What's wrong with my tongue?

[sadlife123]

Been struggling with bad breath and a disgusting taste in my mouth since I can remember. Been to a dentist, ENT and GI. No oral or sinus issues. Slight reflux. Antiacids have no impact on my breath. Got tested for thrush/candida twice and it was negative. Regularily clearing my tonsils. Tongue looks really hairy/furry and the white/yellowish coat can't be scraped off. Sometimes my tongue is pink but the furryness and bad breath remains. It gets worse after stuff like coffee and chocolate and not eating anything for some hours (despite of drinking regularily). I have a gut dysbiosis (alkaline stool PH, Escherichia coli overgrowth and lack of Enterococcus and Lactobacillus). I've been taking probiotics for years which improved my bloating and bowel movement but sadly it had no influence on my breath. Tried stuff like berberine, disgestive enzymes, celery juice, collagen, diet rich in fiber and diatomaceous earth powder. I am currently eating vegan and gluten-free and feel even worse than before. I have suspected SIBO but cant be tested where I live. I am really hopeless

[Stevian]

Ok, I usually discount digestive sources of bb unless strong evidence otherwise.

Your tongue looks like it has the typical biofilm of sufferers of intra-oral bad breath. Ver similar to mine, actually.
Unless you also have periodontal disease, I suspect smelly off-gases of oral bacteria, mostly on the tongue, especially at the back of the tongue, underneath the epiglottis, which is difficult to reach.

So, in addition to regular oral hygiene, you’d need to get a tongue scraper going on the tongue, and get to work with a toothbrush at the very back, even if it makes you gag. You’ll get used to it. It’s important.

You’ll also need a good mouthwash used afterwards, and perhaps several times during the day. I use Therabreath Plus Maximum Strength. Smartmouth is a good one as well. And Maybe, if you work close to people, cover up with gum or mints as needed during the day.

None of the above will cure inta-oral chronic halitosis, but it’ll help a lot in getting it under control.
If it’s intra-oral, as I suspect, it’d take a targeted antibiotic oral rinse to kill it off, followed by a course of chlorhexadine antibacterial mouthwash.
Usually that involves oral bacteria samples taken and sent to a lab for analysis, then formulation of a customized mouthwash to target those specific strains of bacteria.
My experience with North American dentists is most are woefully ignorant on all this, including my general practice dentist and my periodontist.
I tried oral-internal (swallowed pills) antibiotics a decade ago, but it came back. I really think the prescription oral rinse is a better approach.
There may be others offering this, but Dr. James Hyland in Toronto uses this approach, and you can contact him through his website oravital.com, or look up his business phone and leave a message. He may have trained associate practitioners in your area. You can look those up on his website.

That’s not exactly a plug for Hyland, because I haven’t used his services, but I’m thinking I will shortly.

Good luck. All you have to lose is your bad breath!

[Stevian]

There’s also a tongue cleaning process called Laser Tongue Debridement, also known as Laser Tongue Rejuvenation, using a combination of laser and high pressure water jet. This may take several visits and cost thousands of dollars. There’re at least 2 clinics in the US that offer this, and I think one in western Canada.

I sort of lean towards the antibiotic oral rinse approach.

[poco333]

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Hey Sadlife, your tongue actually doesn't look too bad. So glad you posted a pic!! Mine used to be much worse, with more of a hairy tongue and big crack down the middle. This is a pic of my tongue now. I've tried pretty much everything over the years, even posted a little about copper (gave up on it, helped with bacteria but did not help with the underlying condition--Hairy Tongue)

Urea is what made all the difference for me. The cause of Hairy Tongue is a lack of shedding of the filiform papillae. I've been toying with keratolytics for almost ten years on and off as well as things like TCA peel. I had tried different approaches with urea but ironically I never tried the simplest thing--just put maybe half teaspoon on my tongue, close my mouth and let it dissolve in saliva, creating kind of a mouthwash. I don't really swish it around though, just try to give good contact to tongue and I leave it in my mouth for probably 5 to 10 minutes then spit it out.

When I did this my tongue kinda felt shriveled up and I didn't know if it would do any good or not. Anyways about 24 hours later it felt like there was a bunch of extra junk on my tongue. I stuck it out in the car mirror of all places and I was able to just scrape all of that shedded keratin of with my fingernail. Crazy stuff because those of us who have tried to scrape off a hairy tongue know that it just doesn't work. This didn't hurt the filiform papillae at all just allowed them to shed. I still have them on my tongue they're just little bumps instead of hairs.

Anyways I just did this the one time when it made all the difference. I still do it about once a week but it doesn't seem to do anything because the filiform papillae are not getting long again so there is no keratin to dissolve off of them. Either that or once a week is enough to keep it in check to where I don't notice anything.

I use feed grade urea and I can't find any evidence that it should be harmful to the mouth or body. Saliva is supposed to have a certain amount of urea in it anyways (which may be what I was lacking). People take 15 gram urea supplements for various medical conditions and what I used is just half a teaspoon (about 2.5 grams) (and certainly not daily) and spit it out when done anyways. If anybody is interested here is a link https://www.ureaaide.com/shop-ureaaide/
They even have mint flavor

This has made all the difference in the world in my fight against BB.

[poco333]

I have no use for a tongue scraper anymore thats for sure (after 20 years). Threw that in the garbage. A person can just use their index finger anyways. I also use Therabreath once in the morning and evening like Stevian mentioned. Used to use other things but I got one of those Tanita brath checkers a while back and Therabreath is the only one that gives me scores of 1 or 0. Other things like copper or diluted bleach feel more effective but I was getting readings of 3 to 5 during the day and people were telling me that i still had BB. Just my experience but I guess I'm learning to trust the science.

[poco333]

@Sadlife123 have you ever tried aspirin for your gut problems. I used to have those too but was shocked that one aspirin in the morning and maybe one in the evening solved my problems. I think most of us that have had BB have also had gut problems because of the incredible amount of stress that BB has caused over the years. Don't know if salicylic acid just helps the gut to relax or if there's more to it than that. Just know it worked for me. Used for about a month don't need to anymore

[Speranza]

@poco333 I believe this post has the potential to cure bad breath for many people, my bad breath originates from the lingual partina, I tried antibiotic mouthwashes with metronidazole and amoxicillin which treated my bad breath but after several weeks it came back, I removed the tonsils and I made an anti-reflux plastic but the lingual patina is always present and I think you have hit the spot with urea, now I have some questions to ask you, how long after the urea administration has your bad breath disappeared? this regimen and your halitosis is 100% gone? thank you I hope for your reply

[poco333]

@Speranza If you could post a pic thats always helpful to folks!! I was so glad to see that as an option on this forum!

Urea by itself didn't necessarily get rid of BB. It got rid of the environment in which the bacteria could thrive but those organism still populate the mouth and it seems the body needs a little help to get rid of them (although with enough patience and the right diet and lack of stressful situations the mouth might straighten itself out without any mouthwash etc)

I wasn't really keeping a log of things since it all kind of took me by surprise, but I think that within 4 or 5 days a person could be mostly BB free (although every situation is different). The first time I would recommend doing the urea twice, back to back. For the next 24 hours (the first time only) there is probably going to be a fair amount of BB because of all the keratin loosening.

Mouthwashes. I do like therabreath once a day at least. On occasion it will leave kind of a bad taste in the back of my mouth and I will use diluted bleach. Maybe a person could use Tbreath in the morning and diluted bleach in the evening. As folks on here already know diet is important as well. I try to avoid sugary stuff. I do drink unsweet iced tea most of the day (helps keep mouth moist) and will often add a tiny bit of baking soda just to cut back the acid a little. I will drink coffee as well, especially if I eat something sweet.

I have a Tanita breath checker hc-312f and I consider it indispensable (it gets embarrassing having to ask people if my breath smells good or not). Certain foods/ mouthwashes/ beer/ etc. will give it a false reading but I mostly use it first thing in the morning because I can't get a false reading then. If I'm getting 0's or 1's then I am happy.

@Speranza I wouldn't say I am 100% BB free (nobody on this planet is lol). I am maybe 95% BB free . Anyways my mouth is sooooo much healthier than what it used to be. I only stumbled into this approach with urea recently so I am on a steep learning curve yet. I greatly appreciate any help and feedback from people on this forum. We're all in this together

[AlphaB]

You summed up Oravital perfectly. I just Hyland about 3 weeks ago, although it's his daughter who handles the breath patients now. She is very knowledgeable, they are very thorough and overall a great experience. That being said, I've tried my third round of Oravital Abx rinses and none have helped with the tongue coating.

In my case, I also have 3 different odours not counting food/stomach related odours after eating. The worst of the 3 is definitely tonsil stones. I get rid of those by using a water flossing. Hyland's daughter said it is the best way, along with potentially a metronidazole rinse twice a year. The other persistent smell is a yeast one from the back of the tongue. It's not nearly as offensive as the tonsil stone smell, but still unpleasant and definitely noticeable on my orabrush when I scrape my tongue. The third smell is somewhat intermittent, seemed to go away for the first week of the oravital abx rinse, but returned by the second. It is a sour type of smell and a have a feeling it comes from my sinuses, since I smell it more strongly in the morning and after I sneeze. I can smell it even with my mouth closed.

One other thing that in trying that may be helpful to someone, is isotretinoin cream. I'd read a paper in a medical journal somewhere that said it was an effective treatment for hairy tongue, and therefore I suggested it to my dermatologist who prescribed it to me. I was using it in between my oravital rinses but saw no effect after 2 weeks. I will try again after my 2 weeks of chlorhexadine/oravital ABX gum cream, as apparently abx are one of the more common causes of hairy tongue.

Urea

The urea thing also sounds promising.. I was going to try that myself first, but opted for isotretinoin as I assumed it was the more effective, stronger treatment as it required a prescription too.. I have had this persistent coating and long papilae for 3 years now and it is driving me nuts. It's accompanied by a burnt, dry feeling on my tongue and a persistent bitter taste that won't go away. My mouth was fine 3 years ago, no odd tastes, smells or sensations... also, do you have a clearer picture of your tongue now?

Here's mine:

[poco333]

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@AlphaB Your tongue actually doesn't look too bad. You can actually see the fungiform papillae in amongst the filiform ones. I realize cell phone pics don't always do justice to reality. Here's a little clearer pic of mine-- not perfect but not even recognizable from what it used to be. I don't have to ever scrape it or anything anymore this is its everyday working clothes lol.

Isotretinoin (synthetic vitamin A) is a new one to me. If its a gel that you apply topically and let sit on the tongue for a while I wouldn't be too optimistic. Being as it's not a keratolytic I would be cautious as to it affect on other tissues in the mouth. But I could be wrong if you decide to try it I hope it works!

I have tried many things over the years. TCA peel completely clears off the surface of the tongue, leaving it baby smooth, and can taste everything so clearly, but after a week or so the filiform papillae grow back and long again. I used to use urea topically, just holding my tongue out and leaving urea sit on it for as long as I could. It was moisturizing but other than that I just didn't notice much, and that was using it topically every day. Ironic that letting it dissolve in mouth and holding there for ten minutes or so before spitting out is a whole different animal. And I only had to do it a few times (may not need to again time will tell).

Also I am using pure urea, similar to what I posted a link to above. Most of the dental journals mention a urea gel, 30 to 40 percent. To be clear that is not what I am using, never have.

[poco333]

@AlphaB you said three years ago your tongue was fine didn't have issues. Can you trace the problems back to an origin like an antibiotic or antifungal. There is quite a bit of evidence that drugs like Flagyl can cause folks to end up with a hairy tongue (seemingly permanently) even though their tongue was perfectly healthy to start with. Kind of alarming really.

These pics on here are great folks!! Should be very helpful to people

[Speranza]

@poco333 hello so urea is the answer for a language with a lot of keratin, but i still have questions in my european country i can't find any kind of edible urea only agricultural urea and body creams with various percentages of urea what do you recommend to take?

[Speranza]

@poco333 in other question, do you have a picture of when your tongue was white?

[poco333]

@Speranza Unfortunately I do not have a pic of what my tongue used to look like. If I can find something similar I will post it. It was basically a white hairy tongue and also a geographic tongue... it was nasty looking, didn't want to have a pic of it lol.

I guess I hadn't mentioned geographic tongue but urea seems to have rid me of that too. I basically had a very hairy white tongue with red burning bald spots here and there. I think those red bald spots / "ulcers" are the body's attempt to fix the tongue. Now maybe it doesn't need to do that anymore.

[poco333]

@Speranza If it was me I would not be afraid of the agricultural urea. That being said I don't want to give bad advise so please do your own research and don't make any sudden decisions. The creams I have never tried but they are not pure urea (only 40% I think) and not sure how safe they are for the mouth. But if their ingredients seem safe maybe worth a try?

Actually the urea I used was an agricultural urea but was labeled feed grade and was for livestock.

Also lab grade I think should be more pure than feed grade. Maybe that would be an option?