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White patches on the tongue can be caused by various factors, including bacterial or yeast overgrowth, smoking, drinking alcohol, oral thrush, leukoplakia, and syphilis. While most of these conditions are not serious, some may require medical attention. Patients with compromised immune systems are at higher risk.
Many different conditions can cause white patches on the tongue. Most of these conditions are of little or no medical concern, although they can be uncomfortable or embarrassing. Factors such as drinking or smoking can upset the natural microbial balance in the mouth. A yeast infection can take root in the mouth and cause white patches on the tongue. Some potentially more serious conditions, including leukoplakia and syphilis, can also cause tongue blanching.
The tongue and mouth are naturally full of bacteria. These bacteria normally have no impact on the body or are actually beneficial. The microorganisms present in the mouth are typically kept in balance by other microbes and the body’s natural defenses. When they are out of balance, however, they can pile up in large numbers. These excess bacteria combine with debris to form pasty white patches on the tongue, which can develop into a complete coating.
Some activities can upset the microbial balance in the mouth. Any activity that could kill large numbers of bacteria can do it. Bacteria not normally found in the mouth can then colonize the teeth and tongue and produce stains or a coating.
Drinking alcohol, especially distilled liquor, kills many bacteria in your mouth. Smoking can have a similar effect. Mouth breathing, consciously or during sleep, changes the mouth environment and can alter the microbial balance.
White spots can also be caused by yeast growth. The yeast Candidia albicans, the same yeast generally responsible for yeast infections, can infect the tongue. This is also known as oral thrush. Thrush, unlike a simple bacterial overgrowth, can be quite painful. White spots caused by yeast can also bleed slightly.
Patients with compromised or undeveloped immune systems are at increased risk of infection. This includes the very young and the elderly. Individuals who wear dentures are at increased risk for thrush. The loss of most of the normal bacteria in the mouth, most often due to antibiotic use, can also lead to the growth of oral thrush.
Leukoplakia, a condition that causes normal skin cells in the mouth to grow too quickly, can cause white patches. This condition is not serious in and of itself. However, it can eventually lead to cancer, and a doctor may order periodic testing to make sure it doesn’t happen.
Syphilis can also produce white patches on the tongue. This sexually transmitted infection is rare in the developed world and easily treated with antibiotics. However, it can be dangerous if left untreated.
