White tongue 101: Causes and solutions for furred tongue

What is a tongue covering?

A healthy tongue is pale red, smooth, moist, flexible, and free from dark spots or what may appear as white stuff on the tongue. A tongue covering is an often-unsightly new addition that can vary in appearance. You can have a yellow, red, brown, or whitish coating on your tongue. We’ll go on to explore the main reasons for white tongues and other colours in greater detail.

Why do tongue coverings and colour changes occur?

The tongue is an amazing muscle that can even make you aware of unseen illnesses. A few reasons why you may notice a change in colour, or a tongue covering, are:

1. The tongue is a key indicator of our overall state of health. If we are ill, this can often be detected on our tongue. From a purple tongue being a symptom of recurrent epithelial ovarian cancer¹, to a yellow tongue being linked to pre-diabetes², being able to read the signs your tongue gives can be beneficial in seeking help early on.
   
2. Tongue covering can also occur more frequently with age. This is mainly due to changes in a person’s diet. The consumption of predominantly soft foods reduces the natural abrasion of the tongue, so you may not see changes to a baby’s tongue as often as your own for example.
   Tip: If you do notice a change in colour or tongue covering on your baby or young child, be sure to seek medical advice from your family doctor or dentist as it could be a sign of something serious.
   
3. Poor oral hygiene and lacking oral health can also lead to tongue covering. Our tongues are made up of small bumps called papillae, taste buds, and a mucus membrane.³ The spaces on and around your tongue are ideal spots to harbour bacteria which can lead to tongue covering as well as plaque on the teeth if left untreated.⁴
   
4. Frequent and heavy smoking is one of the leading coated tongue causes.⁵ In addition to being bad for your physical health, the use of tobacco products can wreak havoc on your oral health. Smoking cigarettes, cigars, and pipes can lead to dry mouth, increased bacteria activity, and a variety of tongue coverings including white tongue, yellow tongue, and black tongue.

So, what does each colour of tongue covering mean? Read on to find out.

Top causes of different coloured tongue coverings

Now you know the root of the issue, what does your tongue say about your health? Here are five of the most common colours you may come across, and – in addition to poor oral hygiene and smoking – what other issues could be indicated by each tongue covering:

White tongue: The reason for white tongues can vary, but a white coating on the tongue is often a sign of oral thrush.⁶ The additional causes that could result in white stuff on your tongue include:⁷

1. Gastrointestinal illnesses
2. Cold and flu
3. Iron deficiency
4. Oral lichen planus (an inflammatory condition)
5. External irritation such as dentures or braces
6. Regular alcohol consumption

Yellow tongue: Yellow-coated tongue causes vary from eczema to fungal infections. Other issues related to yellow tongue include:⁸

1. Jaundice related to liver, gall bladder, and pancreas illnesses
2. A build-up of excess bacteria
3. Medications
4. Food dyes in candy and other items you consume

Tip: In some cases, a yellow tongue may darken in appearance to appear browner in colour. A brown tongue could be an indication of kidney issues; however, it is more commonly associated with certain medications and heavy smoking.⁹

Red tongue: Also known as strawberry tongue. Typical causes for a red-furred tongue include scarlet fever and vitamin deficiency. But other issues could be indicated by a red tongue covering including:¹⁰

1. The presence of an autoimmune disease
2. Inflammation of the tongue
3. Vascular inflammations
4. An allergic reaction
5. Kawasaki disease¹¹
6. Scarlet fever¹²

Black tongue (‘hairy tongue’): A black tongue is unsightly but mostly unproblematic. The following could be causes of a black tongue covering:¹³

1. Certain medication
2. Food dyes
3. Dark liquids such as coffee
4. Radiation therapy
5. A weakened immune system caused by conditions such as diabetes or HIV

How to get rid of a white tongue

Even a healthy body regularly produces a thin covering on the tongue. This coating consists of food residues, dead cells, and germs. Usually, thorough oral hygiene including tongue cleaning is enough to get rid of a white coating on your tongue and other tongue coverings.¹⁴ So, follow these steps to remove and prevent tongue covering:

• Brush your teeth regularly and thoroughly. You should brush your teeth twice a day, for at least two minutes. Take care to ensure you also clean interdental spaces (this can be done by flossing or using an interdental brush). This will not only help to remove tongue covering, but it is also good for your overall oral health and can help prevent conditions such as gingivitis.
  Tip: The Philips Sonicare Next-Generation DiamondClean 9900 Prestige is specially designed to be gentle on sensitive areas and remove up to 20x more plaque than a manual brush.
  
• Use a mouthwash at least once a day. As part of your regular oral hygiene routine utilising an antibacterial mouthwash is a great way to remove tongue covering causing bacteria and other build-ups on your tongue and around your mouth.
  Tip: If you’re looking for a more natural option, herbs such as chamomile, thyme, and sage have antibacterial qualities.¹⁵ Crushing these and making homemade mouthwash can help to remove tongue covering.
  
• Clean your tongue once a day too. Daily oral care should also entail cleaning your tongue, in order to prevent the settlement of bacteria on your tongue and to remove tongue covering.
  Tip: We recommend investing in the Philips Sonicare Next-Generation DiamondClean 9900 Prestige which offers up to 20x more plaque removal* for a deeper clean, and up to 15x healthier gums**.
  
  
• Rinse your mouth with saltwater. Salt is antibacterial¹⁶ and is a great option if you’re looking for home remedies to remove your tongue covering. If you’re wondering how to get rid of a white tongue, follow these steps to make a salt rinse:
  1. Dissolve a teaspoon of salt in a glass of warm water.
  2. Swill this mix around your mouth for a few seconds.
  3. Rinse your mouth with clean water.
  

• Make a trip to the dentist for professional tongue cleaning. In addition to professional teeth cleaning, some dentists offer professional tongue cleaning. This will remove tongue coverings and bacteria from the tongue.
  
• Reduce or quit smoking. While using the steps above will help you remove the coloured coatings that smoking can cause on your tongue, if you continue to smoke the tongue coating will just reappear. Quitting smoking is a great preventative measure you can take and will be beneficial not only to your tongue but also to your oral health and physical health too.

Tip: If the tongue coating is caused by illnesses or underlying conditions, it could be hard to remove it mechanically at home. In most cases, it will disappear by itself once the illness starts to subside.

So, there you go. Not as bad as you thought, right? With just a few basic pointers this guide can help you understand why you may develop a whitish coating on your tongue, brown coating, and other colours too. Plus, we’ve given you all the tips you need to keep your mouth and your tongue clean, so you’ll always be able to enjoy a healthy smile.

* vs. manual toothbrush
** in Clean mode vs a manual toothbrush in 6 weeks

Sources:

¹ Purple-bluish tongue is associated with platelet counts, and the recurrence of epithelial ovarian cancer, Science Direct

² The tongue associated with type 2 diabetes mellitus, National Library of Medicine

³ Tongue problems, Medline Plus

⁴ Mouth Microbes, National Institute of Health

⁵ Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium, National Library of Medicine

⁶ Oral thrush: Overview, National Library of Medicine

⁷ Sore or white tongue, NHS

⁸ Bacillus as a potential diagnostic marker for yellow tongue coating, National Library of Medicine

⁹ The Response of the Tongue Epithelial on Cigarette Smoke Exposure as a Risk Factor for Oral Cancer Development, National Library of Medicine

¹⁰ Strawberry Tongue, The New England Journal of Medicine

¹¹ Kawasaki disease, NHS

¹² Scarlet fever, NHS

¹³ Black hairy tongue, NHS Royal Berkshire

¹⁴ The Effect of Mechanical Tongue Cleaning on Oral Malodor and Tongue Coating, National Library of Medicine

¹⁵ Antioxidant, Antimicrobial and Antiviral Properties of Herbal Materials, National Library of Medicine

¹⁶ Antimicrobial properties of salt (NaCl) used for the preservation of natural casings, National Library of Medicine