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White spots or patches may appear on your tongue as a symptom of several conditions. They’re generally benign, but knowing the possible causes will help determine when to contact a doctor.
Here are the most common causes of white spots on the tongue:
Oral thrush is a fungal infection caused by Candida yeast. It often appears as white patches on the tongue, mouth, and throat and is typically harmless.
Oral thrush is most common in babies. Healthy adults don’t often develop it, but factors that increase the risk include:1
The white patches may be small and spotty or coat a significant portion of the tongue.
Other symptoms of oral thrush include:
Babies with oral thrush may not want to feed and can develop a rash elsewhere on their bodies.2
Treatment usually involves an antifungal medication. The medicine is applied topically for a course of 1 to 2 weeks.
Fluconazole may be taken orally or by injection for more severe infections.
In leukoplakia, thick, white patches form on the gums, tongue, and inside of your mouth. These patches cannot be wiped off. Most instances are benign, but some can be precancerous.
The exact causes are unknown, but leukoplakia has been associated with tobacco use. Chronic irritation from sharp teeth or dentures may also play a role.
Using tobacco in any form puts you at a much higher risk of developing leukoplakia. You may also increase your chances if you drink alcohol.
Between 1 and 9% of people with leukoplakia will develop mouth cancer or malignancy in the future, with an increased incidence in women.3 Signs that the lesion may be at risk of being precancerous or cancerous include:
You might notice symptoms other than the lesions, including:
If you notice any of these symptoms, see a doctor immediately.
Discontinuing unhealthy habits that irritate the mouth, such as using tobacco or drinking alcohol, can resolve the issue for most people.
In more severe cases, your doctor may remove the patches with a scalpel and biopsy the tissue, and you may need routine follow-ups.
Oral lichen planus is a common inflammatory condition affecting the mouth's mucous membranes. Lacy white patches occur on the tongue and other soft tissues in the oral cavity.
Possible causes include:
The disease is not contagious. However, studies have shown that oral lichen planus can undergo malignant transformation, so routine follow-ups are needed to monitor for changes.
Women are twice as likely as men to develop oral lichen planus.4 It’s most commonly found in middle-aged adults; it’s unlikely to affect children or older people.
Some people may develop redness and sores in their mouths. You may also notice lichen planus on other parts of your skin.
There is no cure for oral lichen planus. However, some treatments, including corticosteroids or immune response medicines, may ease symptoms.
Syphilis is a sexually transmitted bacterial infection. It can occur in the mouth as a result of oral sex.
Bacteria enter the body through a cut in the mouth and create a chancre, or a sore, at the entry point. These chancres can be found on the tongue, lip, or inside of the mouth.
Chancres can resemble pimples or other conditions, which can delay diagnosis. One study showed that it took nearly 9 months for people with only oral symptoms to be diagnosed with syphilis.5
Engaging in unprotected oral sex makes you much more likely to develop oral syphilis. A condom or protective barrier can prevent oral sexually transmitted infections (STIs).
Poor oral hygiene can also make your mouth more vulnerable to bacteria.
Syphilis symptoms depend on the stage of the infection:
These stages can happen in a different order for different people. Some people may only experience some of these symptoms.
Oral syphilis is highly treatable if you catch it early. Antibiotics are the most common treatment, administered by injection.
The chancres may go away on their own, but that doesn’t mean the infection has. Seeking treatment is vital to avoid lasting consequences.
Mouth ulcers, also known as canker sores, are painful lesions that can occur for various reasons. They’re most common on the tissues surrounding the teeth but can also occur on the tongue.
Many things can cause a mouth ulcer to form, including:
Ulcers are not contagious and typically heal on their own after 1 to 2 weeks. If you have an ulcer that is not healing after two weeks, seek care from a dentist or doctor as soon as possible.
You may be more prone to developing canker sores if you have one or more of the following:
Maintaining a balanced diet, practicing good oral hygiene, and using stress management skills can help prevent mouth ulcers from developing.
In addition to the sores themselves, you may also notice the following symptoms:
Most canker sores will resolve independently. Some may need treatment to prevent complications and relieve symptoms as they heal.
Treatment involves using an antiseptic gel, keeping your mouth clean, and avoiding certain foods. Some severe cases may require immunosuppressant medication.
Geographic tongue is also known as benign migratory glossitis. It’s a condition where the top and sides of your tongue don’t have papillae.
Irregular red spots with white serpentine borders characterize the condition. In most cases, treatment isn’t necessary.
Factors that may worsen the symptoms of geographic tongue include:
Irregular red spots with white serpentine patches are a symptom of geographic tongue. These patches can frequently change their location and size. They may start in one area and then slowly move to another.
In addition, some people may experience mild discomfort or sensitivity to particular foods
Geographic tongue typically does not require treatment. In cases where the condition causes significant discomfort, a dentist or healthcare professional may recommend:
Oral cancer is a serious condition that can present as white or red patches. The patches may develop in areas like:
Here are some risk factors for oral cancer:
Oral cancer comes with more serious symptoms, and some may reoccur. Other symptoms associated with oral cancer include:
The treatment for oral cancer varies depending on the stage and extent of the disease. Common treatments for oral cancer include:
Contact a healthcare professional if you experience:
Your doctor can conduct a full examination and run tests if needed.
The method of diagnosis will vary depending on the condition your doctor suspects. They may perform a biopsy, run blood tests, or examine your mouth.
Your diagnosis will determine your treatment. Habit change and practicing better oral hygiene can resolve some issues entirely.
Other conditions may have no cure, but their symptoms may be treatable using topical gels, oral medications, or injections.
Most causes of white patches are benign. Generally, they will resolve on their own or can be treated by a healthcare professional.
Some underlying conditions may have the potential to become precancerous. Mouth cancer can occur at any age, with 20% of all cases appearing in adults under 55.6
Catching any issues early can improve your outlook.
The best way to prevent issues with your tongue is to practice excellent oral hygiene. Medical professionals suggest:
These tips can help prevent complications in the future.
White spots on your tongue are a common symptom of many conditions. They are usually benign, non-contagious, and treatable. However, they can sometimes indicate a more severe condition, so visiting your doctor early is important.
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