White tongue is a term used to describe any area of the tongue that has a grayish-white coating on it. The coating may cover the entire tongue, or it may appear in patches.

There are a few different reasons for a white tongue, and each has a specific treatment. A white tongue is usually a harmless symptom, but in rare cases it can indicate a serious condition.

In this article, we look at common causes of a white tongue and home remedies to get rid of the problem.

Causes

The most common cause of a white tongue is poor oral hygiene. Small bumps on the tongue called papillae can swell up and become inflamed in a mouth that is not cared for well.

Plenty of germs, debris, food particles, and dead cells can get stuck between these papillae. This causes the tongue to appear white as the particles build.

Oral and hygiene issues that can lead to a white tongue include:

• dry mouth caused by mouth breathing or sleeping with the mouth open

• not brushing or flossing the teeth correctly

• not cleaning the tongue

• dehydration

• irritation from sharp edges inside the mouth, such as teeth, braces, or dentures

• regular alcohol consumption

• smoking, chewing, or dipping tobacco

Basic oral hygiene is essential for everyone, but some conditions cause a white tongue even in people who take great care of their mouths. These include:

Oral lichen planus

Oral lichen planus is a chronic inflammatory condition that can affect the mouth and tongue. It can also affect the lips, inside of the cheeks, and gums. Researchers are unsure what causes it, but it may be due to an immune response or genetic factors.

Symptoms that affect the mouth include:

• white, lace-like patches of skin

• ulcers

• pain, including discomfort, soreness, or a burning sensation

• swelling and redness

Treatment

Oral lichen planus is a chronic condition, and in many cases, a doctor or dentist will simply monitor it to make sure lesions heal properly.

In severe cases, a doctor may prescribe topical or oral corticosteroids.

Leukoplakia

Irritants such as tobacco and alcohol can lead to leukoplakia. It may also result from inflammatory conditions and irritation from dentures. It can affect all areas of the mouth, including the tongue, cheeks, and gums.

Leukoplakia may appear as thick, white patches that cannot be scraped off. Sometimes, the patches may appear red and white.

The patches that leukoplakia cause are harmless by themselves. In rare cases, leukoplakia can progress to cancer, so it is best to have a doctor diagnose this right away.

Treatment

A healthcare professional should monitor leukoplakia to make sure it is not getting worse. They may recommend cutting down the amount of alcohol a person drinks or stopping smoking.

Sometimes, a doctor needs to remove the patches with surgery.

Oral thrush

Oral thrush is another condition that may cause the tongue to appear white. Oral thrush is a fungal infection caused by the  yeast.

Symptoms include:

• white or off-white patches in the mouth and on the tongue

• unpleasant taste or loss of taste

• pain, especially when eating or drinking

• redness or soreness

People who have a weakened immune system may be more likely to develop oral thrush. This includes people who have recently taken antibiotics or undergone chemotherapy. Poor oral hygiene or wearing poorly fitting dentures are other risk factors.

The use of inhaled corticosteroids for asthma can also cause oral thrush. Certain conditions, including diabetes and HIV, may increase the risk of infection.

Treatment

Treatment for oral thrush typically includes antifungal medications. A person applies these medications to the inside of the mouth for 1 to 2 weeks until the condition has run its course. For severe cases, a healthcare professional may prescribe oral or intravenous antifungal medications.

Syphilis

Syphilis is a sexually transmitted infection (STI) that can lead to symptoms in several areas of the body, including the mouth.

Symptoms include:

• white patches on the tongue

• red and white sores, known as chancres, on the tongue or lips

• firm, raised lesions in the mouth

These symptoms typically arise 10–90 days after a person comes into contact with the bacteria. Chancres may resolve on their own with time, but the disease can remain in the body and progress without treatment.

Treatment

Syphilis requires medical treatment with the antibiotic penicillin. This antibiotic kills the bacteria that cause the disease. People who are allergic to penicillin may take a different type of antibiotic.

Reducing irritants in the mouth, such as alcohol and tobacco, may also help clear up the white patches.

Other conditions

Rarer but sometimes serious conditions can lead to white patches on the tongue.

Mouth or tongue cancer may cause a white tongue. Common causes of these types of cancer include chronic tobacco or alcohol use and human papillomavirus (HPV) infections.

Underlying chronic inflammatory disorders may influence a white tongue as well.

When to see a doctor

Most appearances of a white tongue will clear up easily, although this is not always the case.

If the symptoms do not respond to basic oral care or occur alongside other symptoms, a person should speak with a doctor.

Home remedies

Some home remedies and habits may also help with getting rid of a white tongue.

Probiotics

Probiotics are another way to influence oral symptoms, such as a white tongue. Probiotics are strains of bacteria that are good for the digestive system.

While lots of research on probiotics focuses on improving gut health, probiotics may also be helpful for the mouth and tongue.

A 2017 review noted that probiotic bacteria can occupy the mouth as well as the gut. In some cases, these bacteria can help fight off infectious yeasts and other bad strains of bacteria.

While the evidence is not conclusive, probiotics may still help balance the environment in the mouth and prevent a white tongue.

A range of probiotics is available for purchase online.

Baking soda scrub

Adding food-grade baking soda to a toothbrush and scrubbing the tongue, teeth, and gums may help reduce the bacteria that cause a white tongue.

One study found that a baking soda oral rinse can reduce harmful bacteria that commonly cause infections in the mouth, such as Streptococcus.

Raw garlic

Eating garlic may help the body fight off infections caused by bacteria and fungi. Research noted that garlic has both antibacterial and antifungal properties, including the ability to fight off Candida.

People may eat a clove of raw garlic whole each day or chop it up and eat it with a little olive oil.

Tongue scraping

Gently scraping the tongue from back to front may also help reduce and remove the bacteria and debris that settle in the mouth.

Many companies make specific tools for tongue scraping, which are available for purchase online. However, a person can use the edge of a spoon just as easily.

Prevention

While it is not always possible to avoid getting a white tongue, basic oral hygiene can help prevent many cases. This includes brushing the teeth twice a day and flossing at least once a day.

Many people also benefit from using a tongue scraper every day or brushing the tongue with a toothbrush.

Additionally, lifestyle choices may help prevent a white tongue at times. Avoiding tobacco products and alcoholic drinks may help, as well as eating a varied and nutritious diet.

Going to a dentist every 6 months for a checkup will help keep the mouth as clean as possible. People should report any worrying symptoms to a doctor for proper diagnosis and treatment.

Outlook

The outlook for a white tongue is typically very good. In many cases, it is harmless, even if it may be distressing to see.

Symptoms may not always respond immediately to improvements in hygiene or lifestyle choices, but improving oral health is suggested for anyone with a white tongue.

In rare cases, a white tongue is an indication of a serious underlying condition. Following the treatment plan set out by a doctor is the best way to relieve symptoms.