Should I be worried about a white coating on my tongue that can't be removed?

Hi there!

Hope this reply finds you well.

A white tongue generally shouldn't ring any alarm bells. However, its always best advised to monitor the white coating, especially if there are any episodes of pain that comes along with it.

There are several conditions that could be linked to a white tongue.

Leukoplakia - There could be sometimes white patches formation on the tongue, as well as on the inside of your cheeks. Excessive alcohol intake and smoking are linked to the formation of leukoplakia.

Oral Candidiasis aka Oral thrush - This is a fungal infection that can affect patients with lowered immunity. White coating on the tongue sometimes can be removed by scrapping. However, do take precaution that scrapping may sometimes cause a little bleeding. Anti-fungal medication might be required to resolve this sometimes.

Oral Lichen Planus - This is an inflammatory condition that can affect the mouth. And the white coating normally appears on the insides of your mouth and the tongue. This could also affect patients with lowered immunity. There could be open sores sometimes if the condition is further aggravated.

A white tongue generally wouldn't need much treatment. However it's best if you do undergo periodic monitoring and examination by your practitioner. And do take note to see the doctor if any serious symptoms (burning sensation, open ulcers, fever, having difficulty eating or swallowing) arise.

Have a good day!

Thank you very much for your enquiry. My esteemed colleagues Dr Kenneth Tan and Dr Paul Ang has answered very well and i hope you find the information that they presented useful.

I would just like to add that for my patients who have had issues or worries with a white coating on the tongue that is longstanding, I always tell them that it is not unreasonable to get a small tissue sample of the coating to have it tested in a biopsy in the Lab. Just to be sure and to have peace of mind!

This way, you can be absolutely sure of what it is, and you can then get definitive treatment for it.

If you like, you can consider going to your usual dentist to see if such a service is available.

Take care !

Kind Regards,

Dr Gerald Tan

Thank you for your interesting questions.

You appear to be talking about Leukoplakia, which is a condition with white patches in the mouth and/or tongue.

If it is painful, then it can be thrush or a fungal infection. You can try to scrape it to tell the difference.

It is usually harmless and should go away by itself.

However, some conditions can be related to it, such as heavy smoking, bad fitting teeth, or other medical conditions. If you are worried, you can always visit a general practitioner to check it out.

It's true also that a smooth tongue, or a red beefy tongue can mean some vitamin deficiencies. Otherwise, I'm not aware of any other colours being related to medical conditions.