What does plaque mean and when is it normal?
The surface of the tongue is covered with filiform papillae, between which desquamated epithelium and microorganisms are retained. Saliva and tongue movements constantly clean this surface, but at night, when breathing through the mouth, with a small amount of liquid and with soft food, self-cleaning decreases and plaque accumulates. A thin, translucent, easily removable coating, through which the pink papillae are visible, is a normal variant. What should alert you is the dense layer that hides the structure of the tongue, does not disappear after hygiene and lasts for weeks.
- The norm is a thin whitish coating, especially in the morning
- Easily removed with a brush or scraper
- The pink surface shines through
- Alarming - dense, persistent, colored plaque
- Alarming - plaque with pain, burning, smell
What does color say?
Color itself does not make a diagnosis, but it does suggest the direction of search. A white dense cheesy coating, which is removed to expose the red mucous membrane, is characteristic of candidiasis. A yellow or brownish tint is more often associated with smoking, coffee, tea and dry mouth. A dark, almost black “hairy” tongue occurs when filiform papillae grow due to smoking, antiseptic rinses and certain medications and, despite its frightening appearance, is safe. A bright red, smooth tongue occurs with a deficiency of vitamin B12, iron and folic acid.
- White curdled - candidiasis
- White thin - normal or dry mouth
- Yellow-brown - smoking, coffee, tea, dehydration
- Black hairy - proliferation of papillae, safe
- Bright red smooth - deficiency of B12, iron, folic acid
- Spotted "geographic" tongue - a benign feature
Causes of persistent plaque
Most often, it is a matter of local factors: irregular brushing, caries and tartar, wearing dentures, smoking and dry mouth. Dryness can be a consequence of taking diuretics, antihistamines and psychotropic drugs, breathing through the mouth with a stuffy nose, or diseases of the salivary glands. Common causes include diabetes mellitus, dehydration, fever, taking antibiotics and diseases of the gastrointestinal tract, in which plaque is accompanied by heartburn, belching and abdominal pain.
- Insufficient oral and tongue hygiene
- Smoking and chewing tobacco
- Dry mouth, taking medications, mouth breathing
- Oral candidiasis
- Dehydration and fever
- Diabetes mellitus
- Diseases of the stomach and esophagus
- Removable dentures and tartar
What examinations are needed
It’s more logical to start with the dentist: he examines the tongue, teeth, gums and dentures, evaluates hygiene and decides whether scraping is needed to exclude candidiasis. If the plaque is accompanied by heartburn, belching, nausea or abdominal pain, the gastroenterologist continues the examination. If you have a dry mouth, thirst, or frequent urination, be sure to check your blood glucose. Indelible white plaques and non-healing ulcers require special attention: they are examined by a specialist, with a biopsy if necessary.
- Dental examination, assessment of hygiene and dentures
- Tongue scraping for mushrooms
- General blood test
- Blood glucose
- Examination of the stomach for digestive complaints
- Consultation with a specialist for indelible plaques
How to care for your tongue
The tongue needs to be cleaned daily - this is the most underrated part of hygiene and at the same time the main source of bad breath. Use a special scraper or the back of a brush, moving from root to tip with gentle movements without pressure, once or twice a day. Excessive zeal and attempts to clean off plaque are painfully harmful to the mucous membrane. Additionally, drinking enough fluids, quitting smoking, regular professional hygiene and caries treatment also help. If the plaque persists for more than two weeks despite care, an examination is needed.
- Clean your tongue with a scraper or brush 1-2 times a day
- Move from root to tip without pressure
- Drink enough fluids
- Stop smoking
- Regularly undergo professional hygiene
- Treat caries and care for dentures
- See a doctor if plaque does not go away within 2 weeks