Ask Fuzzy: Tongue hygiene more than smell deep

That fuzzy feeling can be symptomatic of wider problems when felt on the tongue, writes Professor P. Mark Bartold.

Question: What is the coating that grows on our tongues? Does it matter?

Answer: If you've encountered someone with halitosis you'll know it can be quite unpleasant. The build-up of material on the tongue  is one of a few possible causes.  

You can't smell your own breath, but a simple test is to lick, then sniff the back of your hand.

A mouthwash might help, but mostly they just mask the underlying odour. We don't recommend mouthwashes with alcohol because they can dry your mouth, and make the problem worse.

The coating on our tongues is usually a white or pale yellow colour but may also be stained according to various foods and liquids ingested.  It is normal, but the amount of tongue coating varies considerably between individuals.

It is composed of bacteria and fungi and is a normal part of the oral environment.


This coating is one of the major causes of halitosis (bad breath) and so regular gentle tongue cleaning is encouraged as part of normal oral hygiene practices.  This can be achieved with special tongue scrapers or just a toothbrush.

Other causes for changes on the tongue surface which can be problematic are listed below.  Dentists are trained to observe, monitor and manage such lesions.

Oral thrush – a significant fungal infection which can cause white accumulations on the tongue as well as a "burning sensation" on the tongue.  These white patches can be scraped off.  Main causes are recent ingestion of antibiotics, diabetes and immunosuppression.

Leukoplakia – usually more a "white patch" on a relatively clean tongue surface.  This is generally a benign lesion but in rare cases it can become cancerous.

Lichen planus – Seen as white  thin streaks on a relatively clean tongue.  This condition is uncommon on the tongue and usually asymptomatic but in severe cases can be very painful.

Response by Professor P. Mark Bartold AM, Professor of Periodontology, University of Adelaide.

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