The condition of the tongue can reveal a lot about a person’s health. While a white coating isn’t always a sign of a serious illness, its persistent appearance can indicate underlying health issues. Pablo Turrion, Medical Director at Hospital Sanitas La Moraleja, explains that a white coating on the tongue is not a diagnosis in itself, but analyzing it provides valuable information about one’s overall health.
According to the specialist, a white coating consists of an accumulation of dead epithelial cells, bacteria, fungi, or food debris on the surface of the tongue. This layer can be temporary or persistent. Often, it appears for minor reasons and can be resolved by changing certain habits, but sometimes it may indicate a more serious problem. Factors that contribute include sleeping with an open mouth, inadequate water intake, and poor oral hygiene. Smoking and a diet low in fruits and vegetables can also be causes.
Most cases, as Dr. Turrion emphasizes, are benign. The most common and easily addressed causes are dehydration, poor oral hygiene, and smoking. In these situations, changes in the color or texture of the tongue are related to the buildup of deposits, which can be removed with proper brushing and restoring fluid balance. Daily cleaning of the tongue with a toothbrush or a special scraper not only improves its appearance, but also freshens breath and supports overall oral health.
Sometimes, a white coating is caused by oral candidiasis—an infection triggered by the fungus Candida albicans. In such cases, white plaques appear on the tongue and may partially detach when scraped off, leaving red and sore areas. Other symptoms include burning, dryness, an unpleasant taste in the mouth, and, in some cases, difficulty swallowing. Candidiasis can develop due to weakened immunity, prolonged use of antibiotics, inhaled corticosteroids, or ill-fitting dentures. This infection responds well to antifungal medications, which must be prescribed by a doctor.
A white coating on the tongue can also be linked to internal disorders. Dr. Turrion notes that, in some people, this sign may indicate intestinal dysbiosis, liver disease, or chronic digestive disorders. In such cases, the coating is just one symptom and should be considered along with other signs, such as changes in bowel movements, persistent fatigue, or abdominal discomfort.
Not only diet or infections affect the condition of the tongue. Certain types of medication can also trigger the appearance of a white coating. Antibiotics, by altering the microflora of the oral cavity and gastrointestinal tract, promote excessive fungal growth. Inhaled corticosteroids, chemotherapy drugs, or immunosuppressants may have a similar effect. If you notice persistent changes on your tongue after starting a new medication, you should discuss this with your doctor.
Although not every case requires immediate intervention, there are situations when consulting a specialist is necessary. According to Dr. Turrion, you should make an appointment if the white coating persists for more than two weeks, is accompanied by pain, bleeding, a constant unpleasant taste, deep cracks, or firmly attached plaques. A combination of coating with fever, weight loss, fatigue, or swollen lymph nodes is also a cause for concern. Medical examination in such cases can help rule out infections, nutritional deficiencies, or systemic diseases.
