What Does It Mean When Your Tongue Is White?

Reviewed on 7/6/2022
A doctor checking a man's tongue with a tongue depressor
A white tongue can be caused by poor oral hygiene, dehydration, dry mouth, tobacco, alcohol, irritation, geographic tongue, oral thrush, lichen planus, leukoplakia, syphilis, and cancer.

A white tongue can be a sign of many things, ranging from poor oral hygiene to a health condition. A white tongue is usually not serious and often can be easily treated.

12 Causes of a White Tongue

A variety of causes and conditions can cause a white tongue. These include: 

  • Poor oral hygiene: Bacteria build up on the tongue when leftover food particles aren’t removed properly
  • Dehydration: Inadequate fluid intake can reduce immunity and allow bacteria to flourish
  • Dry mouth: If there is not enough saliva in the mouth, this can lead to increased bacteria
  • Tobacco use: Smoking or chewing tobacco greatly increases the risk for oral cancer
  • Alcohol: Drinking alcohol can lead to dehydration and can also cause tongue soreness, dryness, and pain
  • Irritation: Sharp edges of teeth, dentures, or braces can scrape and injure the tongue, which can introduce bacteria and germs
  • Geographic tongue: This occurs when the old surface of the tongue replaces itself and the top layer of the tongue does not come away evenly
  • Medical conditions

What Are Symptoms of White Tongue?

Depending on the cause, a white coating on the tongue may be accompanied by symptoms such as: 

  • Unpleasant taste in mouth
  • Bad breath (halitosis)
  • White spots in the mouth
  • Sore throat
  • Irregular, smooth, red areas
  • Bleeding and irritation with tooth brushing
  • Feels like cotton is in the mouth
  • Sensitivity to hot, spicy, or acidic foods
  • Gum inflammation (gingivitis)
  • Discomfort speaking, chewing, or swallowing

How Is White Tongue Diagnosed?

A white tongue is diagnosed with an oral examination by a dentist or doctor. 

Tests used to diagnose the cause of the white tongue may include: 

  • Analysis of an oral scraping of the white substance from the tongue 
  • Endoscopy 
  • Biopsy 

What Is the Treatment for White Tongue?

Treatment for white spots on the tongue depends on the cause. 

Most of the time, a white coating on the tongue is due to poor oral hygiene. Follow good oral hygiene practices such as: 

  • Brushing your teeth twice daily with a toothpaste proven to fight cavities, decay, and plaque
  • Upgrading to an electric toothbrush for a better clean or change manual toothbrushes every three months
  • Gently scraping your tongue with a tongue scraper or brush to remove leftover food particles 
  • Using an irrigator or interdental brush to help remove food particles stuck between teeth and hard to reach areas
  • Visiting a dentist every six months
  • Staying hydrated
  • Not smoking

Other treatments to help get rid of a white tongue involve treating the underlying condition: 

  • Oral thrush
    • Antifungal medications 
  • Lichen Planus
    • May go away on its own but can also last years
    • Prescription mouthwashes and sprays can help relieve burning or sore gums
    • Corticosteroids, oral, topical, or by injection 
    • Immunosuppressants 
  • Leukoplakia
    • Stop smoking/chewing tobacco
    • Limit or avoid alcohol
    • Surgical removal of white patches if it is suspected it could become cancerous
  • Syphilis 
    • Antibiotics
    • Sexual partners should also be treated
    • Sex should be avoided until both the patient and partner have been treated
    • Patients should be re-tested about three months after their diagnosis because many people are re-infected from untreated sexual partners
  • Cancer: treatment depends on the type of cancer and its stage and may include: 
    • Chemotherapy
    • Radiation
    • Surgery
    • Immunotherapy
    • Hormone therapy
    • Targeted drug therapy
    • Bone marrow transplant

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Reviewed on 7/6/2022

Image source: iStock Images