDS, a
board-certified periodontist with Mid-Peninsula
Dental Specialists in Los Altos, California,
tells Health.
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For the most part, a white tongue occurs when
bacteria, food, and dead skin cells get trapped
between the papillae on your tongue's surface.
That causes those papillaenormally small and
string-liketo swell up, causing a white
appearance on your tongue. Sometimes, those
papillae can grow large enough to give off a
brown or blackish appearance, according to
Brigham and Woman's Hospital's Division of Oral
Medicine and Dentistry. That buildup on the
tongue, per Brigham and Women's, is largely
asymptomatic (aside from the white appearance)
and can be remedied through oral health and
dietary interventions (like drinking more water
or cutting back on caffeine). But there could be
other causes behind a white tongue as well. Here
are six more reasons your tongue could have a
whitish appearanceand how best to remedy each
one.
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TONGUE INJURY
"It's common to bite or burn your tongue which
can be painful and result in white tissue,"
Amanda Lewis, DDS, a board-certified dentist
based in Dallas, tells Health. You might also
notice white tissue surrounding a recent tongue
piercing. A "geographic tongue," meaning a tongue
with glossy, red patches with white or light
borders around the edges, is a normal part of
healing as your tongue regrows tastebuds. General
ly, a tongue injury will heal within a week and a
half. Just avoid irritating substances like hot,
spicy, or acidic foods and drinks to support the
process. If you've recently gotten your tongue
pierced, an antifungal mouthwash like Nystatin
(like Nystop) could also help combat bacterial
growth in the area, per the Cleveland Clinic.
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LEUKOPLAKIA
"Leukoplakia is a condition where thick, white
patches appear on the tongue," Sharon Huang, DDS,
a cosmetic dentist and founder of Les Belles NYC,
a dentistry practice in Manhattan, tells Health.
But the difference between these white patches
and others are that they cannot be rubbed off or
diagnosed as another condition or disease,
according to the Academy of Oral and
Maxillofacial Pathology (AOMP).
It's important to diagnose and treat leukoplakia
in a timely mannerper the AOMP, over time, a
percentage of the lesions can transform into oral
cancer. To diagnose leukoplakia, an oral surgeon
will biopsy the white growth to look for its
potential to become cancerous. Changes seen in
the biopsy under a microscope can determine if
the leukoplakia is "epithelial atypia" or
"epithelial dysplasia"the latter of which is
ranked as mild, moderate, or severe.
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With epithelial atypia and mild cases of
epithelial dysplasia, per the AOMP, doctors will
take a more watchful waiting approach and suggest
lifestyle changes (like quitting smoking). With
moderate or severe cases, they will likely
suggest removing the white patches through
scalpel excision, electrocautery, liquid nitrogen
application or laser surgery, the AOMP says.
Sometimes, even after removal, the leukoplakia
can recur and will need to be removed again.
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ORAL LICHEN PLANUS
Lichen planus is a benign condition that can
affect the tongue or inside of the mouth, and
sometimes both, per the AOMP. According to Dr.
Huang, this is a chronic inflammatory condition,
meaning it's not thought to be caused by an
infection or lifestyle habit. When lichen planus
shows up in the mouth, it can take one of two
forms reticular lichen planus, which usually
shows up as a lace-like white pattern or erosive
lichen planus, which is characterized by erosions
in the mouth that can be tender or painful, the
AOMP says. Neither kind is contagious. "There is
no cure for lichen planus, so treatment is mainly
to alleviate any painful symptoms," says Dr.
Nyugen. This may include medication such as
corticosteroid pills and pain-relieving mouth
rinses, plus lifestyle changes like gently
brushing your teeth with a plain toothpaste and
avoiding tobacco, alcohol, and irritating foods,
per the Mayo Clinic.
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ORAL CANDIDIASIS
Oral candidiasissometimes more commonly known as
oral thrushis a fungal infection that occurs in
the mouth, says Dr. Nyugen. It can show up as
creamy white lesions on the tongue or inner
cheeks, and it's caused by an overgrowth of a
yeast-like fungal organism, Candida albicans,
which is naturally present on your skin and
inside your mouth. (This fungus can also cause
vaginal yeast infections in women, per the
AOMP). Though everyone has the fungus living in
or on their bodies, an infection by it is most
common in immunocompromised people, like those
living with HIV/AIDS, diabetes, or cancer or
those who smoke, have a dry mouth, or wear
dentures, per the Centers for Disease Control
Prevention (CDC). Doctors will usually prescribe
antifungal medication for cases of oral
candidiasis, the AOMP says, and the infection can
clear up pretty quickly once medication is being
used, says Dr. Huang. The AOMP warns, however,
that home remedies like eating yogurt or avoiding
yeast will treat or prevent the condition.
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SYPHILIS
"Syphilis is a sexually transmitted bacterial
infection that can leave oral lesions in several
areas including the tongue, lips, and roof of the
mouth," says Dr. Nyugen. According to the CDC,
painless lesions typically emerge about 21 days
after exposure and have a firm, round
appearance. If you suspect your white tongue is
linked to syphilis, it's important to seek
treatment immediately. Depending on the stage of
your infection, one or multiple injections of an
antibiotic will kill the bacterium and prevent
further damage, per the CDC.
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ORAL CANCER
If you have white spots on your tongue, oral
cancer is another possibilityespecially if you
have a history of risky behaviors like smoking or
chewing tobacco, says Dr. Nyugen. Among other
factors, a family history of cancer, a habit of
drinking alcohol, or a human papillomavirus (HPV)
infection could also increase your risk,
according to the American Cancer Society
(ACS). With an exam and biopsy, a dentist can
determine whether you have mouth cancer. After
that, surgery is the most common treatment
option, but depending on the stage of cancer you
may also consider additional radiation or a
combination of radiation and chemotherapy,
according to the ACS.
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WHEN SHOULD YOU SEE A DOCTOR FOR A WHITE TONGUE?
Often, you can treat a white tongue at home with
good oral hygiene practices (more on this
later!). However, if it doesn't go away within a
week, causes so much pain it's hard to drink,
eat, or speak, or comes with other concerning
symptoms like a fever, call a dentist or your
primary care doctor immediately. "If you see a
suspicious white lesion on your tongue, even if
it isn't symptomatic, it is a good idea to ask
your dentist about it," Dr. Nyugen says. "It's
always better safe than sorry, and a simple
dental visit is the best way to find out what the
white lesion may be." At your appointment, your
dentist may take a high-quality photograph to
diagnose the root cause of your problem and
monitor any changes over time.
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HOW CAN YOU PREVENT A WHITE TONGUE?
Sometimes, there's nothing you can do to prevent
a white tongue. But you can do your best to avoid
the most likely reason for a white tongue poor
oral hygiene. Here are a list of the top tips to
maintain a healthy mouth (and thusly, prevent any
strange color changes of your tongue) throughout
your lifetime, per the CDC Use fluoride
toothpaste and drink fluoridated water, if you
can Brush your teeth twice a day and floss
between your teeth daily Visit your dentist once
a yeareven if you wear dentures Don't use
tobacco products and limit use of alcohol If you
have diabetes, work to maintain the disease Avoid
medications that cause dry mouth if that's not
possible, manage it with plenty of water and
sugarless gum Contact your dentist ASAP if you
notice any sudden changes in your mouth
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