White Tongue with Red Spots

They say that the oral cavity is a reflection of a person's overall health. Hence, any kind of aberration with regard to the structures in the oral cavity often points towards a local or systemic infection. Same is the case with the tongue. The normal color of tongue is reddish pink and the normal texture is smooth and velvety. Hence, when there are tongue sores, then the color and appearance of the tongue changes. This is when symptoms like white tongue with red spots can appear. There are different causes for the appearance of such a symptom and the treatment for it also varies accordingly.

Causes and Treatment Options

Oral Candidiasis
One of the most common conditions that can lead to a white tongue with red patches is oral thrush. This is a fungal infection of the tongue that is caused due to an organism known as Candida albicans. This is generally, seen as an opportunistic infection in people that are immunocompromised, that is, they have a compromised immunity. It is also seen in people that have been wearing ill-fitting dentures over a very long period of time. The common thrush symptoms include the presence of a large or irregularly shaped velvety white spots on tongue. This white coating is generally removable. If it scraped off, then it reveals a raw, red bleeding portion on dorsal surface of the tongue. This condition i.e. white coated tongue, is normally seen to affect any part of the dorsal surface of the tongue. Along with the appearance of a white tongue bumps, there is also often a burning sensation felt along with bad breath, general discomfort and pain on eating spicy food. Thus, if the infection spreads, it can also lead to white tongue and sore throat. The oral thrush treatment will mostly consist of dealing with the fungi, by making use of topical antifungal medication. Along with this, there is also need for supportive treatment, in the form of proper hydration and diet.

Geographic Tongue
Geographic tongue is a condition where there are large irregular and clearly demarcated tongue patches seen on the dorsal surface of the tongue. The pathophysiology of this condition lies in the fact that, there is shedding of the normal filiform papillae, which are present on the dorsal surface of the tongue and are responsible for its normal, smooth and velvety appearance. Due to this shedding, there is the appearance of bald patches of white tongue. These patches have very visible demarcations from the rest of the surface of the tongue, which is why there is appearance of white tongue. The filiform papillae eventually regrow and then shed in another region of the tongue (restricted to the dorsal surface of the tongue though), which is why this condition is also known as benign migratory glossitis. The exact cause of geographic tongue is not yet known, although heredity and vitamin B complex deficiency have been implicated in many studies. This condition is generally asymptomatic, although at times there may also be symptoms like pain, sensitivity, burning sensation and metallic taste in mouth. In such cases, the person will need to resort to geographic tongue treatment, which will mostly deal with treating the symptoms, as there is no full and final cure for this condition due to its recurring nature.

Other Causes
Certain sexually transmitted diseases, like infectious mononucleosis can also lead to white tongue with red rash. Also, in the unlikely event that a person ends up suffering from two different infections at the same time, there could be symptoms like white tongue with red splotches, like if an anemic person suffers from scarlet fever.

This is a relatively rare symptom and many people tend to diagnose it as a fungal infection in most instances. In the end, if there is confusion regarding the diagnosis of this condition, then it is best to take a swab and then accordingly reach a diagnosis and design a treatment plan after the lab results come back.