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Causes of White Spots on the Tongue

Dr. Sumaiya Khan
Oral thrush, leukoplakia, lichen planus, etc., are some of the contributing factors for white spots on the tongue. This story provides information on the causes and treatment options for such spots.
The tongue is the strongest and one of the most active muscles in the body. It is normally pinkish-red in color. A change from the normal color of the tongue to either white, bright pink, black, or brown could be indicative of poor oral hygiene. At times, the change in the color and texture of the tongue could be a sign of a medical condition.
For instance, white spots could appear on the tongue in case of individuals affected by oral thrush. Thus, white spots are not a disease but merely a symptom that is seen in many oral conditions. While some of these conditions are benign, some are serious. It's advisable to seek medical assistance, if these spots persist.
At times, these spots might be accompanied by other symptoms such as pain and burning sensation in the mouth, especially on the intake of spicy food.

Contributing Factors

Oral Thrush
Oral thrush is a form of candidiasis that can affect any part of the oral cavity. However, on most occasions, oral thrush is seen on the palate and tongue. It mostly affects the palate in case of individuals with faulty and ill-fitting dentures. In case of loose dentures, space is present between the palate and the denture.
Saliva accumulates in this space, due to which it acts as a breeding ground for bacteria and fungi. It must be noted that this condition often affects immunocompromised individuals.
For instance, individuals diagnosed with AIDS are often affected by oral thrush. This condition manifests in the form of white spots, which may appear as patches or a uniform coating on the tongue.
Leukoplakia
Leukoplakia is an oral pre-cancerous lesion that can affect any part of the oral cavity. Those who chew tobacco, place tobacco in a certain part of their mouth for long periods, or smoke tobacco are highly susceptible. This condition is considered to be pre-cancerous because there is excessive growth of cells.
This leads to the development of white spots in the oral cavity, especially on the tongue. Although this condition is often asymptomatic, it needs to be diagnosed at the earliest. This can help prevent the condition from progressing into tongue cancer. Also, one must completely refrain from smoking or chewing tobacco.
Lichen Planus
Oral lichen planus is a condition that is characterized by discoloration of the tongue. It gives rise to the development of raised white lines or lace-like patterns in the oral cavity, either on the buccal mucosa or the tongue. Although the exact cause for this condition is not known, it is believed that it might be linked to the use of tobacco and excessive stress. Also, one must completely avoid smoking or chewing tobacco, as lichen planus may in that case act as a pre-cancerous lesion.
Geographic Tongue
Geographic tongue is a condition that is characterized by the loss of filiform papillae on the dorsal surface of the tongue. This causes the affected part of the tongue to look bald, while the outline of the lesion appears as white spots.
Although the exact cause of geographic tongue is not known, it is often observed in individuals affected by psoriasis or fissured tongue. The patches disappear and reappear on different parts of the tongue after certain intervals, due to which it is also called benign migratory glossitis.
Although this condition is normally said to be asymptomatic, and is not dangerous or malignant at all, it has increased in occurrence in patients affected by diabetes and AIDS.
Other Conditions
There are certain other conditions that may cause white-colored spots on the tongue. Such conditions include tongue ulcers, enlarged and stained taste buds, and white hairy tongue. Of all these conditions, white hairy tongue is often the most alarming of conditions, when in fact, it simply denotes the overgrowth of filiform papillae.
It is not necessarily a disease, but merely a symptom which can be easily treated by using a tongue scraper. The good news is that filiform papillae are not associated with taste, and this condition is often asymptomatic and non-contagious. In certain cases, white spots might appear on a very dry, fissured, and cracked tongue.

Treatment Options

Medical help must be sought for proper diagnosis and treatment. The treatment will depend on the underlying cause. In case of pre-cancerous lesions, the affected individual should stop the intake of tobacco completely. Use of vitamin A supplements and topical application of ointments on the lesions would prove beneficial.
Treatment is not really required for geographical tongue. If the condition is very painful, then the person can use certain topical anesthetizing agents for relief.
To cure oral thrush, topical application of antifungal creams is recommended. Also, if the person is using ill-fitting dentures, then he should get them properly fitted. Last but not the least, one must practice oral hygiene.
Thus, white spots are not always a cause of serious concern. However, if the condition gets painful and persists for a very long time, then it is best to visit a doctor for proper diagnosis and treatment.
Disclaimer: The information provided in this story is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.