White Coated Tongue

I've had a thick white coating on the back of my tongue for just over a year now. I also believe I have geographic tongue because I get those small white circles in various parts of my tongue day-to-day. My tongue is fissured with a large groove down the middle. Spicy and hot (temp) foods irritate it but I've managed. My tongue always seems inflammed, red, and warmer than usual to the touch. The front half of my tongue is not really coated. The back, however, looks like someone layed a white puzzle piece on it, meaning that the line that seperates the white coating is very jagged and prominent. I've seen my physician for a complete physical since this was bothering me and it felt like the glands in my neck were tender. He treated me for thrush (oral med that I swished for a couple minutes) but that did not help. I was worried this might be related to HIV since I had an anonymous female partner a few months prior, partially unprotected. I was tested for HIV (by two different clinics) around the 3 month mark and both came back negative. My saliva is also sticky. It tends to collect on the roof of my mouth. Should this oral condition be anything I should be really concerned with? I brush 2-3 times a day and rinse with a non-alcohol rinse, and that's the best my mouth feels all day. I'm self conscious of my mouth and it makes me not even want to talk. During the day it's either very dry or very moist as if I'm going to spit when I speak. Please advise. Thank you

[Kevin Pho, MD]

I agree with the workup so far.

The two major causes of this would be thrush and hairy oral leukoplakia (associated with HIV).  These options have already been evaluated by your medical team.  

At this time, a referral to an oral surgeon can be considered for a biopsy of the lesion.  

This option can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[carolan]

have you tried eating yougurt? this helped me when I had similiar symptoms.

[txman32]

Doctor,

It is very scary to hear that the only thing that is associated with is HIV.   SHould I get tested again or is that not a likely result now?

Please respond

[pookie53]

Could your tongue problems be associated with B-vitamins deficiency? Or some kind of vitamin deficiency?

[PlateletGal]

In Chinese medicine, it means that you have dampness. I notice my tongue is often white and coated with allergy problems.I often get the white coated tongue, but I don't have HIV. I do, however, have another problem with my immune system --- chronic fatigue immune dysfunction syndrome.

In addition to the advice you were already given, you might want to consider trying the Candida diet. Google that name and you will find some helpful websites. You might also want to see a physician who specializes in traditional chinese medicine. I was shocked that the physician knew EXACTLY how I felt just from looking at my tongue.

[godson28]

A related discussion, digestive problem was started.