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Wednesday, October 1, 2014
Dental and Oral Health Center
White-ish Coating on Tongue Won`t Go Away
I have chronic bad breath. I brush, floss and clean my tongue daily, but usually about an hour after brushing I get bad breath. There is usually a white-ish/yellow-ish coating mainly on the back of my tongue. I have tried "Breath RX" toothpaste, various mouthwashes, and have rinsed my mouth with hyrdogen peroxide, but nothing seems to work. Otherwise, I am in very good health. Have never smoked or used tobacco, do not drink, and exercise regularly.
Bad breath (halitosis) can be a challenging problem to deal with. To begin with, the source of the halitosis has to be identified. Sometimes it's related to chronic sinus infection, sometimes it's due to periodontal (gum) disease, and sometimes it's caused by bacteria and food particles that collect in the normal folds and grooves of the tonsils. It can also be caused by normal oral bacteria that live on the top surface of the tongue. All of these aspects would need to be evaluated by both dentists and otolaryngologists (ears, nose and throat doctors).
The white coating on the top surface of the tongue is simply the normal build-up of keratinized (dead) cells, which are constantly being produced by everyone's tongue. A soft diet will cause the dead cells to build up (usually they're knocked off and swallowed when we eat), but too much irritation of the lining of the mouth (from smoking, hot beverages, chemicals - such as hydrogen peroxide) can cause the surface of the tongue to produce the keratin at a faster rate, again resulting in a build-up of these dead cells.
Bacteria that are present in everyone's mouth like to live on the dead cells, actually breaking them down and releasing sulfur-containing compounds. These compounds usually don't smell very good. A tongue scraper, used once daily, and rinsing with a mouthwash that contains either chlorhexidine (available as a prescription) or cetyl-pyridinium chloride should help.
But the other possible causes of halitosis would also have to be evaluated to make sure they're not contributing to your problem.
Carl M Allen, DDS, MSD
Professor Emeritus of Oral Pathology
College of Dentistry
The Ohio State University