Dear Alice,

Are there other causes for white-coated tongues?? I believe I have thrush. Do I need a tongue culture to confirm it? Can my mate get it by kissing? Could it be the reason for my chronic sore throats lately?? The only difference I notice is I don't have any metallic or salty taste in my mouth. When I get it really bad, that is what I usually experience, as well as a raw tongue. Thanks for any help!!

— Lindee

Dear Lindee,

Sounds like you already know a few things about thrush (also referred to as an oral yeast infection). The good news is that thrush isn't necessarily considered a transmittable infection (more on that later). However, there could be other reasons for a white-coated tongue — thrush is just one of a few possible diagnoses. To know for sure what's causing it and to determine whether to stop the smooching or not, it’s best to get to your health care provider’s office to confirm and be treated if necessary.

To give you a bit more info on the condition in question: thrush is an infection caused by the fungus Candida, the same little beastie responsible for other types of yeast infections. For more information on Candida yeast, check out A fungus among us: Candida (yeast). Thrush is common among babies, who may be exposed to the microorganism as they pass through the birth canal. People who take antibiotic or steroid medication, folks with compromised immune systems, and smokers are also at risk for an oral yeast infection. In all of these cases, the infection occurs when healthy balance of bacteria in the mouth is disrupted, making it easier for Candida yeast to grow and spread. Also, sometimes thrush can be a sign of a more serious, underlying condition such as diabetes or HIV.

Symptoms of an oral yeast infection can include:

  • White patches on the tongue and insides of the cheeks
  • Creamy, cottage cheese-like sores, also on the tongue and in the mouth
  • Pain or burning in the mouth and throat
  • Lessened ability to taste food
  • Metallic or unpleasant taste in the mouth

Since you mentioned you’ve also experienced a sore throat, it might be time to consult a health care provider. S/he might be able to diagnose you just by examining your mouth, or s/he might use smears, stains, or cultures of the mouth or throat to confirm if it is indeed thrush.

Another reason to see your health care provider is that your white tongue may be caused by another condition, which could include:

  • Scarlet fever — a condition during which the tongue has a white coating for the first two days
  • Lichen planus — a skin infection that causes lacy white patches on the tongue and inner cheeks if the mouth is infected
  • Leukoplakia — an irritation of the mouth, which can sometimes cause a white-coated tongue

So, do you need to cross kissing off your list for the time being? While thrush is considered a non-communicable disease, kissing can technically spread the yeast from the kisser’s (your) mouth to the kissee’s (your mate) mouth. This does not necessarily mean that the kissee will develop a yeast infection because thrush is an opportunistic infection. This means that whether an infection occurs or not depends on the conditions of the environment in which the yeast reside. So, although someone with thrush will not directly transmit it through kissing, you're wise to think of placing a hold on smooches until you can confirm the cause of your white tongue, just in case your condition can in fact be spread through kissing.

Best wishes for a healthy, pink tongue!

Alice!
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