what causes white tongue? savina dental clinics malta and gozo

The sight of a white tongue looking back at you in your bathroom mirror can be frightening. However, although the discolourations may be a sore sight, the condition is usually benign and short-lived. In some rare circumstances, a white tongue could be a symptom of an underlying serious condition like cancer in its early stages or a fungal infection.

As such, it’s important to be keen and watch out for the manifestation of other symptoms. If the white patches don’t disappear in a couple of weeks, you should consult a medical professional.

The Causes of a White Tongue

  • Poor oral hygiene: A clean and healthy tongue is pink and rough due to the tiny nodules on the tongue’s surface. Without proper oral hygiene, food debris gets lodged between these nodules resulting in a white coating.
  • Dry mouth
  • Dehydration
  • Smoking or other oral tobacco use
  • Excessive alcohol use
  • Mouth breathing
  • Low roughage diet (eating soft or mashed foods)
  • Mechanical irritation from sharp tooth edges or dental appliances
  • Fever

If you have any pressing dental issues or questions, you can book an appointment online or contact us directly on (+356) 2125 7253 (Skyparks Business Centre, Malta International Airport), or (+356) 2155 7323 (Dingli Street, Victoria, Gozo). For international patients, it is recommended to request a free e-consultation where we can discuss your individual case and treatment options.

Conditions Linked to a White Tongue

In some rare instances, a white tongue can be a sign of:


This is a common condition that results from the body’s overproduction of the cells that line the insides of the mouth. The excessive cells usually combine with protein keratin deposited on the tongue to form white patches. The white patches are often on the tongue, but can also form on the gum and inside of the cheeks.

Leukoplakia is caused by chewing tobacco, smoking, or excessive alcohol intake. While the white patches are usually harmless, they can develop into oral cancer.

Oral lichen planus

This is a long term inflammatory condition that affects the mouth. It develops as a result of an immune system disorder and is not contagious.

Oral Thrush

This is a yeast infection (known as Candida) that manifests in the mouth. Persons with diabetes, weak immune system, HIV/AIDs, Vitamin B or Iron deficiency are susceptible to developing oral thrush. People who wear dentures are also at risk of developing this condition.


Syphilis is a sexually transmitted disease that causes sores to develop in the mouth. When not treated, it causes white patches referred to as syphilitic leukoplakia on the tongue.

Other Possible Causes

Geographic Tongue

This condition appears on the sides, bottom and top of the tongue. It is characterized by wavy, white lines surrounding the red areas, making the tongue look like a map. After some time, the patches and lines tend to change their shape and position.


Some medication like antibiotics can cause yeast infections in the mouth, which in turn breeds the white spots.

Mouth or tongue cancer

Tongue cancer often develops in the front of your tongue. Cancer that develops at the back is called oropharyngeal cancer. Symptoms of this cancer include mouth ulcers, sores and white patches on the tongue.

Treatment Options

Often, a white tongue doesn’t need treatment as the symptoms usually disappear on their own.

You can get rid of the white coating on your tongue by brushing gently using a soft brush or by using a tongue scraper. Drinking a lot of water can also help to flush out debris and bacteria from the mouth. But in case you need treatment, the type of medication you require will depend on the cause.


Usually, this doesn’t need treatment. However, you should visit your dentist regularly to monitor your condition.

Oral lichen planus

This also doesn’t require treatment. But in the event the condition gets worse, your doctor may prescribe a steroid spray.

Oral thrush

This condition is treated with some antifungal medicine. Antifungal medicine is available in different forms, including liquid, pills, gel and lozenges.


Syphilis is treated with penicillin, which helps kill the bacteria causing syphilis. If you’ve had the condition for a longer period, you should take more than a single dose. You should also visit your doctor.

When to See a Dentist or Doctor

when to see a medical professional

If your only symptom is a white tongue, then there’s no need to see a medical professional. However, if it doesn’t go away in a few weeks, then you should book an appointment with your dentist.

Also, if any of the below symptoms manifest, you should see a doctor:

  • Trouble talking, chewing and swallowing
  • Open sores in the mouth
  • Painful tongue with a burning sensation
  • Other symptoms such as skin rash, weight loss or fever

How to Prevent a White Tongue

Unfortunately, there is no foolproof method of preventing a white tongue. But fortunately, there are some tips you can use to reduce your risk of it developing.

The main thing you should do is to practice good oral hygiene. This will include;

  • Using a soft-bristled toothbrush
  • Using fluoride toothpaste
  • Brushing your teeth twice a day
  • Using fluoride mouthwash on a daily basis
  • Flossing once every day

In addition to these, you should also;

  • See your dentists twice a year for cleaning and routine checkup
  • Avoid tobacco products and reduce alcohol intake
  • Eat a diet with lots of fresh vegetables and fruits

White Tongue FAQ

Does Tongue Scraping Help?

Tongue scraping helps in clearing the bacteria on the tongue and improve the tongue’s overall appearance and sensation. It also helps in reducing bad breath, but should not be used as a replacement for brushing your teeth.

Why do you have a white tongue in the morning?

There are several causes of a white tongue. However, waking up with a white tongue in the morning is probably as a result of poor oral hygiene. Ensure you brush your teeth and tongue twice a day.

A white tongue in the morning could also be caused by breathing through the mouth the whole night, which causes the mouth to dry out.

What causes white tongue on babies?

White tongue on babies is caused by milk residue, and so it should be no cause for alarm. The milk residue often dissolves an hour after feeding.

Can white tongue cause bad breath?

Yes. Since a white tongue is caused by a build-up of debris and bacteria, bad breath is a possible side effect. However, the bad breath should go away with the white tongue.

Generally, the white tongue is harmless, even though it might be a sore sight. The symptoms may improve after a change in lifestyle or oral hygiene. Nonetheless, these improvements are encouraged. If the symptoms don’t go away after some time, seek medical assistance.

Have You Tried Our Free e-Consultation Service?

If you are worried about a dental related issue, interested in travelling to Malta for a dental holiday or have questions about any of the treatments we offer, please contact us using our new free e-Consultation service. One of our highly qualified team will respond to your query as soon as possible. Our e-Consultation service is live 9am – 6pm Monday to Friday.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.