What white tongue means & what to do about it

White tongue is a health condition in which a white coating grows on part or all of your tongue’s surface. Bad breath, hairy tongue, irritation, and a burning sensation may accompany white spots on the tongue.

Even though a white tongue may look unattractive, it’s typically not severe and goes away on its own. On rare occasions, however, a white tongue is a symptom that can warn of a more serious condition in your body like oral thrush, syphilis, heart disease, or (in rare cases) cancer.

It’s vital to watch out for other warning symptoms. Call your healthcare provider if these white lesions don’t resolve in 2-3 weeks.

Keep reading to learn the causes, risk factors, and the best treatments for white tongue.

What causes white tongue?

In general, a white tongue happens if debris (from food and sugar), bacteria, and other dead cells collect on the surface of your tongue. They can become trapped between the papillae on your tongue and lead to inflammation.

But there are many potential root causes of white tongue that make cells collect on the tongue. Some aren’t serious, while others require medical attention.

  • Your tongue may be white due to:
    Candida yeast infection (oral thrush)
  • Congenital heart disease
  • Geographic tongue (missing patches of papillae on your tongue)
  • Leukoplakia
  • Oral cancer
  • Oral lichen planus
  • Poor oral hygiene
  • Reaction to certain medications, like antibiotics or steroids
  • Syphilis, which can cause oral sores
  • Tongue injury from teeth or sharp objects
Does white tongue mean that you have an infection? White tongue can mean you have a yeast infection in your mouth, but it can also result from an unhealthy diet, dehydration, disease, or early mouth cancer.

Risk Factors

Risk factors for white tongue include:

  • Alcohol use
  • Antibiotic overuse
  • Breathing through your mouth
  • Cancer treatments
  • Dehydration
  • Dentures
  • Diabetes
  • Diet of primarily soft foods
  • Diet of spicy foods
  • Dry mouth
  • Fever
  • Hypothyroidism
  • Iron deficiency
  • Poor oral hygiene
  • Smoking or chewing tobacco products
  • Tongue piercing
  • Very young or very old age
  • Vitamin B12 deficiency
  • Weak immune system

Treatment options for white tongue

How do you treat a white tongue? If it doesn’t resolve within a couple of weeks, you can treat a white tongue with certain medications or natural remedies.

1. ANTIFUNGAL MEDICATION
If oral thrush is the cause of your white tongue, consider an antifungal, such as a lozenge, pill, or natural antifungal. Talk to your doctor about options to treat oral thrush — preferably antifungal medication with few to no side effects.

After a tongue piercing, a typical white patch of bacterial overgrowth may grow around the piercing. A simple antifungal mouthwash should take care of this cause of white tongue.

2. PENICILLIN
Penicillin treats white tongue caused by syphilis by eliminating the bacterial cause of this condition.

3. PROBIOTICS
Oral probiotics can help balance your oral microbiome — the good bacteria in your mouth. Probiotics may improve oral health and resolve the issues causing white tongue.

This 2019 study shows that probiotics have a beneficial effect against oral thrush, one of the most common causes of white tongue.

For the best results, use a good chewable oral probiotic, not just probiotics for the gut.

Many probiotic foods may also support your oral microbiome:

  • Kefir
  • Kimchi
  • Kombucha
  • Miso
  • Natto
  • Pickles
  • Sauerkraut
  • Sourdough bread
  • Tempeh
  • Yogurt

4. BAKING SODA
Baking soda is naturally antifungal and antibacterial, which can help clean your mouth of bad bacteria and yeasts. Harmful bacteria and yeasts are a common cause of white tongue, so baking soda may help clean your tongue without any side effects.

5. GREEN TEA
Unsweetened green tea and green tea extract are widely believed to be antimicrobial, antifungal, antioxidant, antitumor, and many other adjectives that basically mean green tea is excellent for your health.

Green tea may be effective against oral thrush and white tongue, and its side effects are generally preferable to harsher alternatives such as sodium hypochlorite.

6. OIL PULLING
Coconut oil pulling is simply swishing coconut oil around your mouth for a couple of minutes, then spitting it out in the trash. (It’s a liquid in your mouth but a solid at room temperature.)

Oil pulling can reduce harmful bacteria in your oral cavity, which may treat the root cause of your white tongue. A recent scientific review confirms that oil pulling helps prevent oral thrush and dry mouth — two common causes of white tongue.

7. GARLIC
Garlic extract contains compounds that may be antimicrobial, antitumor, and good for your heart.

A 2021 study published in Antioxidants concludes that garlic is “safe and effective in treatment of various oral [diseases],” including the underlying causes of white tongue.

Eating garlic might also confer benefits, but concentrated garlic extract is likely more effective in this case.

8. ALOE VERA
An aloe vera mouth rinse could help treat white tongue.

A 2020 study shows that an aloe vera ethanol extract is an effective antifungal agent. Antifungals can be helpful against white tongue.

9. OREGANO OIL
Oil of oregano has antibacterial, antifungal, antiparasitic, antiviral, antioxidant, and anti-inflammatory properties.

It seems effective at treating oral thrush, a leading cause of white tongue.

Oregano essential oil should probably not be consumed, as it’s so concentrated. But oregano oil extract should be perfectly safe. The spice oregano also offers benefits, but only in large amounts.

10. TONGUE SCRAPING
Gently scraping your tongue can reduce the harmful bacterial load on your tongue’s surface. Don’t scrape too hard — this can cause unnecessary bleeding from your taste buds or the small bumps over your entire tongue.

If oral thrush is the cause of the white coating on your tongue, scraping away the white patches may reveal tender, inflamed areas prone to bleeding.

Tongue scraping may better remove bad breath molecules than brushing your tongue. It may also help remove white tongue-causing bacteria.

11. IMPROVED ORAL HYGIENE
Sometimes, good oral hygiene is all you need to treat white tongue. Do all of the following to maximize your oral hygiene routine:

  • Brush your teeth twice a day — but not right after a meal when there are still acids on your teeth. If you’re brushing after a meal, wait 45 minutes after your last bite.
  • Brush in gentle circles at a 45° angle towards your gums. Don’t brush too hard, or you could hurt your gums.
    Brush with soft bristles, not hard bristles, which could harm your teeth.
  • Toothpaste is mostly optional, but certain formulations could work for your unique situation.I formulated Revitin to address some of the most common missing elements in “natural” toothpaste.
  • Electric toothbrushes tend to remove more plaque than manual toothbrushes. Manual toothbrushes can remove just as much plaque buildup, but only with perfect technique every time.
  • Flossing properly can reduce interdental plaque and the risk for cavities, gingivitis, and white tongue.
  • Air dry your toothbrush with the brush head facing the ceiling. This lowers the risk of bacteria growing on your brush.
  • Keep your toothbrush far away from flushing toilets.
  • Don’t drink alcohol or smoke. Drinking and smoking lead to serious medical conditions and significantly damage oral health.

When to seek medical attention

White tongue is not generally a sign of serious health problems. However, if it doesn’t resolve itself, you’ll want to consult with a healthcare professional.
Seek medical attention right away if you experience any of these serious health issues:

  • Your tongue is burning.
  • Your white tongue doesn’t go away after two weeks.
  • You’re experiencing fever, rash, or unexplained weight loss.
  • There are open sores in your mouth.
  • It hurts to chew, swallow, or talk.
If you want a biological dentist’s unique perspective on your white tongue, schedule an appointment with Rejuvenation Dentistry in NYC. We’ve got years of experience treating oral conditions with non-invasive natural methods and cutting-edge wellness technology

Sources

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  4. Letscher-Bru, V., Obszynski, C. M., Samsoen, M., Sabou, M., Waller, J., & Candolfi, E. (2013). Antifungal activity of sodium bicarbonate against fungal agents causing superficial infections.Mycopathologia,175(1), 153-158. Abstract:https://pubmed.ncbi.nlm.nih.gov/22991095/
  5. Mollashahi, N. F., Bokaeian, M., Mollashahi, L. F., & Afrougheh, A. (2015). Antifungal efficacy of green tea extract against candida albicans biofilm on tooth substrate.Journal of Dentistry (Tehran, Iran),12(8), 592. Full text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847165/
  6. Shanbhag, V. K. L. (2017). Oil pulling for maintaining oral hygiene–A review.Journal of traditional and complementary medicine,7(1), 106-109. Full text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198813/
  7. Bayan, L., Koulivand, P. H., & Gorji, A. (2014). Garlic: a review of potential therapeutic effects.Avicenna journal of phytomedicine,4(1), 1. Full text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103721/
  8. Sasi, M., Kumar, S., Kumar, M., Thapa, S., Prajapati, U., Tak, Y., … & Mekhemar, M. (2021). Garlic (Allium sativum L.) bioactives and its role in alleviating oral pathologies.Antioxidants,10(11), 1847. Full text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614839/
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  12. Pedrazzi, V., Sato, S., de Mattos, M. D. G. C., Lara, E. H. G., Panzeri, H. (2004). Tongue‐cleaning methods: a comparative clinical trial employing a toothbrush and a tongue scraper. Journal of Periodontology, 75(7), 1009-1012. Full text:https://www.researchgate.net/profile/Vinicius-Pedrazzi/publication/261698511_METODOS_PARA_A_HIGIENIZACAO_DA_LINGUA_UM_ESTUDO_CLINICO-COMPARATIVO_EMPREGANDO_UM_MONITOR_PORTATIL_DE_SULFETOS/links/5818b63b08aee7cdc685d223/METODOS-PARA-A-HIGIENIZACAO-DA-LINGUA-UM-ESTUDO-CLINICO-COMPARATIVO-EMPREGANDO-UM-MONITOR-PORTATIL-DE-SULFETOS.pdf

Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience.

He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.