White Tongue

What is white tongue?

A white tongue involves having a thick white film coating your tongue. The coating can cover your entire tongue’s surface, the back part only or it might appear in patches. A white tongue can look alarming, but it’s usually just a sign of trapped bacteria, debris (like food and sugar) or dead cells on your tongue.

White tongue sometimes happens alongside a different tongue problem called black hairy tongue. With black hairy tongue, the food particles, dead cells and bacteria cause your tongue to appear dark and furry instead of white.

White tongue has several causes but usually goes away in a few weeks. See a healthcare provider if it lasts longer than that or if you have problems eating or talking.

Why is my tongue white?

A white film may appear on your tongue when bacteria and food get caught between the tiny bumps on your tongue’s surface, called papillae. Your papillae are raised, creating a large surface area for debris to collect inside your mouth. The papillae may swell and become inflamed. This buildup often causes bad breath and can leave a bad taste in your mouth.

Causes include:

• Poor oral hygiene (not brushing, flossing or scraping your tongue regularly).
• Smoking, vaping, dipping or chewing tobacco.
• Drinking more than one alcoholic beverage daily (which leads to dehydration).
• Wearing dentures or damaging your tongue with sharp objects.
• Taking antibiotics (they can cause a yeast infection inside your mouth).
• Eating a diet with a shortage of fruits and vegetables (and an excess of soft foods).
• Breathing through your mouth.
• Having a dry mouth caused by a medical condition or by using medications (like muscle relaxers and certain cancer treatments).

A white tongue is a symptom of several conditions, including:

• Geographic tongue: A condition that causes patches of redness on your tongue with white borders. It’s more common in people with eczema, psoriasis, Type 1 diabetes or reactive arthritis.
• Leukoplakia: A condition involving white patches or spots inside your mouth. Chewing tobacco, heavy smoking and alcohol consumption are all potential causes.
• Oral lichen planus: A chronic inflammatory mouth condition that causes white patches on your inner cheeks, gums and tongue. It’s likely related to problems with your immune system (your body’s defense against germs).
• Oral thrush: An infection caused by the Candida yeast (fungus). Although Candida is normally found inside your mouth, it becomes a problem when it grows too much.
• Syphilis: A sexually transmitted infection (STI) with many symptoms, including a white tongue.

Although rare, white tongue is sometimes a symptom of oral cancer.

How is white tongue treated?

Usually, white tongue goes away without treatment within a few weeks. But you might want to get treated if it lasts longer or if you want to get rid of it sooner. Treatments for white tongue vary based on symptoms and causes.

Tongue rash

Usually, rashes clear up without treatment. If you have a rash associated with oral lichen planus that doesn’t resolve, your healthcare provider can prescribe steroidal mouthwashes (steroid pills dissolved in water) and steroid sprays to reduce symptoms like burning or sore gums.

Infection

For fungal infections, like oral thrush, your provider will prescribe antifungal medicines such as fluconazole (Diflucan®) or nystatin (Nystop®).

If syphilis is causing your white tongue, you’ll need antibiotics (penicillin) to kill the bacteria.

White patches

There’s no risk of the white patches associated with geographic tongue becoming cancerous. Treatment primarily involves managing unpleasant symptoms. For example, you can avoid food and drinks that cause pain. Antifungal treatments on your tongue can also help soothe symptoms.

If there’s a risk that the patches could become cancerous, as is sometimes the case with leukoplakia, your healthcare provider will remove them. They may use a scalpel, laser or (rarely) another method like cryotherapy (freezing them with liquid nitrogen). This surgery will help ensure that your tongue cells don’t turn cancerous.

What can I do at home to treat white tongue?

Most people can get rid of white tongue by practicing good oral hygiene and drinking plenty of fluids to prevent dehydration. Tips you can try at home include:

• Drinking at least eight glasses of water daily.
• Brushing your teeth using a soft toothbrush.
• Brushing your tongue or using a tongue scraper to remove the white coating.
• Using mild fluoride toothpaste and mouthwash.
• Avoiding substances that can expose your tongue to toxins, like cigarettes and vape pens.
• Avoiding foods that can irritate your mouth, including foods that are spicy, salty, acidic or very hot in temperature.

Take over-the-counter (OTC) painkillers if your white tongue is painful or uncomfortable.

What are the possible complications or risks of not treating white tongue?

Without treatment, the bacteria and gunk that coat your tongue can lead to gum disease. The infection can spread to other parts of your body. The white patches associated with leukoplakia can eventually progress to oral cancer.

How can I prevent white tongue?

Sometimes, you can’t prevent getting white tongue. But you can reduce your chances by practicing good oral hygiene. Get a checkup at your dentist’s office every six months. Brush your teeth at least twice a day. Floss daily and eat healthy foods with a good mix of fresh fruit and vegetables.

If your provider tells you that your white tongue symptoms are serious, consider quitting alcohol or tobacco (or using less of either). Schedule regular follow-up visits with your dentist or provider. Consistent care can help prevent your white patch from becoming cancerous.

Should I see a doctor if I get white tongue?

It depends. Usually, white tongue is harmless and temporary. If white tongue is the only symptom you notice, you may be safe to wait and see if it goes away.

If your white tongue doesn’t return to a normal color after a few weeks, see your provider or dentist. You should also get checked if your tongue hurts, itches or you have trouble eating or speaking. Your provider can help you clear it up. Or they can check to be sure it’s not a more serious condition. You should also make an appointment if you have these symptoms with a weak immune system or HIV.

Do tongue piercings cause white tongue?

If you (or your teenager) have just had a tongue piercing, you might see a white coating on your tongue. It’s normal bacterial growth that you can reduce with antifungal mouthwash, like nystatin (Nystop). You might also notice a white ring of tissue around both sides of your piercing, but it’s just how your tongue normally heals from a wound.

Does a white tongue mean you're sick?

Not necessarily. Often, a white tongue means you should focus on your oral hygiene or overall health. For example, it may mean that you need to brush and floss more regularly and steer clear of tobacco and alcohol.

Still, a white tongue may signal a yeast or bacterial infection. If you’re unsure, see your healthcare provider or dentist.

A note from Cleveland Clinic

Your oral hygiene is important, so get regular dental checkups to spot any problems early. White tongue usually isn’t harmful, but you should see your dentist or provider if your tongue (or even just its appearance) is bothering you or if you’re having any pain. This way, they can find any health risks early and treat you before things worsen.