What’s that white coating on your tongue? How to tell if you’re healthy or not

When it comes to oral health, most people don’t go beyond brushing and flossing their teeth. But it may be a good idea to, once in a while, take a good look at your tongue.

Other than giving you an idea why your breath stinks (if it does), in some rare cases, changes in your tongue’s appearance may be telling you something about your health – such as mouth or tongue cancer, or syphilis.

The tongue's appearance can tell a lot about one's health. Does it look like raw meat or have “hair”? Experts tell CNA Lifestyle what these all mean. Fair warning: Graphic images ahead.

For starters, a healthy tongue is pink and covered with small, short, bristly nodules known as papillae, according to Cleveland Clinic, a non-profit academic medical centre in the US. Any deviation from this appearance or any pain may be a cause for concern.

IS IT NORMAL TO HAVE A WHITE COATING ON THE TONGUE?

What about the thin white coating on the tongue? Does that count as a deviation? In most cases, they are harmless and transient, said Dr Lim Keng Hua, an ear, nose and throat (ENT) specialist at Mount Elizabeth Hospital’s Dr Lim Keng Hua Ear Nose Throat Head & Neck Surgery.

“The white coating is caused by the accumulation of debris, bacteria and dead cells between the enlarged and sometimes, inflamed papillae on the surface of the tongue,” he said, adding that bleeding is rare but if it does occur, you’ll need to see a doctor to rule out cancerous growths.

The coating “may be removed by brushing your tongue with a soft toothbrush or using a scraper,” said Dr Lim, who also advised keeping yourself hydrated.

Other ways of lessening the coating is to simply avoid tobacco and alcohol, added Dr Anna See, an associate consultant in otorhinolaryngology with Singapore General Hospital’s Head & Neck Surgery department.

She also pointed out that a thick coating is “not normal.” The causes can include fungal infection, syphilis infection, lichen planus, the early stages of mouth and/or tongue cancer, or HIV. “A thick white coat, which is sometimes associated with chronic ulcers, mouth bleeding and odorous breath, should be investigated by a specialist doctor to rule out underlying causes,” said Dr See.

OTHER APPEARANCES OF THE TONGUE

Other than the usual white coating, your tongue can also take on other appearances. Here’s a look at the various ways it may present itself, and whether you need to seek medical attention.

• My tongue looks like it has grown hair

The build-up of food debris and dead cells – along with poor oral hygiene – can create these brown or black hair-like protrusions on the surface of your tongue, said Dr See.

Dr Lim added: “Other than its appearance, it may result in a metallic taste, bad breath or a tingling sensation”.

A toothbrush or tongue scraper would remove the “hairs”. However, oral hairy leukoplakia, a condition where the brown or black patches cannot be scraped off, is due to Epstein Barr viral infection, which is commonly associated with HIV infection, said Dr See. If the hairiness cannot be eliminated or keep recurring, see a doctor.

• My tongue looks like raw meat

If your tongue feels tender, and looks red and swollen, you may have glossitis. It’s an inflammation of the tongue that causes the papillae to disappear, making your tongue look like raw beef, said Dr See, who associates it with nutritional deficiencies in Vitamin B12 and iron.

According to Healthline, certain hypertension medications, eating spicy food and even toothpaste may also bring about this allergic reaction. 

Topping up on iron and Vitamin B12, as well as avoiding the triggers that cause the reaction should help. But if the swelling and tenderness don’t improve or they keep recurring, see a doctor.

• There are bumps/sores/ulcers on my tongue

Bumps on the tongue can be caused by general inflammation, said Dr See, which can be due to medication use, nutritional deficiencies or constant irritation of the mouth.

But a small, painless sore on the tongue may be a sign of syphilis, said Dr Lim. “When untreated, it becomes syphilitic leukoplakia. Other symptoms may include headache, joint pain and fever.”

When it comes to sores and ulcers, these can be painful or painless. “Painful sores may be due to viral infections. They should resolve in a couple of weeks. If ulcers or sores persist beyond two weeks, medical attention should be sought,” said Dr See.

• White patches on my tongue look strangely like the world map

You have geographic tongue, said Dr Lim. Yes, that’s what it’s called. The appearance is caused by the tongue’s patchy cell turnover. “No treatment is needed and there is no cancer risk,” he said. Just avoid food and drinks that cause discomfort, he added.

• My tongue is cracked but there’s no pain

There may be a single or multiple painless cracks in your tongue. Should you worry? “This is a benign condition where deep grooves or fissures form on the tongue’s surface,” said Dr See. “It is usually painless and harmless.”

Dr Lim noted that no treatment is needed but beef up your oral hygiene to remove food debris trapped within the furrows.

• My tongue looks like it's covered in cottage cheese

These creamy, white and slightly raised lesions on the tongue or inner cheeks can be a sign of oral thrush, which is an infection caused by candida yeast, said Dr Lim.

“The overgrowth of yeast occurs from the overuse of antibiotics, diabetes, iron and Vitamin B12 deficiencies, poor oral hygiene, weak immune system, smoking, hypothyroidism and cancer treatment.”

Although oral thrush is a common condition, it is less likely to occur in adults than in babies, according to Mayo Clinic. Adults who are infected do not report major problems in most instances. But if you have a weakened immune system, it is best that you see a doctor about the oral thrush.


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What’s that white coating on your tongue? How to tell if you’re healthy or not

Weight-loss expert: 'We advocate moderation, we’re anti-dieting'

Many people who have struggled for years with excess weight know that the hardest and often the most frustrating job is not getting it off but keeping it off.

Recent decades have seen countless popular diet schemes that promised to help people shed unwanted pounds, and as each of these diets failed in the long run, they spawned their successors.

New research identifies the keys to success for long-term weight management.

A diet, after all, is something people go on to go off. Most people think of a diet as a means to an end, and few who go on a food-restricted diet to lose weight expect to have to eat that way indefinitely. And therein lies the rub, with the current unchecked epidemic of obesity as the sorry result.

We live in a land of incredible excess. Rich or poor, most of us are surrounded by calorie-rich vittles, many of them tasty but deficient in ingredients that nourish healthy bodies. “We can’t go two minutes without being assaulted by a food cue,” said Suzanne Phelan, lead author of an encouraging new study in the journal Obesity.

Even the most diligent dieters can find it hard to constantly resist temptation. And once people fall off the diet wagon, they often stay off, and their hard-lost pounds reappear a lot faster than it took to shed them.

But these facts need not discourage anyone from achieving lasting weight loss. Researchers have identified the strategies and thought processes that have enabled many thousands of people to lose a significant amount of weight and keep it off for many years, myself among them.

The new study led by Phelan, professor of kinesiology and public health at California Polytechnic State University, identified habits and strategies that can be keys to success for millions. Yes, like most sensible weight-loss plans, they involve healthful eating and regular physical activity. But they also include important self-monitoring practices and non-punitive coping measures that can be the crucial to long-term weight management.

The study, supported by a grant from WW, the current name for Weight Watchers, was conducted among nearly 5,000 of its members who reported losing an average of about 50 pounds and keeping all or nearly all the weight off for more than three years. Their habits and thought processes were compared with a control group of more than 500 obese people who reported neither gaining nor losing more than 5 pounds over more than five years.

Healthy choices become more automatic the longer people continue to make them.

Phelan recognizes the emotional challenges involved with achieving lasting weight loss. She said, “Weight loss itself is a very rewarding process. People notice and offer encouragement. But that all goes away with maintenance.”

However, she quickly added, “Maintaining weight loss can get easier over time. Over time, less intentional effort, though not no effort, is needed to be successful. After about two years, healthy eating habits become part of the routine. Healthy choices become more automatic the longer people continue to make them. They feel weird when they don’t.”

On the other hand, perfection is not realistic and can be self-defeating, Phelan said. “Successful maintainers know there will be lapses. But they also know they can recover from lapses and how to get back on track. They accept slips and don’t engage in black-and-white thinking like ‘I was bad,’ an attitude that is self-defeating. Rather, they know there will be ups and downs, and they have a plan for coping with lapses that’s empowering.”

Rather than constant deprivation and self-denial, I practice moderation.

A personal example from one who lost a third of her body weight and kept it off for half a century: I anticipate and plan for the times when I expect to be confronted with culinary largesse. I’m a little more abstemious beforehand, enjoy the indulgence and get back to normal the next day.

Rather than constant deprivation and self-denial, I practice moderation. The study’s co-author, Gary Foster, who is chief scientific officer for WW, explained that in the WW program, “Everything is on the menu. Fad diets are overly restrictive, which dooms them from the onset. We advocate moderation, we’re anti-dieting. People have to find habits and routines that make long-term weight loss sustainable.”

And as many of the successful weight maintainers in the study reported, time and practice have permanently modified what I find appealing, so I rarely feel deprived and have less need to exercise self-denial all the time. I do admit, though, that I’m less good at ignoring cravings than many in the new study are. I’m more likely to give in but control the amount I consume.

What’s on your mind is as important as what’s on your plate.

What I may be best at is monitoring my weight. I weigh myself every day and keep within a range of 2 or 3 pounds. Nearly all the successful maintainers in the study weigh themselves weekly or more often, which makes it easier to self-correct before the numbers on the scale rise significantly.

Foster said, “What’s on your mind is as important as what’s on your plate. Weight management is something you do for yourself because you’re valuable, you’re worth taking care of.”

People must abandon the notion that “they can’t like themselves until they lose weight,” he said. “Rather, they have to start with a sense of self-worth and compassion. Weight management is a positive process, not a punitive one. Beating yourself up is not helpful, it’s de-motivating.”

Among the useful strategies identified in the new study is to keep lower calorie foods like fruits and vegetables more accessible. “We eat what we see,” Phelan noted. The corollary is equally important: Keep high-calorie, less nourishing foods relatively inaccessible and out of sight if not out of the house entirely.

A good friend who struggles with his weight gets furious with his wife for bringing cookies into the house. “She knows I can’t resist them, and I’ve asked her repeatedly not to buy them.”

Foster’s suggestion: “Be very clear about what you want the person to do and not do. Say, ‘I’d really appreciate it if you didn’t bring cookies home. I want to live a long life with you and that’s not helping,’ and be sure to thank the person for following through.”

Other helpful tactics used by the successful maintainers in the study are setting daily calorie goals and keeping a food diary, recording everything eaten each day. This has helped another friend of mine sustain a loss of about 30 pounds for decades. “It keeps me honest,” she told me.

Although physical activity is not by itself very helpful with weight loss, adopting an exercise routine can give weight maintainers more leeway and help to keep lost pounds from creeping back. As Foster told me, “Calories in must balance calories out if you don’t want to gain.”

By Jane E. Brody © The New York Times


Taken from this article:
Weight-loss expert: 'We advocate moderation, we’re anti-dieting'