A white tongue can be a sign of many things, ranging from poor oral hygiene to a health condition. A white tongue is usually not serious and often can be easily treated.
12 Causes of a White Tongue
A variety of causes and conditions can cause a white tongue. These include:
- Poor oral hygiene: Bacteria build up on the tongue when leftover food particles aren’t removed properly
- Dehydration: Inadequate fluid intake can reduce immunity and allow bacteria to flourish
- Dry mouth: If there is not enough saliva in the mouth, this can lead to increased bacteria
- Tobacco use: Smoking or chewing tobacco greatly increases the risk for oral cancer
- Alcohol: Drinking alcohol can lead to dehydration and can also cause tongue soreness, dryness, and pain
- Irritation: Sharp edges of teeth, dentures, or braces can scrape and injure the tongue, which can introduce bacteria and germs
- Geographic tongue: This occurs when the old surface of the tongue replaces itself and the top layer of the tongue does not come away evenly
- Medical conditions
What Are Symptoms of White Tongue?
Depending on the cause, a white coating on the tongue may be accompanied by symptoms such as:
- Unpleasant taste in mouth
- Bad breath (halitosis)
- White spots in the mouth
- Sore throat
- Irregular, smooth, red areas
- Bleeding and irritation with tooth brushing
- Feels like cotton is in the mouth
- Sensitivity to hot, spicy, or acidic foods
- Gum inflammation (gingivitis)
- Discomfort speaking, chewing, or swallowing
How Is White Tongue Diagnosed?
A white tongue is diagnosed with an oral examination by a dentist or doctor.
Tests used to diagnose the cause of the white tongue may include:
- Analysis of an oral scraping of the white substance from the tongue
- Endoscopy
- Biopsy
What Is the Treatment for White Tongue?
Treatment for white spots on the tongue depends on the cause.
Most of the time, a white coating on the tongue is due to poor oral hygiene. Follow good oral hygiene practices such as:
- Brushing your teeth twice daily with a toothpaste proven to fight cavities, decay, and plaque
- Upgrading to an electric toothbrush for a better clean or change manual toothbrushes every three months
- Gently scraping your tongue with a tongue scraper or brush to remove leftover food particles
- Using an irrigator or interdental brush to help remove food particles stuck between teeth and hard to reach areas
- Visiting a dentist every six months
- Staying hydrated
- Not smoking
Other treatments to help get rid of a white tongue involve treating the underlying condition:
- Oral thrush
- Antifungal medications
- Lichen Planus
- May go away on its own but can also last years
- Prescription mouthwashes and sprays can help relieve burning or sore gums
- Corticosteroids, oral, topical, or by injection
- Immunosuppressants
- Leukoplakia
- Syphilis
- Antibiotics
- Sexual partners should also be treated
- Sex should be avoided until both the patient and partner have been treated
- Patients should be re-tested about three months after their diagnosis because many people are re-infected from untreated sexual partners
- Cancer: treatment depends on the type of cancer and its stage and may include:
- Chemotherapy
- Radiation
- Surgery
- Immunotherapy
- Hormone therapy
- Targeted drug therapy
- Bone marrow transplant
From 
Image source: iStock Images
https://www.nhs.uk/conditions/sore-or-white-tongue/
https://crest.com/en-us/oral-care-tips/gum-health/why-is-my-tongue-white
https://www.cancer.gov/about-cancer/treatment/types