Public Health

Yellow tongue: Causes and treatment

Yellow Tongue Causes & TreatmentA yellow tongue is not a disease but it is a sign which indicates a clinical problem. It is important to figure out the cause to have the accurate treatment and avoid more complications. Usually, it is a harmless condition and will go away on its own in time. Yellow coated tongue tends to be common in the morning when you wake up i.e. Yellow tongue in the morning that could be yellow green, yellow white or orange. The problem can also be present at night or always. It all depends on what could be behind it.

Causes of Yellow Tongue :

Normally, there is a balance between formation of new cells and shedding of dead cells and bacteria on the tongue to have the normal coating. However, the most common cause of yellow tongue is due to accumulation of dead cells and bacteria on the upper surface of the tongue. Bacteria release pigments that can turn your tongue yellow. Food, tobacco, and other substances can also get trapped on your tongue and turn it yellow because of poor oral hygiene and improper tongue brushing.

The yellow tongue has different causes and forms and may be due:

Tooth extraction, or tonsillectomy: A yellow tongue may follow a piercing, tooth extraction, or tonsillectomy as a result of papillae inflammation. It’s important that you follow proper oral care after these procedures to reduce the risk of infection.

Pregnancy: It is common to see a yellow tongue in pregnant woman as it may be related to hormonal changes.

Black hairy tongue “yellow furry tongue“: it is a harmless condition occurs due to enlargement, roughness and swollen of tongue papillae “which located on the upper surface of the tongue” and this leads to more accumulation of epithelial squamous and proliferation of chromogenic (color-producing) microorganisms giving the black or yellow coating on the tongue.

Black hairy tongueAlso, general debilitation, hypo salivation (decreased salivary flow rate), radiotherapy, overgrowth of fungal or bacterial organisms, the use of antimicrobial medications (tetracyclines), oxidizing mouthwashes or antacids may cause black hairy tongue.

A soft diet is recommended as normal food has an abrasive action on the tongue, which keeps the filiform papillae short.

When your tongue is yellow due to a black hairy tongue, you are likely to have other symptoms such as: metallic taste, bad breath “halitosis“ and itchy sensation especially if your papillae have overgrown.

Dry mouth and mouth breathing:  Normally, saliva wash out the bacteria and food debris from the mouth and help in prevention of tooth decay. Dry mouth may occur due to Sjogren syndrome, diabetes, radiation, chemotherapy and mouth breathing.

Geographic tongue: is an inflammatory condition of the mucous membrane of the tongue, usually on the inner surface (Dorsal Surface). It is characterized by areas of smooth, red depapillation (loss of tongue coat) which migrate over time. The name comes from the map-like appearance of the tongue.

Geographic tongue appearance

Geographic tongue appearance

This lesion usually changes in shape, size and migrates to other areas, sometimes within hours. The lesion’s patches are often red, but they can turn yellow too.

The cause of geographic tongue is unknown, but the condition is entirely benign and doesn’t represent oral cancer. Geographic tongue may also cause a burning sensation on the tongue.

Jaundice: is a disease where your skin, tongue and whites in your eyes become yellow.  It happens when your liver is damaged and can’t properly process the waste product bilirubin. Bilirubin is a yellow pigment that’s produced when red blood cells break down. When bilirubin builds up in the blood, your skin, whites of your eyes, and tongue can turn yellow.

Medicines that contain bismuth: Pepto-Bismol “which is used to treat diarrhea and relieve the symptoms of an upset stomach“ and other bismuth-containing medicines can turn your tongue colors that range from yellow to black.

Mouthwashes that contain oxidizing agents: Using a mouthwash that contains peroxide or menthol can turn your tongue color into yellow.

Tobacco smoke: Chemicals in tobacco smoke can make your tongue turn a yellow color.

Antibiotic use: The use of some antibiotics can cause yellow tongue due to an imbalance of microbes, which causes bacteria or yeast to grow.

Pregnancy: It is common to see a yellow tongue in pregnant woman as it may be related to hormonal changes.

Post-nasal drainage: Post-nasal drainage may cause a yellow or even white tongue which can also cause bad breath. Excessive mucus accumulates at the back of the nose and throat and is commonly caused by allergies, acid reflux, or swallowing disorders.


If yellow discoloration is the only symptom you have, you don’t need to visit your dentist. But if you have another symptoms or infection, it is better to call your dentist for a consultation.

Other symptoms may be abdominal pain, blood in stool, yellow discoloration of your sclera and skin, vomiting, fever, persistent discoloration that doesn’t go away after improvement of oral hygiene, pain and burning sensation of the tongue.

Complications of Yellow Tongue:

Yellow tongue usually doesn’t cause any complications. However, the conditions that cause jaundice can lead to problems including:

  • Liver scarring.
  • Liver failure.
  • Swelling in your legs and belly.
  • Enlargement of your spleen.
  • Bleeding in your gastrointestinal tract.
  • Liver cancer.

Treatment of Yellow tongue:

Generally, you have to improve your oral hygiene including tongue brushing, teeth brushing and flossing. Brush with a mixture of one part hydrogen peroxide and five parts water once a day. Then rinse your mouth out several times with water. Treating any underlying condition that is the cause of your yellow tongue should relieve this symptom.

To treat Black hairy tongue :

  1. Brush your teeth and tongue at least twice a day, including after each meal.
  2. Don’t smoke.
  3. Rinse your mouth out with water a few times a day.

To treat dry mouth:

  1. Your doctor can prescribe medicine or recommend that you use a special mouth rinse to increase the amount of saliva in your mouth.
  2. Avoid caffeine, tobacco, and alcohol, which can dry out your mouth even more.
  3. Drink water or other sugar-free drinks throughout the day.
  4. Chew sugarless gum to stimulate saliva production.
  5. If you breathe through your mouth at night, turn on a humidifier to add moisture to the air in your bedroom.
  6. If a medicine caused your dry mouth, ask your doctor if you can change the dose or switch to another drug.

To improve oral hygiene:  

  1. Daily flossing of your teeth.
  2. Brush your teeth twice a day with fluoride toothpaste and a soft-bristled brush.
  3. Limit sweets, especially sticky foods like toffee and gummies.
  4. See your dentist every six months for a checkup and cleaning.

For treatment of geographic tongue:

  1. Take over-the-counter (OTC) pain relievers or use a mouth rinse with an anesthetic (Tantum Verde) to relieve any pain.
  2. Your doctor might also prescribe corticosteroid ointments or rinses to treat discomfort from the condition.

To treat Jaundice:

  1. If an infection such as hepatitis (it is an inflammatory condition of the liver. It’s commonly caused by a viral infection) caused jaundice, your doctor may give you medicine to treat it.
  2. For jaundice caused by a blood disorder like sickle cell anemia. Blood transfusions or chelation medications that bind iron might be part of your treatment.

(In sickle cell anemia the RBCs have an abnormal crescent shape resembling a sickle. This makes them sticky and rigid and prone to getting trapped in small vessels, which blocks blood from reaching different parts of the body. This can cause pain and tissue damage).

  1. Avoid or reduce the amount of alcohol you drink to protect your liver from further damage.
  2. For severe liver disease, a liver transplant may be an option.

To quit smoking:

  1. You can try a nicotine replacement product, such as a patch, lozenge, gum, or nasal spray. These products help reduce your urge to smoke.
  2. Your doctor can prescribe medicines such as varenicline (Chantix) or bupropion (Zyban) to relieve the symptoms of nicotine withdrawal.
  3. Telephone-based help, support groups, and one-on-one counseling can help you cope with any issues that arise from quitting.

How to avoid yellow tongue:  

To reduce the number of bacteria and amount of cell build up in your mouth that can cause yellow tongue, try these tips:

  1. Quit smoking.
  2. Brush your teeth twice a day and floss at least once daily.
  3. Use a tongue scraper to gently remove dead cells, food, and other debris from your tongue.
  4. Increase the amount of fiber in your diet, which will reduce the number of bacteria in your mouth.