In most instances, if you spot a white patch on your tongue, it’s most probably down to a case of oral thrush, Dr Kailesh Solanki, dentist for Dentalphobia, told Express Health. But particularly if you’ve recently contracted Covid or been vaccinated, he added. Dr Solanki continued: “Other triggers may include smoking, antibiotics, diabetes or anaemia.
A much less common cause is leukoplakia, characterised by thick white or grey patches on the cheeks, gums and bottom of the mouth as well as on the tongue.
Dr Solanki explained: “Sufferers tend to be tobacco users and drinkers and it is thought that once contracted, the virus will lie dormant with occasional flare ups throughout your life.
“A break from smoking and drinking will usually help to clear up the episode of leukoplakia.”
According to Amanda Shayle, developer of JA Self Care by Puriskin, white spots can be classified in three ways:
Topography are (taste) buds/papillae that are swollen. This could mean a hormone imbalance, with pale or transparent meaning deficiency and red meaning heat/inflammation, said Shayle.
She added: “Or if the tongue ‘fur’ has lengthened and possibly clumped together this could mean an excess of some kind in that area – the fur looks like a flame or if together this is combined with a stagnating condition which is considered a form of dampness leading to stagnation of the area or organ.”
Is there an area of porridge-like coating but just in one particular part of the tongue?
White spots/patches or large areas are always considered as a damp condition and a western view of damp is called ‘candida’ or ‘thrush’.
Shayle said: “This can be the result of illness and antibiotic use. Fungus growth is also considered damp which is a sign of a weakened immune system and failure of normal levels of healthy bacteria – eg in the gut. If in the upper part of the tongue this could indicate bronchitis or other phlegm conditions.
“A large white porridge area in the back of the tongue could show dampness in the bowel and, if slightly yellow, constipation.
“A geographic tongue is areas that are white or slightly yellow fur and other areas where the tongue fur has peeled off. This would indicate more chronic conditions of heat and/or deficiency of the digestive system and probably other health problems as well.”
Is this white spot/area really white? Or is it slightly yellow? White represents excess cold, yellow represents excess heat, said Shayle.
The state of your oral health says more about your wider health than you might think, said Sarah Ramage, Clinical Director, Bupa Dental Care.
“The relationship between the tongue and oral/general health is closely related. Dentists can often advise their patients about potential concerns before they’ve had the chance to raise them with their doctor.”
Ramage said white or red patches on the tongue can be signs of oral cancer.
She explained: “Rates of mouth cancer have increased by nearly 60% in the last decade, so it’s important to know what a healthy tongue looks like and be aware of any changes. A healthy tongue is pink in colour with a slightly rough surface.
“Your dentist will look for signs of mouth cancer during your routine check-ups. White, pale or red patches, or spots or lumps on the tongue could be a sign of oral cancer. If your dentist spots this, they’ll ask you some questions about your symptoms and your medical history, and then if there are any concerns they will refer you to a GP or doctor specialising in mouth cancer.”
Ramage advised some people develop a white coating across the tongue as a result of a build-up of bacteria, food debris and dead cells.
She added: “ It can also be yellow in colour, caused by nicotine, tea or coffee stains.
“We all know that we should brush our teeth twice a day but it is also important to brush your tongue every time you clean your teeth.
“The tongue harbours the majority of the bacteria in your mouth. It’s important to keep your tongue healthy to prevent the bacteria transferring to your teeth and gums, causing damage and creating bad breath. Brush your teeth twice a day, floss and don’t forget to brush your tongue too.”
If a white patch in your mouth hasn’t cleared up within ten days, contact your dentist for an examination to rule out any other potential serious condition.