Discolouration & coating of tongue

Normally, one’s health is analysed by the pink of his tongue. In case of any discolouration or coating, one needs to be cautious since it may be an indication of a serious disorder.

The tongue normally remains soft, moist and rosy with slimy, colourless saliva coating. Even though there is slimy saliva coating, it will not be realised unless one loses and gets his tongue dry. Tongue saliva coat is also felt when saliva is thick – by this the mouth/tongue will be felt as if it is not at all brushed. Anyhow, occasional white / slight yellow coating in dorsum of tongue can be treated as normal as deposits / colouring of food particles.

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Any persistent, abnormal tongue colour or coating usually reflects chronic persisting illnesses. Change in tongue colour, texture and coating can occur any time with or without taste differences. Usually, the rough look of the tongue is provided by papillae. When it gets atrophied or grows more, the problem gets started in the tongue, i.e. atrophy of papillae causes smooth glistening tongue which indicates ulcers / glossitis, overgrowth of papillae will attract infection and coating due to deposits of food particles or infective germs.

Discolouration – The discolouration of tongue can occur in various diseases especially with anaemia, glossitis, lichen planus, syphilis, leukemia, etc. One needs to be cautious if the tongue is pale, blue and white since pale indicates lack of blood, blue indicates lack of oxygen and white indicates dead cells and sloughing (indication of oral thrush or cancer or AIDS).

Tongue colour may turn

• Pale – in case of anaemia, poor nutrition, vitamin deficiencies, poor blood circulation or any chronic illness

• Reddish – in case of infection, inflammation and ulcerations (glossitis). It also occurs in malnutrition, pellagra (Vit B3 deficiency - niacin), betel chewing.

• Yellow – in case of jaundice, smoking

• Blue – cyanosis (lungs and heart ailments)

• Purple – cyanosis (lungs and heart ailments)

• Brown – in case of end stage of life with diseases

• White – in case of coating, dehydration, fungal infection, leukoplakia, lichen planus, syphilis

• Strawberry tongue – in case of scarlet fever, Kawasaki disease

• Black – in case of lichen planus, fungal infection

• Mapped tongue – it is also called as Geographic tongue / glossitis areata exfoliate / erythema migrans / pityriais linguae. In this condition, tongue seems to be coated in patch due to scalding / peeling (due to ulcers) of some areas. It may be smooth in some parts, rough in some parts, reddish in some parts, white in some parts and yellow in some parts. The infected parts will be red in its edges. The patchy, infected / coated areas get joined in some areas to look like a geographic map and so is named thus.

Coatings - The coating of tongue commonly occurs in many disease conditions with poor appetite. For example, in case of flu or cold, it gets coated white. Sometimes, it may look dirty with grey coating. Traditionally, persistent coating of tongue is thought to indicate liver, spleen and stomach disorders. Anyhow, it can also be present without any reason or disease. The incidence of tongue coating occurs more with children than with adults. Children usually get rid of it as they grow older. Commonly, tongue coating occurs in the dorsum of the tongue in white or dirty yellow. It can be slimy / greasy with or without taste differences. Coating of tongue can attract infection, so patients who have tongue coating often suffer with halitosis, i.e., foul breath. Coating can go off with brushing it or on its own. Tongue coatings usually respond well to treatment. If left untreated, it may lead to oral thrush.

Most of tongue complaints are painless, so people bother less about it but since auto immune disorders, cancers, AIDS, etc., often have discoloured or coated tongue, one need to be cautious.

• Can these coatings or discolouration be just brushed away?

• Can it get cleared completely?

One can get answers to these questions only when they have realised all the facets of the existing disease(s) – if there is any.

Causes – The causes for tongue discolouration and coating are innumerous. The most common are

• Poor oral hygiene

• Unhygienic foods and nutritional deficiencies

• Reduced blood volume / supply

• Infections and inflammations (bacterial or fungal or viral)

• Chemical reactions from added preservatives and colouring pigments

• Strong chemical toothpaste / mouthwash.

• Very hot drinks / foods (which can cause scalding)

• Foods containing excess spices, salt and chillies, likewise sour foods / fruits / juices too

• Habit of smoking, tobacco chewing and drinking large quantities of alcohol

• Drugs - especially while using heavy antibiotics and pain-killers repeatedly

• Treatments given for weakened immune system (chemotherapy, radiation therapy, strong chemical drugs, etc. especially in the case of AIDS, cancer and auto immune disorders)

Diagnosis – On ruling out external causes (heavy smoking, tobacco chewing, etc.) tongue discolouration and coating should be investigated all the way with routine blood and urine analysis. If necessary, ultra sound scan or CT scan for abdomen or endoscopic procedures should be done when there arises a suspicion of digestive tract involvement. Other important tests which can guide for diagnosis are:

• Scraping and culture – to identify fungal (Candida) or bacterial infection

• Biopsy – to diagnose cancer

Complications - Disgust for food / drinks with taste difference occurs in due course with thick coating or disease advancement.

Prevention – To avoid tongue discolouration and coating of tongue, maintain good oral hygiene (by proper brushing and scraping) and take good nutritious diet.

Take

• Nutritious diet (especially fruits, vegetables and greens)

• Plenty of water before and after meal

• Take right medicines in right dosage from right doctor in case of any disease

Use

• Tongue scraper gently whenever there arises a need

• Mild toothpaste and mouth rinse / wash

Avoid

• Smoking, drinking alcohol and chewing tobacco /betel leaves

• Strong toothpaste or mouthwashes

• Drinking aerated drinks, coffee and tea often

• Tin-packed or preservative added foods / snacks / toffees

• Unnecessary medication, especially pain-killers and antibiotics for prolonged period

• Foods containing excessive amount of spices, chillies, pepper and pickles

General treatment – In general, unless otherwise, tongue or disease indicates any serious disorder, no treatment will be advised or provided. Doctors treat diseases (if there is) with antibiotics or anti-fungal medicines or change medicines (if cause is suspected to be medicines) or otherwise they simply prescribe only vitamins, minerals and antioxidants with the advice for intake of good nutritious food.

Homeopathic approach – Tongue discolouration and coating can be treated well in Homeopathy system of medicine. Tongue discolouration and coating should be given importance just like an iceberg – the tip of an inner disease. So, treatment should be started as early as possible to tackle it completely and to have speedy cure. Later, the discolouration may become permanent.

In addition to diagnosing the disease, tongue discoloration and coating can also help Homoeopathy find the right choice of drug (simillimum). Homeopathic medicines are prescribed especially on the basis of individualisation which helps treat the patient on the whole.

According to homoeopathic concept, external applications / treatment / washes are usually condemned. It believes in internal treatment which provides treatment on the whole. In fact, Homeopathy, unlike other systems of medicines, doesn’t concentrate in just healing the spot or treating the patient in parts, i.e., Homeopathy cares for disease symptoms and patient symptoms. Homeopathy treats the patient at the root and eradicates diseases effectively by raising the immune level. Usually, the coating (if it is mild) responds quickly with treatment whereas discolouration will take some time to respond. Anyhow, starting of proper treatment will arrest its spread.

In Homeopathy, there are lots and lots of medicines for tongue discolouration, coating and disorders. The right simillimum medicine will act to the core of the disease and clear tongue problems simultaneously. Even in case of incurable diseases, where the cause is unknown, Homeopathy can treat the patient in a better way with tongue indications and characteristic symptoms of patients. For example:

• Red patches in the tongue – Nat sulp

• Strawberry tongue – Belladonna, Fragaria Vesca, etc.

• Tongue smooth and glossy / shiny – Causticum, Terebinth, Kali Bich, etc.

• Tongue smooth, red and cracked – kali bich,

• Red on margin – Plumbum met

• Red in tip – Rhus tox

• Red and glossy – Acid nit, Cantharis, Nat mur,

• Red streaks in centre – Antim crud, Verat alb,

• Red streak in middle of yellow coated tongue – veratrum veride, etc.

• Yellow tongue – Chelidonium, Kali sulf, Merc proto iodide, Nat phos, Bryonia, etc.

• Dry and brown – Ailanthus, Anti tart, Ars alb, Bry, Baptisia, Lachesis, Rhus tox, etc.

• Pale tongue – Carbo veg, Cina, Ferrum met, Ipecac, Veratrum alb, Zinc met, etc.

• Brown in centre – Baptisia, Phosphorus, Secale cor, Vipera, etc.

• Blue tongue – China, Ipecac, Lachesis

• Purple tongue – Digitalis, Echinacea, Lachesis, Merc cor, etc.

• Black tongue – crocus sativus, Muriatic acid, opium, secale cor

• Clean anterior and coated posterior – Nux vom

• Furred tongue – Antim crud, Arg nit, Bry, Carbo veg,

• White coating in the tongue – Antim crud, Causticum, China, Mercury, Nat mur, Puls, Thuja, etc.

• Yellow coating in base of the tongue – Iodium, Merc prot, Nat phos, Taraxacum, etc.

• Oil paint like glistening coating in the tongue – Ars alb

• Mapped tongue – Ars alb, Lachesis, Nat mur, Nitric acid, Taraxacum, etc.

• Sensation of hair in tongue – Natmur, silicea, etc.

• Moist tongue with excessive thirst – Mercurius, etc.

• Dry tongue with excessive thirst – Bryonia

• Dry tongue without thirst – Pulsatilla, Nux mos, etc.

These medicines should be taken under the advice and diagnosis of a Qualified Homeopath.