Dear Doctor,

A few days ago, I saw whitish patches on my tongue. Although they didn’t cause any pain, I felt a bit of discomfort. Could I be sick?

Eric

Dear Eric,

White patches or plaques on the tongue are overgrowth of the tongue papillae or filaments. Dead and destroyed cells and accumulation of bacteria give it a whitish look. It could be simply due to poor hygiene. Chronic constipation can also cause coating over tongue which may look like white patches. Use of low roughage diet regularly can also cause it. It can occur due to cigarette smoking, use of alcohol. Loose tooth or denture can constantly irritate the tongue leading to chronic inflammation and red/ white patches. One can have those patches due to dehydration. Fungal infection can cause white curd like patches, which cause pain during swallowing food or even liquids. Viral infections like herpes can cause whitish patches which are associated with vesiculo-papular eruptions. It can be due to prolonged use of antibiotics. Fever and sepsis can be associated with white patches on the tongue. Among sinister conditions, sometimes these patches can turn into cancerous lesions (leukoplakia) and are indicative of pre cancerous stage.

If there are no features of any sickness like fever or no loose tooth, swallowing is not painful, no painful sores or blisters, then sickness is unlikely.

Avoid taking tobacco and alcohol. Try taking fresh fruits, vegetables, whole grains or nuts, healthy food and drink more water. Improve hygiene of mouth by brushing or rinsing mouth regularly after food. The white patches should

Improve. If not, then necessary tests are needed to know the nature of illness.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital