White Tongue and Geographic Tongue Causes and Treatment

A white tongue is something that nobody wants to have.  Not only does a coated tongue look abnormal, but if it is left untreated, it's a strong indication of a breath problem. People who have the condition known as geographic tongue are definitely more likely to experience a white tongue. Geographic tongue simply means a tongue that has lots of grooves and fissures in it, and these grooves and fissures make an excellent breeding ground for the anaerobic bacteria that cause bad breath and a white tongue. The way around this problem is simply making sure that your tongue is kept as clean as possible. However, not all tongue cleaning is created equal....

Tongue cleaning (or tongue scraping) is a process that the majority of people in the United States don't do on a daily basis.  It's one of the most important steps you can take to keep your breath clean and fresh!

It's not difficult to do, and it's not even that time consuming. That extra minute or two per day can reap huge rewards in preventing bad breath, helping to prevent white tongue and returning it to its normal colour.

Let me clarify a few things about tongue cleaning:
  1. It's not necessary to scrape hard
    I've seen patients make their tongues bleed because they were pressing down too hard. In general, pressing harder does not remove more bacteria. You simply need to press hard enough so that the tongue cleaner contacts your tongue, flush across the cleaning surface. Try not to leave any gaps.

  2. Tongue cleaning alone does not prevent bad breath
    Tongue cleaning does not kill the bacteria that cause bad breath that are breeding below the surface of a geographic tongue. It simply removes the gunk on the surface of your tongue (mucus and food debris) which are a food source for the anaerobic bacteria. In order to get rid of those anaerobic bacteria (which are responsible for white tongue), you must use an oxygenating toothpaste which can penetrate beneath your tongues surface.

  3. It's not necessary to use one of those complex, expensive gizmos to successfully clean your tongue
    All you need is a fairly rigid instrument that you can easily make flush with the largest amount possible of your tongue's surface area. The electronic tongue cleaners you see can be helpful if you have arthritis, difficulty with coordination, or in general have a tough time performing the actions listed below.
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                Step-By-Step Instructions to Successfully Clean A Geographic Tongue and Prevent White Tongue


Here is an average tongue cleaning from start to finish from one of my patients who volunteered to allow me to take his picture.
  1. Starting at the very base of your tongue, place the tongue cleaner flush against your tongue's surface and make slow sweeping strokes from back-to-front. Start at either side (left or right) and work your way to the other. Depending on the tongue cleaner you are using, you might need to make 3-4 different 'swaths' across your tongue.

  2. Once the surface debris from your tongue has been removed, apply a small bead of oxygenating toothpaste to the head of your tongue cleaner.

  3. Gently coat the surface of your tongue (as far back as possible without gagging) with the toothpaste. This allows it to penetrate below the surface of your tongue to neutralize those sulfur-producing anaerobic bacteria! There are more bacteria in the rear of your tongue than in the front.

  4. Once your tongue is coated, allow the toothpaste to stay on the surface of your tongue as long as you can, up to 90 seconds is ideal. If you begin to cough, or your gag reflex kicks in, it's alright to spit it out whenever you need to.

  5. Ideally, it's best to leave the toothpaste on the surface of your tongue, while you brush your teeth normally.
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