A white tongue can be caused by various factors, including poor oral hygiene, dehydration, thrush, leukoplakia, and lichen planus. While some causes are benign, others may require treatment or indicate precursors to cancer. Good oral hygiene and smoking cessation can help prevent it.
There are many different things that can cause a white tongue. Some are benign or can be easily resolved, others may require treatment, and still others may indicate precursors to cancer. Most of the time, waking up with a very occasional white tongue in the morning could indicate a need to practice better hygiene. It can also mean that you have a cold or allergies and you breathe through your mouth most of the night, as mouth breathing is a common cause of white tongue.
Typically, occasional white tongue, especially when the entire tongue is white (not white in spots or patches), is due to mild inflammation of the papillae, the small bumps that cover the tongue. These can, like skin cells, collect things like white blood cells, bits of bacteria, and the like, and appear swollen and white in color as a result. This condition can be caused by poor oral hygiene, dehydration, or it can be chronic for smokers. People on medications that cause dry mouth may encounter white tongue on a fairly regular basis, with symptoms residing after moisturizing the mouth in the morning.
A tongue that looks mottled white can indicate another condition, thrush, a type of oral yeast infection. This can be caused if you have recently taken antibiotics and is not uncommon in infants and the elderly. People with diabetes may be more prone to thrush, and some oral inhalants for asthma can also cause the condition. Thrush requires treatment and you should see your doctor if you suspect it.
Another condition, leukoplakia, causes white patches on the tongue. This condition often occurs in people who smoke or use tobacco products and should definitely indicate a trip to the doctor, as it can be seen as a potential precursor to oral cancer. This is not always the case and the condition can resolve itself if the tobacco use behaviors stop.
Lichen planus, a rare rash condition can cause white streaks to appear on the tongue. It may itch, and you may notice the rash appearing on other parts of the body, especially the wrists, forearms, mid-back, and above the ankles. The rash may appear first and if you notice that your tongue has lacy white streaks or patterns, you should probably discuss this with your GP. Lichen planus can also result from tobacco use and can resolve itself if the affected person stops smoking or chewing.
In most cases, white tongue is either benign or causes conditions that can be treated easily. Good oral hygiene and smoking cessation can also help to avoid it. Patches, stripes or perforations on the tongue are another story. These should be evaluated by a doctor to rule out the conditions mentioned above.
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