White tongue: when should you worry?

A white tongue, or saburral tongue, gives information about your state of health. Several more or less serious pathologies can be the cause. What are the causes and when should you be concerned? Doctissimo tells you everything.

Is it serious to have a white tongue?

A healthy tongue generally has a pink-red color and a relatively smooth appearance. However, it can happen that it takes on a whitish, more or less pasty appearance on its upper surface. This unusual coloring is most often transient, and not serious. Note that, depending on the cause, the coating may take on a specific appearance. The whitish tongue is indeed a symptom with multiple entries. Thus, white spots can be a sign of poor oral hygiene or oral mycosis, while the appearance of white spots must definitely raise the suspicion of leukoplakia and require a consultation with the dentist.

Stress, cancer, infection… Possible causes of a whitish tongue

In the majority of cases, a whitish tongue is explained by an accumulation of bacteria and cellular debris as well as a thickening of the papillae present on the surface – we also speak of saburral tongue or white spots. The coating that covers it can be removed by scraping the tongue.

The causes are multiple and varied. They range from simple localized infections to an alteration in the person’s general state of health, or even illnesses:

In the most common cases, a white deposit on the tongue is of infectious origin, caused by a microscopic fungus (mycosis), dead cells or food debris. We then speak of candidiasis, or oral thrush, most often developed after treatment with antibiotics. Bacteria unbalance the digestive flora and allow certain fungi to develop in significant quantities in the mouth and digestive tract;
Insufficient oral hygiene can lead to bad breath, also called halitosis. Brushing too short and/or poorly done, or overuse of alcohol-based mouthwashes can lead to an imbalance in the oral flora. Certain foods can also help promote the formation of a deposit;
Canker sores, occurring in the oral cavity after a burn (too hot drink or food) or a dental accident (after the breakage of a crown or dental appliance) can also lead to the appearance of a white tongue;
Gastric reflux is also one of the common causes of white tongue. The acidity of the stomach which rises towards the esophagus creates permanent irritation in the digestive tract and the mouth;
In some cases, constipation can be the cause of a tongue that turns white. The stagnation of stools in the colon unbalances the intestinal flora and, over time, the flora of the entire digestive tract and the mouth;
Tobacco, stress, taking certain medications (antidepressants, antihistamines), which modify the quantity of saliva and its quality, can also be the cause of a white tongue, due to drying out. It is also one of the consequences of an engorged liver or cancer (we then speak of leukoplakia), but these causes are much rarer;
Finally, the origin may be allergic. Eczema or psoriasis can sometimes be associated with a white tongue.

In infants, especially when breastfed, the tongue may turn white after feeding. Nothing serious: it’s just a milk deposit. On the other hand, if this white coloring persists between each feeding, the possibility of thrush, due to a fungus, cannot be ruled out. In this case, you must consult to treat this infection which risks irritating the baby.

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Can stress cause a white tongue?

Stress changes the quality and quantity of saliva, which can cause dehydration of the tongue and promote the appearance of whitish deposits.

Spot on the tongue, white dot…How to recognize a white tongue?

Saburral tongue takes on very different aspects depending on the cause. This whitish deposit can be more or less thick, cover the entire tongue or only appear on certain well-localized areas, giving the impression of spots. The deposit can be painful, burn, cause difficulty swallowing, give a metallic taste in the mouth, etc.

This is why it is important to consult a doctor, because it is all the symptoms that will help guide your diagnosis.

White tongue: when to worry?

It is recommended to urgently consult your doctor if the white tongue appears suddenly. On the other hand, if it sets in gradually, over several days, it is always preferable to see a doctor, dentist or dermatologist, but without rushing.

The GP will first carry out a clinical examination of the tongue and general. If he suspects an infectious origin, he will request an analysis by taking a sample of the deposits from the tongue (biopsy) as well as a blood test to make a precise diagnosis.

White language and Covid 19

In June 2020, British researchers reported several cases of mouth ulceration and blisters in patients with the disease. Then, Professor Tim Spector, British epidemiologist and scientific writer, highlighted this symptom – a white-stained tongue – in a patient infected with the coronavirus. This symptom nevertheless remains quite rare and not specific to COVID. Without intraoral examination, these signs may also go unnoticed.

White tongue: evolution and possible complications

The progressive white coloring of the tongue should not cause alarm. It is only when it is accompanied by other symptoms (itching, burning, change in taste, etc.) that it merits emergency medical consultation. Sometimes the presence of white spots can indicate the presence of cancer.

Treatments: how to get rid of white tongue?

To make a white tongue disappear, you must treat its cause. And each cause has its solution. The doctor may prescribe an anti-reflux for gastric problems, an antifungal in case of candidiasis, treatment for constipation if transit is the cause, antibiotics in case of bacterial infection, elimination of irritating agents in case leukoplakia…

Without forgetting the modification of habits related to oral hygiene, if this is in question. Which may also include a change in your diet, if necessary.

In more serious cases, if the white tongue is a side effect of anti-cancer treatment for example, global solutions will need to be considered to improve the patient’s state of health.

Prevention: how to avoid white tongue?

Generally a white tongue is not a serious phenomenon. Just follow a few tips to maintain good oral hygiene:

First, brush your teeth two minutes after each meal, except for gum disease (3 times), for two minutes each time. It is also advisable to pass dental floss or brushes in the inter-dental cavities to eliminate excess bacteria. It is not recommended, however, to brush your tongue regularly, and especially not with a traditional toothbrush. It is also important to consult a dentist regularly to maintain good oral hygiene.
Cleaning with a tongue scraper and the use of an antibacterial toothpaste can prevent recurrences.
As for mouthwash solutions, they must be alcohol-free, unless prescribed by a doctor – generally following treatment or an infection. Medical mouthwashes are not intended for long-term use, otherwise they could unbalance the oral flora. There are also specific mouthwashes, designed for cases of halitosis (bad breath), for example.
You can also sprinkle your toothbrush with a little baking soda. It reduces the acidity of the mouth and promotes the proliferation of good bacteria.

Finally, remember to drink enough water, eat healthily and limit your alcohol consumption. A natural fermented yogurt without sugar helps maintain the bacterial balance of the tongue and intestine.

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