What causes a white tongue and how to treat it

What causes a white tongue and how to treat it

A whitening of the top layer of tongue or the presence of white spots or patches on the tongue is not uncommon.

It could be due to several causes, the most common being-

Poor Oral Hygiene

Small bumps on the tongue called papillae can start to swell up and become inflamed when oral hygiene is neglected. Plenty of germs, debris, food particles and dead cells can get stuck in between these papillae and the buildup causes the tongue to appear white.

Other conditions that can cause a white tongue are –

Benign Migratory Glossitis

In this condition a constantly changing pattern of serpiginous white lines appear on the surface of the tongue. It keeps changing its appearance and therefore is also known as “wandering rash of the tongue”. It is often more prominent during conditions of psychological stress.

Candidiasis/Oral Thrush

It is a fungal infection having different forms that affect the mouth. In the most common form of Candidiasis soft, white, slightly elevated plaques appear on the tongue and other areas of the mouth.

Leukoplakia

It is a condition affecting the oral cavity and has different forms. In the homogenous form of Leukoplakia uniform white lesions may appear on the tongue.

Oral Lichen Planus

It is a common muco-cutaneous disease that can cause bilateral white striations, papules or plaques on the tongue and other areas of the mouth.

Other Conditions

Rarely more serious conditions like mouth or tongue cancer may cause a white tongue.

Seldom some underlying chronic inflammatory disorders may also cause a white tongue.

Other issues that can lead to a white tongue include

  • Dry mouth – caused by mouth breathing or sleeping with the mouth open.
  • Dehydration
  • Irritation from sharp edges inside the mouth such as from pointed or broken tooth, braces or dentures.
  • Regular alcohol consumption
  • Smoking or chewing tobacco

 

TREATMENT

Mostly white patches on the tongue do clear up easily either on their own or on cleaning the tongue. If they do not respond to basic oral care, medical advice should be sought.

Maintaining Good Oral Hygiene

  • Brushing twice a day
  • Flossing of teeth regularly
  • Cleaning the tongue
  • Mouth rinsing/ using a mouthwash

Medical Or Surgical Intervention

  • No treatment is usually necessary in Benign Migratory Glossitis. However symptomatic lesions may be treated with topical prednisolone.
  • In Candidiasis the white plaque can usually be wiped away with a gauze. In other cases anti-fungal drugs like Nystatin can be used.
  • Cases of Leukoplakia can be treated through cryosurgery, laser surgery, surgical excision, Photodynamic therapy, Retinoids and other drugs.
  • In Oral Lichen Planus symptomatic treatment such as topical numbing agents can be used. Corticosteroids may be used to reduce inflammation. Medications that suppress the body’s immune response may also be used.

 Lifestyle Changes

  • Avoiding alcohol consumption
  • Quitting smoking or chewing tobacco
  • Large intake of water

Home Remedies

Certain home remedies can prevent development of a white tongue and also help in treating it to some extent.

  • Probiotics: These are strains of bacteria that are good for the digestive system as well as the mouth. These can be found in fermented foods and drinks such as pickles, yoghurt etc. Probiotic bacteria help balance the environment in the mouth and avoid a white tongue.
  • Baking soda: It has been found to kill harmful bacteria that cause common infections in the mouth such as Streptococcus and Candida. Adding baking soda to the toothbrush and scrubbing the tongue, teeth and gums with it may help reduce bacteria that cause white tongue.
  • Raw Garlic: It can help the body fight off infections caused by Fungi like Candida. One clove of raw garlic can be chewed daily to reduce the risk of white tongue.
  • Tongue Scraping: Gentle scraping of the tongue from back to front with a tongue cleaner help reduce bacteria and debris that settle on the tongue.

Dental Visits

When white tongue develops inspite of maintaining good oral hygiene and does not respond to home remedies, it is advisable to visit a dental practitioner. Regular visits to a dentist at an interval of six months is recommended for all kids and adults.

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Dr Gunjan Agarwal

Dr Gunjan Agarwal - Dental surgeon practising at Siliguri, West Bengal. B.D.S (Bachelor of Dental Surgery) from RGUHS, Karnataka in the year 2011
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