Table of ContentsView AllTable of ContentsOral ThrushGeographic TongueOral Lichen PlanusOral LeukoplakiaCanker SoresCoated TongueMilk TonguePrevention
Table of ContentsView All
View All
Table of Contents
Oral Thrush
Geographic Tongue
Oral Lichen Planus
Oral Leukoplakia
Canker Sores
Coated Tongue
Milk Tongue
Prevention
A normal tongue will look pink and be covered with tinybumpscalledpapillae(also known as “taste buds”). When your tongue is coated with creamy white patches or lesions, this is most likely due to a common fungal infection calledoral candidiasis(oral thrush).
However, there are other possible explanations for awhite tongue, some of which may be potentially more serious, like oral lichen planus and oral leukoplakia. Other things can also cause a whitish coating on the tongue, including geographic tongue, canker sores, and benign conditions called coated tongue and “milk tongue.”
This article will describe a normal tongue versus one with oral thrush. It also lists other conditions that may be mistaken for thrush, including their symptoms, risk factors, and treatment options.
Verywell / Jessica Olah
Thrush Causes and Risk Factors
Signs of Oral Thrush
Oral thrush occurs when a fungus naturally found in the body—calledCandida albicans—suddenly overgrows and causes creamy white patches on the tongue and other tissues in the mouth.
Oral thrush is not contagious but can cause serious harm if it spreads beyond the mouth into the throat, windpipe, lungs, and internal organs.
Risk Factors
Risk factors for oral thrush include:
Is a White Tongue a Sign of Dehydration?
Symptoms
Symptoms of oral thrush include:
Treatment
Oral thrush is typically treated with prescriptionantifungal drugs, including:
What Causes a Ranula (Cyst Under the Tongue) and How Is It Treated?
Geographic tongue does not cause any long-term health problems, and it is not contagious. Most people have no symptoms or only mild symptoms, It is considered a cosmetic concern.
It is not known exactly what causes geographic tongue, but risk factors include:
How to Treat a Sore Tongue: Effective Home Remedies and Medical Treatments
Geographic tongue happens when parts of the upper layer of the tongue shed too quickly. Symptoms include:
The patches may come and go and change in size, shape, and location.
Pictures of White Spots on Tongue
Treatment for geographic tongue isn’t necessary. If discomfort is significant, the following may be recommended:
Oral lichen planusis a chronic (long-term) inflammatory condition of the mouth. It can also affect other areas of the skin andmucous membranes. Almost half of all people with oral lichen planus also havecutaneous (skin) lichen planus.
Oral lichen planus is not contagious.
While anyone can get oral lichen planus, it occurs twice as often in females than in males. Oral lichen planus mostly affects adults 50 and older.
Other risk factors include:
Symptoms of thereticular typeinclude:
Symptoms of theerosive typeinclude:
Some cases of oral lichen planus resolve on their own without treatment. Severe cases may be treated with topical and oral medications, including:
Occasional flare-ups are common.
While leukoplakia isn’t dangerous in and of itself, it can eventually turn into oral cancer. About 3% to 17.5% of people with leukoplakia will develop squamous cell carcinoma (a common type of skin cancer) within 15 years.
Leukoplakia occurs most often in males between the ages of 50 and 70. It is rare in younger adults, with fewer than 1% of cases occurring in people less than 30 years of age.
Leukoplakia is often associated with:
There are two main types of oral leukoplakia—homogenous and non-homogenous—each of which causes different symptoms. The oral lesions cannot be scraped off and are typically not painful.
Symptoms ofhomogenous leukoplakiainclude:
Symptoms ofnon-homogenous leukoplakiainclude:
Non-homogenous leukoplakia is seven times more likely to become cancerous than the homogenous type. This is especially true when the lesion has a verrucous surface (referred to as proliferative verrucous leukoplakia), with nearly every case eventually becoming cancerous.
Treatment for oral leukoplakia is usually centered on preventing it frombecoming cancerous. The efficacy of treatment can vary. The lesions may be removed, but they often return.
Treatment may involve:
If patches are surgically removed, an examination every six to 12 months is recommended until there is no evidence of precancer, cancer, or other abnormal cellular changes for at least three years.
Aphthous Ulcers (Canker Sores)
Canker sores typically occur in people between the ages of 10 and 20, but anyone can get them.
Symptoms of canker sores include:
Tingling or a burning sensation may develop before the sore appears
Canker sores usually clear up on their own within a couple of weeks. To ease pain and promote healing, your healthcare provider may recommend:
Papillae are composed of keratin. When the keratin is overproduced, the papillary layer on the tongue can thicken and take on a “hairy” appearance.
Coated tongue is not contagious and commonly associated with conditions that either dry out mouth tissues or affect the natural shedding of keratin. These include:
Most people with coated tongue have no symptoms other than a cosmetic concern. Some people experience mouth dryness or an unpleasant, stale, or abnormal taste in their mouths. Long papillae can cause pain and bleeding if you pick at it
Coated tongue will usually resolve on its own once the underlying cause is resolved. Other ways to help include:
A white tongue iscommon in young babiesand doesn’t always mean it’s thrush.
Causes and Prevention
Each condition that causes a white tongue, including thrush, has unique causes, treatments, and prevention, but they also have some in common.
Ways toencourage oral healthinclude:
Transient Lingual Papillitis (Lie Bumps)
Summary
While a white tongue is often harmless, it can signal a more serious health condition like oral lichen planus or oral leukoplakia. Other less serious conditions that mimic oral thrush are geographic tongue, canker sores, coated tongue, and “milk tongue.”
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Patil S, Rao RS, Majumdar B, Anil S.Clinical appearance of oral Candida infection and therapeutic strategies.Front Microbiol. 2015;6:1391. doi:10.3389/fmicb.2015.01391American Academy of Family Physicians.Thrush.MedlinePlus.Geographic tongue.Cleveland Clinic.Geographic tongue.American Academy of Oral Medicine.Oral lichen planus.Nosratzehi T.Oral lichen planus: an overview of potential risk factors, biomarkers and treatments.Asian Pac J Cancer Prev.2018;19(5):1161–1167. doi:10.22034/APJCP.2018.19.5.1161British Medical Journal.Oral leukoplakia. In:BMJ Best Practice.London UK: BMJ Publishing Group; 2023.Benahmed G, Noor S, Menzel A, Gasmi A.Oral aphthous: pathophysiology, clinical aspects and medical treatment.Arch Razi Inst.2021 Nov;76(5):1155–1163. doi:10.22092/ari.2021.356055.1767Cedar-Sinai.Canker sores (aphthous ulcers) in children.Shyam N, Cohen BA.Clinical pathology of the oral mucosa. In:Pediatric Dermatology (Fifth Edition).Philadelphia, PA: Saunders; 2022. doi:10.1016/B978-0-7020-7963-4.00018-0Brigham and Women’s Hospital.Coated/hairy tongue.Seattle Children’s Hospital.Thrush.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Patil S, Rao RS, Majumdar B, Anil S.Clinical appearance of oral Candida infection and therapeutic strategies.Front Microbiol. 2015;6:1391. doi:10.3389/fmicb.2015.01391American Academy of Family Physicians.Thrush.MedlinePlus.Geographic tongue.Cleveland Clinic.Geographic tongue.American Academy of Oral Medicine.Oral lichen planus.Nosratzehi T.Oral lichen planus: an overview of potential risk factors, biomarkers and treatments.Asian Pac J Cancer Prev.2018;19(5):1161–1167. doi:10.22034/APJCP.2018.19.5.1161British Medical Journal.Oral leukoplakia. In:BMJ Best Practice.London UK: BMJ Publishing Group; 2023.Benahmed G, Noor S, Menzel A, Gasmi A.Oral aphthous: pathophysiology, clinical aspects and medical treatment.Arch Razi Inst.2021 Nov;76(5):1155–1163. doi:10.22092/ari.2021.356055.1767Cedar-Sinai.Canker sores (aphthous ulcers) in children.Shyam N, Cohen BA.Clinical pathology of the oral mucosa. In:Pediatric Dermatology (Fifth Edition).Philadelphia, PA: Saunders; 2022. doi:10.1016/B978-0-7020-7963-4.00018-0Brigham and Women’s Hospital.Coated/hairy tongue.Seattle Children’s Hospital.Thrush.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Patil S, Rao RS, Majumdar B, Anil S.Clinical appearance of oral Candida infection and therapeutic strategies.Front Microbiol. 2015;6:1391. doi:10.3389/fmicb.2015.01391American Academy of Family Physicians.Thrush.MedlinePlus.Geographic tongue.Cleveland Clinic.Geographic tongue.American Academy of Oral Medicine.Oral lichen planus.Nosratzehi T.Oral lichen planus: an overview of potential risk factors, biomarkers and treatments.Asian Pac J Cancer Prev.2018;19(5):1161–1167. doi:10.22034/APJCP.2018.19.5.1161British Medical Journal.Oral leukoplakia. In:BMJ Best Practice.London UK: BMJ Publishing Group; 2023.Benahmed G, Noor S, Menzel A, Gasmi A.Oral aphthous: pathophysiology, clinical aspects and medical treatment.Arch Razi Inst.2021 Nov;76(5):1155–1163. doi:10.22092/ari.2021.356055.1767Cedar-Sinai.Canker sores (aphthous ulcers) in children.Shyam N, Cohen BA.Clinical pathology of the oral mucosa. In:Pediatric Dermatology (Fifth Edition).Philadelphia, PA: Saunders; 2022. doi:10.1016/B978-0-7020-7963-4.00018-0Brigham and Women’s Hospital.Coated/hairy tongue.Seattle Children’s Hospital.Thrush.
Patil S, Rao RS, Majumdar B, Anil S.Clinical appearance of oral Candida infection and therapeutic strategies.Front Microbiol. 2015;6:1391. doi:10.3389/fmicb.2015.01391
American Academy of Family Physicians.Thrush.
MedlinePlus.Geographic tongue.
Cleveland Clinic.Geographic tongue.
American Academy of Oral Medicine.Oral lichen planus.
Nosratzehi T.Oral lichen planus: an overview of potential risk factors, biomarkers and treatments.Asian Pac J Cancer Prev.2018;19(5):1161–1167. doi:10.22034/APJCP.2018.19.5.1161
British Medical Journal.Oral leukoplakia. In:BMJ Best Practice.London UK: BMJ Publishing Group; 2023.
Benahmed G, Noor S, Menzel A, Gasmi A.Oral aphthous: pathophysiology, clinical aspects and medical treatment.Arch Razi Inst.2021 Nov;76(5):1155–1163. doi:10.22092/ari.2021.356055.1767
Cedar-Sinai.Canker sores (aphthous ulcers) in children.
Shyam N, Cohen BA.Clinical pathology of the oral mucosa. In:Pediatric Dermatology (Fifth Edition).Philadelphia, PA: Saunders; 2022. doi:10.1016/B978-0-7020-7963-4.00018-0
Brigham and Women’s Hospital.Coated/hairy tongue.
Seattle Children’s Hospital.Thrush.
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