DEAR DR. GOTT: I have a problem with my tongue turning white. I brush the coating off each morning, but by nighttime, I have to do it again. I can’t understand why this happens. It is worse when I eat a lot of sweets. What do I need to do? I like a pink tongue.
DEAR READER: The white coating to which you refer is the result of inflammation of the tiny projections on the surface of your tongue, caused by dead cells, bacteria and debris. There are several reasons for this generally harmless condition. The first is dehydration. Then there’s excessive alcohol consumption and smoking. You may be a mouth breather, have a bacterial infection, geographic tongue, oral lichen planus, oral thrush or leukoplakia. Or you may have been placed on a medication that has white tongue as a side effect. Oral lichen planus is an autoimmune inflammatory disorder. Oral thrush is a candida infection that causes lesions on the tongue, inner cheeks, roof of the mouth, gums and back of the throat. Your symptoms don’t appear to fit the profile for geographic tongue. Leukoplakia is commonly the result of tobacco use, smoked, chewed or used in other forms. It is generally a benign condition but could be precancerous.
See your physician, who will examine you and might choose to order testing to determine whether an underlying cause, such as diabetes, is at the root of the problem. Once specific conditions and infections can be ruled out, medication or other treatment might be appropriate. Or he or she might suggest you follow up with your dentist.
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