A white tongue is often a harmless condition that can be caused by a buildup of dead cells on the papillae (the tiny bumps on your tongue). However, sometimes a white tongue may indicate an underlying health issue. Here’s an overview of what different types of white tongues could mean.
What causes a white tongue?
A white tongue is typically caused by an overgrowth and swelling of the papillae on the tongue’s surface. Dead cells can get trapped between the papillae, creating a white coating.
Some potential causes of a white tongue include:
- Lack of oral hygiene – Not brushing or scraping your tongue regularly can allow dead cells to build up.
- Dehydration – Dry mouth from inadequate fluid intake can make dead cells accumulate faster.
- Food debris – Milk products, soft drinks, coffee, and lack of fiber can leave food particles on the tongue that create a white film.
- Oral thrush – A fungal infection that causes white lesions on the tongue.
- Oral lichen planus – An inflammatory condition that produces white patches on the tongue.
- Leukoplakia – White plaques caused by excess cell growth on the tongue.
- Strep throat – A bacterial throat infection that can coat the tongue during illness.
- Pregnancy – Hormonal changes may increase the risk for white tongue during pregnancy.
Types of white tongues
White tongues can vary in appearance. Here are some of the more common types:
Completely white tongue
A tongue that is entirely white often occurs due to a buildup of debris, bacteria, dead cells, and fungi. Poor oral hygiene is the most common cause. Conditions like oral thrush or dehydration can also cause a solid white coating.
White spots
Small white spots or patches on the tongue can be caused by irritation of the taste buds. Spicy, acidic, or rough foods can inflame the taste buds. Canker sores are another source of white spots. Fungal infections like oral thrush produce patches of white deposits on the tongue.
White stripes
Linear white stripes on the tongue are typically benign. Eating crunchy foods like chips can scrape away debris and create thin white lines. Harmless conditions like geographic tongue or furrowed tongue can appear as white stripes due to missing layers of papillae.
White tip or side
A white coating on just the tip or side of the tongue is generally temporary. It can occur when your tongue rubs against teeth or dental work. Drinking and eating can also leave debris just on the front part of the tongue. Unless it persists, a white tongue tip is not concerning.
Thick white coating
A thick, pale, white substance coating the tongue could indicate oral thrush. Oral thrush usually occurs in people with weakened immune systems. The candida fungus overgrows and creates creamy white lesions. Leukoplakia can also appear as thick white patches that scrape off with some difficulty.
What health conditions cause a white tongue?
While a harmless buildup of debris is the most common cause of white tongue, certain medical conditions can manifest with tongue discoloration as well. Conditions associated with a white tongue include:
Oral thrush
Oral thrush is a yeast infection caused by an overgrowth of candida fungus in the mouth. It covers the tongue in white, creamy lesions. Oral thrush is common in newborns and older adults, as well as people with diabetes, cancer, HIV, or who use inhaled corticosteroids.
Leukoplakia
Leukoplakia appears as thick, fuzzy white patches that are difficult to scrape off. It is often caused by chronic irritation from tobacco use. Leukoplakia is benign but can sometimes become precancerous.
Oral lichen planus
Oral lichen planus is an inflammatory reaction that can cause white patches inside the mouth. It may affect the tongue with lacy white lesions. Oral lichen planus may clear up on its own, but some cases persist.
Strep throat
Strep throat is a bacterial throat infection caused by group A streptococcus bacteria. During illness with strep throat, the tongue may develop a thick, white coating.
Dehydration
Dry mouth from dehydration or medications can cause dead cells to build up and coat the tongue. Drinking more fluids clears up dehydration and debris buildup.
Oral hairy leukoplakia
Oral hairy leukoplakia appears as white lesions with a hairy texture, usually on the sides of the tongue. It often occurs in people with weakened immune systems from HIV, organ transplant medications, or chemotherapy.
Geographic tongue
Geographic tongue is a harmless patchy condition where the tongue is missing some papillae. The irregular smooth patches give it a map-like appearance. Geographic tongue periodically changes pattern and causes the tongue to look white in those areas.
Oral cancer
In rare cases, unexplained patches of white tissue could be early signs of precancerous changes or oral cancer. See a dentist promptly if you have any unexplained lesions lasting more than 2 weeks.
When to see a doctor
Schedule an appointment with your doctor if you have any of the following:
- A white tongue that persists longer than 14 days
- Soreness or pain along with tongue discoloration
- Development of lumps, ulcers, or lesions
- Changes in texture of the tongue surface
- Trouble eating or swallowing due to tongue changes
- Fever or unexplained weight loss
Seeking prompt medical care is recommended if you are in an at-risk group, such as being immunocompromised, smoking tobacco, or drinking alcohol excessively. Any mouth changes could require further evaluation.
How to get rid of a white tongue
A white tongue caused by debris buildup can often be treated at home with a few simple steps:
- Brush your tongue – Gently brush the surface of your tongue at least twice a day.
- Scrape your tongue – Use a tongue scraper to remove bacteria and fungi.
- Drink more water – Stay hydrated to prevent dry mouth and dead cell buildup.
- Avoid irritants – Limit alcohol, tobacco, spicy foods, and acidic drinks.
- Rinse with salt water – Swish a saltwater rinse to reduce inflammation.
- Practice good oral hygiene – Brush and floss regularly to prevent debris accumulation.
For recurring cases, your doctor may suggest using an antifungal medication or making dietary changes. Seeking treatment for underlying conditions can also help resolve white tongue.
White tongue treatment options
If home care does not clear your white tongue, treatments may include:
Antifungal medications
Oral thrush is commonly treated with prescription antifungal drugs such as Nystatin or Fluconazole. These help kill candida overgrowth.
Steroid medications
Steroids help reduce inflammation that contributes to white lesions in conditions like oral lichen planus.
Surgery
Precancerous patches from leukoplakia may need to be surgically removed to prevent them from turning into oral cancer.
Lifestyle changes
Eliminating tobacco use, eating a balanced diet, managing stress levels, and practicing good hygiene can help prevent recurring white tongue.
Home remedies for white tongue
Some natural remedies to remove white tongue coating include:
Baking soda
Create a paste with baking soda and water and rub it on the tongue with a toothbrush. Rinse when done. The antifungal properties may help clear debris.
Hydrogen peroxide
Dilute hydrogen peroxide and swish it around your mouth. Spit it out after a minute. It can kill bacteria and whitening layers.
Aloe vera
The antimicrobial properties of aloe vera gel can help rid dead cells when applied to the tongue regularly.
Probiotics
Consuming probiotic yogurt or supplements can promote good bacteria in the mouth to fight off fungal overgrowth.
Coconut oil
Swishing coconut oil may have antifungal effects against candida overgrowth when used regularly.
Prevention tips
You can help prevent white tongue by:
- Brushing your teeth and tongue twice daily
- Flossing once a day
- Scraping your tongue
- Avoiding excessive alcohol and tobacco
- Drinking plenty of water
- Eating yogurt with live cultures
- Going for regular dental cleanings
When to see a doctor for white tongue
See your doctor promptly if you have:
- Unexplained white patches lasting over 2 weeks
- A tongue coating that worsens despite home care
- Difficulty swallowing or eating
- White lesions with associated fever or unintentional weight loss
- Changes to tongue texture or color
- Pain or tenderness along with discoloration
A persistent white tongue in these situations warrants medical evaluation to check for underlying conditions. Prompt treatment can improve outcomes.
Conclusion
A white tongue is most often a harmless buildup of debris that clears with improved oral hygiene. However, sometimes it could reflect an underlying condition like oral thrush, lichen planus, cancer, or immune deficiency. See your doctor promptly for any abnormal tongue appearance lasting over 2 weeks. Catching conditions early leads to better management and outcomes. With simple care, you can keep your tongue pink and healthy.