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 commonly seen in individuals who are overweight or have digestive issues leading to edema and excess 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 and greasy 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, Job’s tears), and Shan Zha (Hawthorn) are beneficial for strengthening the spleen and transforming dampness.Tongue Appearance 2: Thick Yellowish-White Coating
If a thick yellowish-white coating is present 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, it is likely due to excessive eating or consumption of greasy foods, leading to poor digestive function or disruption, commonly referred to as food stagnation.Expert Recommendation:In such cases, it is advisable to maintain a relatively light diet. If food stagnation occurs, one may consider taking digestive herbs or foods, such as Shan Zha (Hawthorn), mushrooms, or radishes. If stools are particularly dry, mild laxatives may be used.Tongue Appearance 3: Black Coating
Extreme heat or cold can cause a black tongue coating, excluding cases of tongue 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: Shedding Coating or No Coating
When the tongue coating completely or partially sheds, it is referred to as peeling (shedding) coating. A completely shed coating results in a tongue surface that is smooth and mirror-like, known as “glossy tongue” or “mirror tongue”; if the coating is partially shed, leaving smooth areas without coating and patchy remnants, it is called “patchy peeling coating”.Peeling coating indicates insufficient stomach qi, depletion of stomach yin, or deficiency of both qi and blood, representing a state of overall weakness.Expert Recommendation:For patients with no coating, a light diet is recommended, 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, Chinese yam) and Yi Yi Ren (Coix, Job’s tears), and consider taking herbal formulas like Jian Pi Wan (Spleen Strengthening Pill) or Sheng Mai San (Generate Pulse Powder). Regular exercise is also advised to enhance immune function.Should 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, helping to freshen 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 tongue 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 tongue coating, and cleaning the tongue surface, including the coating, can greatly reduce the number of bacteria in the mouth.Using a tongue scraper primarily helps to effectively remove food residues and bacteria from the tongue coating, reducing the risk of periodontal disease and cavities, and can alleviate bad breath. Therefore, if possible, using a tongue scraper occasionally is advisable.2. Improper Use of Tongue Scrapers Can Harm Taste BudsThe small protrusions densely distributed on the tongue, known as papillae, contain taste buds that can easily be damaged if scraped too forcefully.Thus, tongue scrapers should be used cautiously; frequent vigorous scraping can irritate taste buds, damage the papillae, and even lead to numbness of the tongue surface, reduced taste sensation, and decreased appetite.It is recommended to scrape the tongue no more than once a week. When scraping, do not apply excessive force; gently brush the tongue surface without causing pain or discomfort.Each scraping session should not last too long; brushing from the root to the tip of the tongue 7-10 times is sufficient.In fact, 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 diseases, merely scraping the tongue will not suffice; a medical examination is necessary. Self-scraping may interfere with the 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 bad breath is ineffective.
