White Tongue: Causes & Treatment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

If you woke up today and looked in the mirror only to find a white tongue, you might be alarmed. Should you be, though? It depends on the cause of that white tongue. This lesson describes many of the the alarming and less-alarming causes of a white tongue and potential treatment options.

A Healthy Tongue

Go in front of the mirror and stick your tongue out. What do you see? You should see a nice and uniform reddish-pink tongue. That's the sign of a healthy tongue! If that tongue is white, however, or has some white lines or patches, then you need to start asking some questions as to why that's the case. One easily explainable cause is the fact that you ate some white candy just a second ago that has discolored it much like blue candy commonly does. But there are plenty more causes. Let's go over them and the ways by which a white tongue may be treated.

Causes Of A White Tongue

If your hands are very clean and you're not grossed out by this, you can take a finger and rub it against your tongue. Can you feel that it's not as smooth as glass? It's got a slightly rougher texture to it. That's because the tongue is filled with finger-like projections called papillae. See how there are spaces between the fingers on your hand? Well, there are spaces between the papillae as well. If these papillae enlarge as a result of inflammation, then the debris from the food you eat, the dead cells from the tissues that line your mouth, and the bacteria in your mouth, can all fill these spaces and lead to a white-looking tongue.

Bacteria aren't the only organisms found in your mouth. Fungi (yeast) called Candida may be as well and they can lead to a very white looking tongue in a condition called oral thrush, or oral candidiasis. It will look like there is a cottage cheese-like patch on your tongue.

An example of oral thrush affecting the tongue and other areas of the mouth.
oral thrush

Maybe a bit scarier than this infection of the mouth, is another cause of a white tongue. It's called leukoplakia. This is a condition where a white patch, one that cannot be rubbed off, develops inside the mouth. It is possible, although by no means certain, that a person with leukoplakia will go on to develop oral cancer. Leukoplakia is commonly associated with tobacco users. Actually, oral cancer is another possible cause of a white area on the tongue.

An example of lingual (tongue) leukoplakia.

There are plenty of other causes of white tongue besides these, including:

  • Geographic tongue, which unlike cancer, is a harmless condition that causes a map-like appearance to the tongue.
  • Oral lichen planus, an inflammatory condition that may cause white, lace-like lines to appear on the tongue.

Treatment Of A White Tongue

The treatment of a white tongue has to be custom-tailored to the exact cause. This is why if you're not sure of the cause of your white tongue you need to go to see a doctor so they can figure it out and treat it if necessary. Here are some example treatments. Let's say the person has oral thrush. You know this is caused by a yeast (fungus) infection. In this case, a doctor may give you antifungal medication to kill off the Candida.

If the cause of the white patch on the tongue is leukoplakia, the cessation of tobacco use may help clear it up. If it's oral cancer, then one of three general treatment options may be on the table. This includes surgical removal of the affected area, radiation therapy to zap the cancer cells away, and chemotherapy that poisons the cancer cells.

Since geographic tongue is harmless, treatment isn't necessary in most cases. However, since it may be painful, a doctor may prescribe pain relieving mouth rinses. As for oral lichen planus, there is no cure. Thus, it's all about helping the person feel more comfortable if they are in pain. This may include the use of corticosteroids, drugs that suppress the inflammation found in this condition.

Lesson Summary

A white tongue can be almost entirely white on the top, it may have one or two white patches, or it may have white lines meandering throughout it. It just depends on the cause of the white tongue. These causes include:

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