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What causes white coating on tongue?

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Posted on Fri, 7 Nov 2014
Question: Hello Doctor,
My tongue does not look healthy. It’s not of normal color and it does not remain so as the day progresses. Soon after starting the day’s work, it starts to grow a white coating due to which I will have a metallic taste in my mouth. It always then remains white and if I have any food or drink in the meantime it looks to get added up on my tongue’s surface and hence adds to my misery. I keep my mouth and teeth absolutely hygienic, use tongue scrappers, floss and everything which is required. I am 29 year old male with no medical history quite normal healthwise.
Please suggest
doctor
Answered by Dr. V. N. S. Parinam (17 minutes later)
Brief Answer:
Sometimes temporary and normal

Detailed Answer:
XXXXXX,

Not always a white coating on the tongue is a sign of serious disease. If the coat is thin it is normal and non worrisome. If the coat is thick it could be a sign of disease from leukoplakia, thrush and lichen planus. It is normal to have white layer after each meal because if there are irritants in the food that leads to coating on the tongue.

Is the coat thick or thin? Are you able to clean it off with tongue scraper? Do anyone complain about bad breath?

The white patch seems to be the result of too many cells being produced from the lining of the mouth and a protein called keratin being deposited on the tongue.

Please note that too much of oral rinses with mouth wash can lead to white coating. Are you doing so? You should rinse with mouth wash just do it with water alone after each meal, that suffice.

For now I suggest you to rinse mouth with water alone and not mouth wash. Avoid acidic foods, smoke, alcohol which are irritants. Meanwhile observe my questions and answer them in your follow up.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. V. N. S. Parinam (20 hours later)
Dear Suma,
Thanks for your reply, please find my answers below: -
1) Is the coat thick or thin?
Its not too thick but sometimes it gets thick and covers tongue mainly on the deeper side.
2) Are you able to clean it off with tongue scraper?
I try to clean it but it does not come out all of it mostly in the deeper region of my tongue which is not accessible and in that region its more there.
3) Do anyone complain about bad breath?
Yes, I can feel the breath even myself too. But when I use tongue scrapper, even though not all the whiteness comes off, but the breath gets better.
4) Please note that too much of oral rinses with mouth wash can lead to white coating. Are you doing so?
I have tried it earlier but now I have stopped it completely and I try to rinse with plain water itself.
Moreover, the whiteness on my tongue is not temporary and it has been there from my childhood itself, and as I mentioned in my previous discussion that I keep my oral hygiene up to the mark. So I don't think its something that can get cured without doing anything because it has never been off ever so far. Please suggest!

doctor
Answered by Dr. V. N. S. Parinam (16 hours later)
Brief Answer:
esophageal reflux disease

Detailed Answer:
Hi

I think you should get tested for oesophageal reflux disease. You can start with a trial of pantaprazole every morning with 40 mg dose.

You tongue papillae are producing too much secretion. We need to find out the irritant. If it is acid pantaprazole helps.

All of this after a preliminary oral examination by dentist. Only have bland diet for 15 days.

Call me back after 15 days.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. V. N. S. Parinam (7 hours later)
Dear Suma, thanks for the reply. Two questions please
1) Shall I take PANTOPRAZOLE after breakfast or on empty stomach. If on empty stomach then after what time shall I take the breakfast.
2) After 15 days which number shall I be calling because I didn't see your contact details anywhere.
Thanks
doctor
Answered by Dr. V. N. S. Parinam (23 minutes later)
Brief Answer:
before breakfast

Detailed Answer:
You can take pantaprazole 30 min before breakfast. I mean to say you should take after prior consult with dentist for local examination.

What I mean was to follow up with me on this forum.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
Dr.
Dr. V. N. S. Parinam

General & Family Physician

Practicing since :2008

Answered : 1731 Questions

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What causes white coating on tongue?

Brief Answer: Sometimes temporary and normal Detailed Answer: XXXXXX, Not always a white coating on the tongue is a sign of serious disease. If the coat is thin it is normal and non worrisome. If the coat is thick it could be a sign of disease from leukoplakia, thrush and lichen planus. It is normal to have white layer after each meal because if there are irritants in the food that leads to coating on the tongue. Is the coat thick or thin? Are you able to clean it off with tongue scraper? Do anyone complain about bad breath? The white patch seems to be the result of too many cells being produced from the lining of the mouth and a protein called keratin being deposited on the tongue. Please note that too much of oral rinses with mouth wash can lead to white coating. Are you doing so? You should rinse with mouth wash just do it with water alone after each meal, that suffice. For now I suggest you to rinse mouth with water alone and not mouth wash. Avoid acidic foods, smoke, alcohol which are irritants. Meanwhile observe my questions and answer them in your follow up.