Tongue Appearance 1: Thick White Coating
If the tongue coating is thick and white, it indicates a significant presence of phlegm-dampness in the body.A white tongue coating suggests the presence of cold in the body, whether from consuming cold foods or exposure to cold environments. Nowadays, many people have a white coating due to eating refrigerated fruits and vegetables and frequently drinking cold beverages.Additionally, in daily life, a swollen tongue with a thick white coating is often seen in individuals who are overweight or have digestive issues leading to edema and internal phlegm-dampness.Expert Recommendation:Patients with a white tongue coating should avoid cold and cool foods to reduce irritation to the stomach. Furthermore, those with a thick white coating and obesity should moderate their diet, focusing on fresh vegetables, fruits, and high-fiber foods. Ingredients like Shan Yao (Dioscorea, Chinese yam), Yi Yi Ren (Coix seed), and Shan Zha (Hawthorn) are beneficial for strengthening the spleen and transforming dampness.Tongue Appearance 2: Thick Yellow-White Coating
If a thick yellow-white coating is observed on the tongue, which is sticky and difficult to scrape off, accompanied by a sour and foul odor in the mouth, poor appetite, and dry stools, this condition is likely due to excessive eating or consumption of greasy foods, leading to poor digestive function or disruption, commonly referred to as food accumulation.Expert Recommendation:In such cases, it is advisable to maintain a relatively light diet. If food accumulation occurs, specific digestive medications or foods such as Shan Zha (Hawthorn), mushrooms, and radishes can be used. If stools are particularly dry, mild laxatives may be appropriate.Tongue Appearance 3: Black Coating
Extreme heat or cold can cause a black tongue coating, excluding cases of staining.In daily life, certain medications or foods can also change the color of the tongue coating, but these do not constitute pathological coatings.Generally, stained coatings are bright and superficial, while pathological coatings are difficult to remove. This distinction is crucial to avoid misinterpreting normal coatings as pathological ones.Tongue Appearance 4: Coating Shedding or No Coating
When the tongue coating completely or partially sheds, it is referred to as ‘peeled coating.’ A completely peeled coating results in a smooth tongue surface, known as ‘mirror tongue’; if the coating is partially shed, leaving smooth areas without coating and remnants of coating elsewhere, it is termed ‘mottled peeled coating.’Peeled coating indicates insufficient stomach qi, depletion of stomach yin, or deficiency of both qi and blood, reflecting overall weakness.Expert Recommendation:Patients with no coating should maintain a light diet, avoiding overeating and the consumption of raw, cold, hot, or hard-to-digest foods. It is beneficial to eat vegetables and fruits that strengthen the spleen and benefit the stomach, such as Shan Yao (Dioscorea) and Yi Yi Ren (Coix seed), and consider taking herbal formulas like Jian Pi Wan (Spleen Strengthening Pill) or Sheng Mai San (Generate Pulse Powder). Regular exercise can enhance immune function.Can Tongue Coating Be Scraped?As awareness of oral hygiene increases, various oral care products have emerged, including tongue scrapers.Many vendors claim that tongue scrapers can remove food residues from the tongue coating, freshening breath. Is this true? Does the tongue really need cleaning? What precautions should be taken when using a tongue scraper?1. Removing Tongue Coating Can Effectively Reduce Oral BacteriaHow is tongue coating formed? Tongue coating consists of shed mucosal cells, bacteria, their metabolites, and food residues. Due to the presence of numerous bacteria and food residues in the coating, bacteria decompose the residues, producing odors.From a Western medical or dental perspective, there is no evidence that tongue coating significantly correlates with overall health; however, it is certain that a large number of bacteria reside in the coating, and cleaning the tongue, including the coating, can greatly reduce the number of bacteria in the mouth.Using a tongue scraper can effectively remove food residues and bacteria from the coating, reducing the risk of periodontal disease and cavities, and alleviating bad breath. Therefore, if possible, it is advisable to use a tongue scraper appropriately.2. Improper Use of Tongue Scrapers Can Harm Taste BudsThe small protrusions densely distributed on the tongue—taste buds—can easily be damaged if scraped too forcefully.Thus, tongue scrapers should be used cautiously; frequent vigorous scraping can irritate taste buds, damage the tongue papillae, and even lead to numbness of the tongue, reduced taste sensation, and decreased appetite.
Scraping the tongue should not be done too frequently; once a week is sufficient. When scraping, do not apply excessive force; gently brush the tongue surface without causing pain or discomfort.The scraping duration should also be limited; brushing from the root to the tip of the tongue 7-10 times is adequate.To freshen breath, the best method is to regularly rinse with salt water or mouthwash, or use an oral irrigator to clean the tongue surface.3. Tongue Coating Indicates Health; Seek Medical Attention if NecessaryThe normal tongue coating should be thin and white. If there are changes in thickness or color due to internal conditions, merely scraping the tongue will not suffice; a medical examination is necessary. Self-scraping may interfere with a doctor’s diagnosis.4. Removing Tongue Coating Has Limited Effect on Oral OdorOral odor can arise from various causes, including digestive system diseases such as enteritis and gastric disorders, as well as oral conditions like pharyngitis and gum injuries.Therefore, relying solely on tongue scraping to eliminate odor is ineffective.
