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Tongue coating

introduction

The tongue is essential for speaking and swallowing. If it is occupied, it hurts or burns, this is often an indication of physical illness.
Tongue coating specifically is a film that often covers the top of the tongue and can be wiped off. Similar to dental plaque, bacteria are present in this and, depending on the composition, this film sticks to the tongue to a greater or lesser extent.

It can spread particularly well on the tongue and adhere to it, as there are many taste glands and furrows on the surface of the tongue, between which a deposit is quite possible. Usually it is rubbed on by careful oral hygiene and eating.

Causes of tongue coating

Tongue coating occurs in the most everyday situations and is often due to a very harmless cause. It usually consists of dead cells, food debris and the bacteria that are in the oral cavity.
There are various foods that support bonding, such as onions, coffee, tea or alcohol. After consuming such drinks and food, one very often notices an unpleasant film on the tongue.

The tongue coating is usually rubbed off by the food, but the faster you gulp down your food, the better it clings. Since the chyme is not transported around the mouth long enough, the tongue coating cannot be rubbed off.

Another cause is inadequate oral hygiene. If the teeth are not properly clean, the tongue is also more prone to coating. However, there are also various diseases that trigger a coating on the tongue. A fungal infection of the oral cavity triggers a whitish coating and often also causes a burning sensation in the tongue. In rare cases, infectious diseases such as diphtheria, scarlet fever or typhoid also cause tongue coating.

But smokers also tend to have a covered tongue due to tissue conversion. The cells of the oral mucosa and the surface of the tongue change and the smoke can then stick there or discolour stuck food residues and dead cells. The covering then has a brown color.

Tongue coating after taking antibiotics

As already described a little earlier, a dark tongue coating is not uncommon after long-term antibiotic use. A “black hairy tongue” often forms, with the tongue also sometimes becoming a little thinner. However, these changes are reversible and disappear again relatively quickly after discontinuation of the drug. Should this side effect occur, it should be discussed with the attending physician and a decision should then be made as to whether a change in medication can be made.

Coating of the tongue with a cold

With a cold, the immune system is very weak, viruses have an easy job and in most cases thick saliva is formed. The cell remains form a white film, which is difficult to remove due to the inflammation and the low level of saliva. The coating spreads over the entire tongue, but in the case of inflammation of the throat mainly in the back third of the tongue. Accompanying symptoms here are a sore throat, runny nose, cough or hotness. The tongue coating is harmless in this case and disappears as soon as the cold is healed. Resting and medication for the common cold are the methods of choice here to remove the plaque over the long term.

Tongue coating due to fungus

If the tongue coating is caused by a fungus, it is called oral thrush. It is an infectious disease of the mouth and throat, which is often found in prosthesis wearers. It is mainly caused by the yeast Candida albicans. This affects the cheeks, lips, tongue and palate and forms a whitish coating. If you wipe this off the affected areas, an inflamed, reddish swollen oral mucosa can be seen. Sometimes it bleeds when touched.

At the beginning of the disease, only a few white spots can be seen on the tongue, which over time combine to form larger whitish areas. Various other symptoms occur. Often there is a dry mouth, bad breath, taste disturbances and a burning sensation of the oral mucosa.

Babies, people with a weakened immune system or elderly people are often affected by a fungal attack. The reason for this is the weakened immune system, which cannot fight the fungus sufficiently as an invader. Taking antibiotics and inadequate oral hygiene also contribute to this. This disease is always treated with a fungal agent (antimycotic), which prevents further spread.

Also read: Oral thrush

Is tongue coating an indication of HIV?

HIV infection severely affects the immune system. Pathogens that cause disease then have an easy job and spread faster than in healthy people. A fungal infection often occurs in people infected with HIV. The question then often arises as to whether this symptom is a sign of an acute or a long-standing infection. It can be assumed that this symptom only occurs in a late phase of the disease, as some previous damage to the immune system must be present for the fungus to spread. Mushrooms have bad cards in healthy people, they can only spread in poor health, if there are no longer enough defenses.

This could be interesting for you: Symptoms of HIV infection

Coating of the tongue from smoking

The surface of the tongue changes due to the constant smoke that penetrates the oral cavity. The cells are restructured as a result of the constant stress and become rougher, a kind of horny layer forms in the oral cavity. This ensures an increased formation of tongue coating. The coating on the tongue of smokers is often yellow to brownish and is intensified by the consumption of coffee.

In addition, many smokers also interact with periodontitis, as they are more susceptible to this disease than non-smokers. The increased coating on the tongue is usually also accompanied by an unpleasant bad breath.

Tongue coating after tongue piercing

When a tongue piercing is stung, a tongue coating is created at the wound site, triggered by the healing process, as well as swelling of the tongue in this area. Yellowish wound secretion comes out, which should be removed with a cotton swab. The plaque can be carefully removed with the toothbrush. The area around the piercing can usually only be cleaned very poorly, as this area burns through the wound. In addition, mouthwashes with disinfecting agents such as Chlorhexamed should be used to prevent bacterial inflammation from spreading.

What does the color of the covering mean?

A discoloration of the tongue should always be noticed and carefully examined, as it can sometimes hide serious diseases of the body. Depending on the color and nature of the tongue coating, these are separated from one another.

While a light-colored coating could be a sign of a fungal attack, an inflammation of the gastric mucosa, an iron deficiency or the preliminary stage of cancer (leukoplakia), a dark-colored coating is often a side effect of smoking or various drugs. The “black hairy tongue”, a discoloration after taking antibiotics, can be observed very often, as well as a brown discoloration of the tongue coating after several weeks of using a mouth rinse containing chlorhexidine.

Sometimes liver diseases are also behind the yellowish coating of the tongue. If the tongue turns fiery red, i.e. is more pigmented than normal, there may be scarlet fever, a vitamin B12 deficiency or even an inflammation of the tongue. Other illnesses are syphilis, immune deficiency or metal poisoning.

Yellow coating on the tongue

There are also many possible causes of yellow tongue coating, from harmless to dangerous. Poor oral hygiene, poor nutrition and smoking can be behind this.

However, a disturbed organ function, for example of the stomach or liver, also triggers this coating. An inflammation of the stomach lining (gastritis) should be excluded as well as a disturbance of the intestinal muscles. A portal vein congestion (closure of the vessels that supply the liver with nutrients) or a liver disease can be behind it.

In jaundice (jaundice), the eyes turn yellow in addition to the mucous membranes. The color is caused by a build-up of bilirubin in the tissues. This substance is contained in the red blood cells and is created as a breakdown product when a disproportionately large number of red blood cells are destroyed. This is not a problem for a healthy person. However, if the outflow via the liver is disturbed, the bilirubin cannot be excreted and settles in the tissues. The yellow coloration typical for liver patients develops.

Since there can be very serious illnesses behind it, a doctor should definitely be consulted if the tongue is yellow and does not go away on its own.

White coating on the tongue

This is a coating on the tongue with a variety of causes. The color range extends from light to dark, dirty white. It is made up of dead cells, food, and bacteria during the day and is usually removed through eating and good oral hygiene. However, if the entire oral cavity, including the gums and cheeks, is also covered, this may be a fungal colonization of the oral cavity. One speaks of "Oral thrush“, The covering can be wiped off with a cotton swab, while the tissue underneath is easily inflamed and reddened and starts to bleed when touched.

However, if the tongue coating is firm and it is possibly on the edge or on the base of the tongue, one speaks of a Leukoplakia. Here, the body increasingly forms horn cells as the top layer of the mucous membrane, which have a white appearance. This should definitely be clarified by a doctor, as it may be a preliminary stage of cancer. This can then be removed before the condition deteriorates.

Internal diseases such as gastric mucosal inflammation and problems with the pancreas are also expressed in a white coating on the tongue. If the tongue appears paler than usual, but without a specific coating, iron deficiency anemia may be the cause.

Brown coating on the tongue

While a brown coating on the tongue can be triggered by various foods, there are also various internal diseases that need to be clarified with this symptom.

The consumption of chocolate or smoking are typical causes of the brown coating. But an intestinal disease is also possible. If the tongue swells as well, kidney disease should also be considered as the cause of the plaque.

Mouthwashes with the ingredient chlorhexidine also discolour the tongue brownish when used for a long time or continuously. However, this discoloration is reversible and disappears by itself when the irrigation is stopped. This type of discoloration is extremely characteristic and is also recognized by the fact that the teeth are also more prone to discoloration.

Black coating on the tongue

If the tongue turns very dark or even black, caution is advised. Often it is a side effect that is triggered by a very long antibiotic treatment. Taking this medication changes the structure of the papillae of the tongue, making it look like it is "hairy". This is why this disease is also called "black hairy tongue".
Sometimes the hairy tongue is also accompanied by more serious diseases of a very weakened immune system. This can be the case with infectious diseases such as HIV.

Green tongue coating

If there is a greenish coating on the back of the tongue, a disease of the biliary tract or the gallbladder should be excluded. Since these diseases can have serious consequences for the body if left untreated, it is imperative that a doctor is examined. A sore throat is far more harmless here. Here, too, a greenish coating forms from time to time, but this disappears as the disease heals. Taking medication can significantly reduce the duration of the illness.

Tongue coating only behind

Sometimes it happens that the tongue is mainly very far back, at the transition to the throat. This coating on the tongue often causes unpleasant halitosis as it is very difficult to remove. With the usual aids it can happen that the proximity to the uvula triggers a gag reflex and then vomits.

Therefore, the household remedies mentioned are particularly helpful here. A natural rinsing with salt water rubs off the coating in the back third of the tongue by gargling very well without triggering a gag reflex. The good news, however: in most cases, the tongue coating located this far back is extremely harmless. In the majority of cases, it is triggered by an inflammation of the throat or tonsils. Here it is then necessary to eliminate the cause of the disease in order to get rid of the tongue coating.

Remove tongue coating

Tongue plaque is removed naturally every day and with every meal. Due to the food residues, which are chewed and transported around in the mouth, the tongue coating rubs off by itself and is transported away with the chyme into the stomach. However, particularly sticky deposits are not that easy to remove. It settles deep in the furrows of the tongue and cannot be removed simply by rubbing it off and rinsing it with drinks or a mouthwash. Nowadays, however, there are some aids to ensure a pleasantly fresh mouthfeel here as well.

For example the tongue coating remover, which is manufactured by various companies. It is used after a meal and gently helps to remove the sticky coating. You should place it in the back third of the tongue and then slowly pull it forward. Care must be taken not to press too eagerly as the tongue may tear and become infected.

If you don't have a tongue scraper at hand and still notice the plaque and want to remove it, you should try a similar thing with the toothbrush. Pull this over the tongue from the back to the front and remove the covering. However, it can happen that you have to clean the toothbrush more often because the plaque sticks in the brushes. As this increases the number of bacteria in the toothbrush, the toothbrush should only be used for tongue cleaning in an emergency.

Read on below: How to remove tongue coating

Home remedies for tongue plaque

The simplest tool to remove tongue plaque is, as described above: the tongue plaque remover. You can easily scrape off the tongue coating with it. Remnants such as food and bacteria can be gently removed.

A natural tongue scraper is salt. This is available in almost every household and is used in a conditioner. To do this, put a teaspoon of salt in a glass of lukewarm water, stir and rinse or gargle with it for several minutes and then spit out. You can also put the salt directly into your mouth and then massage it in with a toothbrush. The roughness of the salt removes the coating on the tongue and cleans the tongue very thoroughly.

Baking powder has also proven itself. It is used in the same way as salt, but it also neutralizes acids and helps restore the natural pH value in the mouth. Foods such as sauerkraut, kefir, pickled cucumbers or aloe vera juice are also said to be helpful in removing tongue coatings.

Another very popular method is oil pulling. To do this, distribute olive or coconut oil in your mouth and pull from one side to the other for several minutes. Oil pulling helps remove harmful bacteria and remove toxins from the body. It is important not to swallow the oil-saliva mixture but to spit it into the garbage. However, there is no scientific evidence of its effectiveness.

Learn more about this at: Dental care with coconut oil

Tongue coating cannot be removed

If the tongue appears to be covered, an attempt should be made to remove it mechanically with a spatula or a tongue plaque remover. However, in some cases this does not work. In this case, the doctor should be consulted very promptly, as it can be a pathological change in the lining of the tongue. You should pay particular attention if the change occurs on the edge of the tongue or on the underside of the tongue. It can be a precursor to a malignant disease. These changes are very often caused by smoking or, much less often, by cancer.

Further symptoms with coating on the tongue

Since the tongue is a very sensitive organ that is very closely networked with the brain, other symptoms can occur in addition to the tongue coating in the event of a disease of the oral cavity.

Very pronounced bad breath is reported most often. Sulfur compounds, which are formed by the metabolic processes of various bacteria, are the cause of this. This smell is very rarely perceived by those affected. Here it is above all the relatives who point this out after a while.

The typical burning sensation in the tongue due to inflammation of the surface of the tongue, which occurs, for example, in the case of a fungal attack, is also very widespread. An accompanying tingling or itching is not infrequently described in this context.

If the tongue coating lasts for a long time, it can happen that taste disorders occur and that the tongue hurts when touched by the food. This mainly happens when there is also a disease of the salivary glands and there is very little flow of saliva, as this is triggered by a dry mouth and the tongue coating is not properly removed.

Tongue coating and bad breath

Various bacteria are responsible for the bad breath that accompanies the coated tongue. About 60% of all bacteria in the oral cavity sit on the tongue and feel very comfortable in the tongue coating. They settle in the deposits and feed on the leftover food they contain. Proteins are broken down and sulphurous gases are produced which have a very bad smell. Often, the consumption of odor-producing foods (such as garlic or onions) is enough. With good oral hygiene, however, the bacteria can be quickly removed from the tongue grooves and the odor neutralized.

In some cases, however, it is not enough just to remove the coating on the tongue, as is the case with periodontal disease. This disease is triggered by bacteria, which mainly settle in the gum pockets. However, simply removing the tongue coating does not kill the bacteria in the pockets. They have to be removed by a special therapy at the dentist. The tooth pockets are mechanically cleaned and then gargled with disinfecting mouthwash solutions for a few weeks. When the therapy has been successfully completed, the tongue coating also disappears.

Find out more at: What to do against bad breath

Which doctor takes care of tongue coatings?

The first point of contact should be the attending dentist if the tongue is coated. They are very familiar with the various diseases of the oral cavity and can help in any case. Based on the anamnesis and various diagnostic methods, he will find the reason for the tongue coating and remove it. Depending on the exact disease, a specialist can then e.g. Oral surgeon will take over the therapy.

Duration

The duration of the tongue coating depends on the individual disease. If there are only very harmless foods behind it, the coating can disappear again within a few days.
However, if it is accompanied by a fungal attack or other disease, the coating will last as long as the disease persists. This can take from a week to several months, an exact time cannot be given here as it differs individually from patient to patient. In general, however, a doctor should be consulted if home remedies fail and the tongue is coated for more than 2 weeks.

diagnosis

Eye diagnosis is an important diagnostic tool here. The (dental) doctor takes a very close look at the tongue and the plaque and decides on the basis of anamnesis, color and some other factors what type of plaque and disease it is in the individual case.

Important information for this is the length of time, i.e. since when the plaque has appeared, whether there are additional symptoms such as burning tongue or what previous illnesses exist. In addition, the patient's diet and smoking behavior play a major role. If no exact cause can be determined in this way, a smear or a blood test is important for further diagnosis and therapy.