January 15, 2011

Strange coating on tongue – Are you sure it’s not oral thrush?

Ever noticed that strange coating on your tongue? Many a times it is a harmless care of low hygiene standards, but sometimes it may be more serious than that. If the coating on the tongue is thick and inflamed, it may be a cause for concern. Usually such strange coating on the tongue presents the case for oral thrush. The medical name for oral thrush in children, adolescents and adults is Candidiasis, but simply thrush in babies. It is an infection which affects the mucous membranes in one’s mouth and on one’s tongue and is caused by a yeast fungus called Candida. In most cases, Candidiasis is harmless but unpleasant.


Oral thrush is characterised either by a thick whitish coating which resembles cottage cheese, or lesions, on the mucous membranes in the mouth or on the tongue; or the mucous membranes may become reddish and inflamed. The mucous membranes are the inner lining of the cheeks, the gums, under the tongue and the palate. Severe infections may even affect the tonsils and throat. In some cases adults may feel a burning sensation, mild discomfort or real pain. If some of this Candida layer is scraped away, bleeding may occur. Other symptoms may include a loss of taste and splitting at the sides of the mouth. If left unattended, the infection will spread and may become the cause of more serious medical issues, which may affect certain internal organs, the skeleton and the central nervous system.


It is very extremely rare for healthy people to become infected with this fungus. The causes of Candidiasis are many and varied and some are listed below.

A course of antibiotics or the use of corticosteroids may kill off the good bacteria in the mouth, thereby allowing the Candida fungus to flourish.

One may become infected if there has been an injury to the mucous membranes, for example in those people who wear dentures or orthodontic braces which may rub or abrade a certain spot in the mouth, allowing for the fungus to penetrate and proliferate.

Other causes are a decrease in the flow of saliva or suppression or impairment of the immune system as a result of chemotherapy or radiation therapy in some cancer patients; and the use of Cyclosporine in organ transplant patients. These patients may suffer badly from the infection which often recurs and becomes very hard to control; and it may take many months to cure.

Smoking and anaemia may also lead to oral thrush.

Babies and Adolescents

Babies are susceptible to oral thrush and, besides the tell-tale lesions and cottonwool-like film, may display signs of irritability and have difficulties with breast feeding. It is to be noted that the mother’s breast may become infected as a result, with symptoms such as red, inflamed and itchy nipples, painful nursing, flaky skin around the nipples and short, sharp pains in the breasts. Unless both mother and baby are treated to completely eradicate the infection, they will keep on re-infecting each other.

Adolescents who become infected should be seen by a doctor, as diabetes or some other undiagnosed disease may be the cause.


Treatment will depend on the age of the patient, the actual cause of the oral thrush and other health issues. With breast-fed babies and their mothers, the baby will generally be given an antifungal medicine, while the mother will be prescribed a cream to rub on her breasts. For babies who are not breastfed, their bottles, teats, pacifiers and breast pump, if used, should be thoroughly cleaned with equal parts of ordinary household vinegar and water and then be left to air dry after each use.

Children, adolescents and adults should eat plain, unflavoured yoghurt to restore the balance between the normal bacteria which live in the mouth and the infection; or try acidophilus in liquid or tablet form. Should these options not clear up the infection, an antifungal medicine will be needed.

Patients with compromised immune systems will be prescribed some form of antifungal medicine which may be tablets to suck or swallow, or a liquid for rinsing the mouth.

Bear in mind that antifungal medications may damage the liver, so blood tests may need to be done.

Basic oral hygiene should be practiced. Brush your teeth regularly, use dental floss and, obviously, do not share your toothbrush with anyone. Rinse your toothbrush in a solution of equal parts of ordinary household vinegar and water after every use and stay away from commercial mouthwashes and breath fresheners.

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