Coated Tongue

The causes of a coated tongue can vary widely. First of all, there are foods that give the tongue its pale color. But various diseases can also cause the change in color. Some of these diseases also make themselves felt through a burning or an unpleasant or painful sensation on the tongue. A person's tongue coating (coated tongue) has long been used in various cultures to arrive at a medical diagnosis. Deviations in the color and consistency of the coating are interpreted and treated differently within the various healing systems. The location, color and consistency of the coating are examined. Of course, discoloration caused by food and stimulants (beetroot, blueberries, wine, coffee) must be taken into account. It is best to look at the tongue right after getting up in the morning. In people who constantly have bad breath, the reasons for it can also be traced back to a coated tongue. The back of the tongue offers the perfect breeding ground for bacteria, especially when it is covered with deposits.

What is taken into account in tongue diagnosis?

• Is the tongue swollen or shrunken?

• What color is the tongue?

• Is there a coating?

• Does the tongue show grooves, folds or tooth marks?

A white-coated tongue can be a symptom of the following diseases, among others:

• Mild gastric catarrh: thin white coating in the transition area between the front and middle third of the tongue

• Acute gastritis and other gastrointestinal problems

• Anemia: overall whitish, pale tongue

• Oral thrush: white tongue coating over the entire tongue extending to the mucous membranes of the cheeks

• Pancreatic disorder: white coating to the right and left of the central groove

• Scarlet fever: white-coated tongue with sore throat and fever, followed by a bright red tongue

• Syphilis and other sexually transmitted diseases can also be accompanied by a white-coated tongue

Red-coated tongue:

A so-called strawberry tongue is a typical symptom of scarlet fever, which mainly affects children. A reddened tongue can also indicate a vitamin B12 deficiency or glossitis (inflammation of the tongue). The latter is noticeable through a burning sensation. But a gastrointestinal disease or a disorder of the liver or heart can also be the reason for a red and coated tongue. In these cases, many people suffer from symptoms such as rib, abdominal and headaches in addition to the strawberry tongue.

Yellow-coated tongue:

A yellow-coated tongue, combined with a furry feeling in the mouth, can indicate a fungal infection.

Brown-coated tongue:

A brown-coated tongue can indicate a disorder in the intestinal area or be caused by weak kidney function. In the latter case, the tongue is also slightly swollen.

Black hairy tongue (lingua villosa nigra)

A black hairy tongue can be triggered by strong medications such as antibiotics, antifungals, glucocorticoids, antacids or phenothiazines, by chemical irritants such as mouthwash or disinfectants, but also by vitamin deficiencies, including a lack of B vitamins. You should never forget your tongue in your daily care routine. Regular tongue hygiene not only prevents a coated tongue, but also tooth decay and bad breath, and can even improve your sense of taste. However, if increased hygiene does not help and your coated tongue takes on unusual colors, you should have this checked by a physician as a precaution.

The following assignments between areas of the tongue and organs are made:

• Tip of the tongue – heart and lungs

• Middle of the tongue – spleen and stomach

• Base of the tongue – kidneys

• Edges of the tongue – liver and gallbladder

A healthy tongue is typically pink to red, with a rough surface covered by a thin white film consisting of food residues, old cells, mucus and various germs. This natural tongue coating can be reduced by chewing and brushing your teeth​ (AOK)​.

The relationship between tongue coating and the health of the digestive system is complex. A persistent or unusual tongue coating can indicate a disorder in the digestive tract or dysbiosis in the microbiome, especially when other symptoms such as digestive complaints, general malaise or changes in digestion are present​ (NetDoktor)​​ (gesundheit.de)​.

It is important to note that not all changes to the tongue point directly to problems with the digestive system or the microbiome. Many factors, such as hygiene practices, eating habits and general health conditions, can influence the condition of the tongue. In the case of persistent changes or additional symptoms, a medical examination should be carried out to determine the exact cause and possible treatments.

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