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What Causes A Gray Tongue?

A healthy tongue should be pink, so noticing that your tongue has turned gray can be distressing. What causes a gray coating or coloring to appear on a tongue, and is a gray tongue anything to worry about? What are the most common causes of and treatments for a tongue that has turned gray?


Leukoplakia is an oral condition that can cause white or grayish patches to appear inside the mouth. These patches can sometimes appear on the tongue. The patches associated with leukoplakia can't be easily scraped off or wiped away.

These patches are associated with risk factors, such as excessive alcohol consumption, heavy smoking or chewing tobacco. While leukoplakia usually isn't dangerous, it's not something you should ignore. The Canadian Cancer Society warns that leukoplakia is a precancerous condition, and there's a chance that it could develop into oral cancer.

Oral Lichen Planus

Lichen planus is an inflammatory disease that can affect the inside of the mouth and result in oral lesions. These lesions can look gray and lacy, according to the American Skin Foundation. The patches themselves aren't itchy or painful, though some people develop ulcers, tender sores or a burning sensation on their oral tissues.

Usually, the cause of this condition can't be identified. In some cases, it can be associated with medications, like those used to treat diabetes, heart disease or malaria. It can also be associated with an allergy to dental materials like amalgam fillings. Oral lichen planus isn't generally harmful, the Journal of Oral Pathology and Medicine reports that only one percent of cases are associated with oral cancer and should be evaluated by a dentist.

Oral Thrush

Oral thrush is an infection that's caused by the Candida fungus, also known as yeast. This fungus is naturally present in many people's mouths, but sometimes it can become overgrown. This results in white, cottage cheese-like patches inside the mouth, including on the tongue. These patches can't be easily removed. If you do remove a patch, the area underneath may be red and bleeding.

There are many possible causes of this opportunistic oral infection. It may develop after an antibiotic treatment since antibiotics can kill off the mouth bacteria that normally help keep yeast in check. It can also occur in people with diabetes, cancer or malnutrition.

Poor Oral Hygiene

Sometimes, a white or gray coating on the tongue can be caused by something as simple as poor oral hygiene. The Mayo Clinicexplains that the small projections on the tongue's surface can become inflamed due to poor oral hygiene. Bacteria and dead cells get trapped in these inflamed projections and give the tongue the appearance of a white coating.

This coating isn't just a cosmetic issue. A coated tongue caused by poor oral hygiene often goes hand in hand with bad breath.

Treatments for a Gray Tongue

If you notice your tongue has turned gray, make an appointment to see your dentist. The dentist can examine your tongue and determine the cause of the gray coloring. The treatment for a gray tongue will vary depending on the specific cause.

In cases where leukoplakia is responsible, the Canadian Cancer Society explains that surveillance is the main treatment. This means the dentist will keep an eye on the leukoplakia so that if it becomes cancerous, the cancer can be detected early and be treated.

Oral lichen planus may also be treated with surveillance, and the condition can go away on its own. If the lesions are uncomfortable or painful, there are some treatments that can provide symptom relief. These treatments include corticosteroid mouthwashes, gels or pills.

When a tongue coating is caused by oral thrush, antifungal medications can treat it. Antifungal mouthrinses or lozenges may be used in mild cases, while oral antifungals may be needed for severe cases.

If you've been forgetting to brush or floss as often as you should, try to get back in the habit of brushing twice per day and flossing once per day. When you brush your teeth, remember to clean your tongue, too.

A gray tongue can be caused by many oral conditions, but a dentist can help. If you're worried about your tongue, see your dentist as soon as possible.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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