Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The tongue is a mobile organ that is made up of muscles and attached to the floor of the mouth. The top of the tongue is covered with small bumps called papillae. The majority of our tastes buds sit on these papillae.
The tongue is used for tasting, swallowing, and chewing food. The tongue is also used to form words for speaking. A tongue that is pink and moist with a thin white coating on the surface can be considered healthy. As many of us have experienced, a tongue injury (such as when we accidentally bite our tongue) can be quite bothersome since the tongue is such an instrumental part of our daily lives through eating and speaking. Though very few people know it, the tongue is actually a very good measure of the well-being of the body. This is why your doctor may use the tongue depressor/stick to look in your mouth and tongue during an examination.
Color changes related to the tongue can range from a benign concern to one that requires medical attention. Often, a white tongue could be caused by a removable coating of food debris or bacterial plaque. The following are some common causes of white tongue -- a fungal infection referred to as oral thrush, leukoplakia, oral lichen planus, hairy leukoplakia, and linea alba.
Oral thrush (or candidiasis) is a caused by an overgrowth of yeast in the mouth. The white patches can be scraped off to expose a red surface on the tongue. Illnesses, medications, stress, and antibiotic treatment can cause oral thrush by throwing off the balance of microorganisms in the mouth. Lozenges, tablets, or liquid antifungals are used for treatment.
Leukoplakia is characterized by white patches that cannot be scraped off and may be related to longer-term irritation in the mouth although the cause is not always known. Tobacco use is the most common factor that contributes to leukoplakia. The condition may resolve after smoking cessation. Sometimes the patches are on the sides of the tongue and could be related to constant rubbing next to the lower teeth. Although usually benign, leukoplakia can be the precursor to oral cancer. The risk of cancer increases with age of the individual, size of the lesion, and number of lesions present. A biopsy may be recommended after clinical evaluation by the doctor. A biopsy is a procedure that takes a sample of cells or tissue for microscopic evaluation. Sometimes, the area can be monitored for changes by the doctor. Monitoring is usually performed during routine dental visits or during visits with an ear, nose, and throat (ENT) specialist.
Oral lichen planus on the tongue is a chronic inflammatory condition caused by an autoimmune response. It is characterized by a white lace-like pattern called reticular lichen planus. (There is an erosive form that presents as shallow ulcerations and can be treated with topical steroids.) Regular monitoring of this condition is recommended for any changes, although rare, that could lead to oral cancer. A biopsy may be recommended.
Hairy leukoplakia is a white patch on the side of the tongue that appears hairy or rough. This condition is caused by the Epstein-Barr virus and is usually related to immunocompromised individuals. HIV testing should be considered if hairy leukoplakia presents without a known immunocompromising condition. Antiviral medications such as acyclovir may be used. Recurrence of hairy leukoplakia is common.
Linea alba is a benign condition that is characterized by a thin white line at the lateral borders of the tongue. It is caused by the thickening of the epithelium due to trauma or irritation from chewing. No treatment is necessary.