Paches or White Spots on Tongue Side, Tip, Back or Under: Causes & Treatments 

A patchy dot or small white spots on tongue whether painless or they hurt means a lot. Imagine having a painful white spot on your tip or side of tongue? They can be a source of oral discomfort. Can STDs cause patches appearing on the back of the tongue? Getting rid of spots that won’t resolve and go away would be a tussle but first, know their causes and symptoms before we look at how you can deal with them.


How do these white spots or patches look like? Have a close look at the sample images below. What do you realize from sample pictures? One can notice that symptoms may vary from mouth and tongue sores, white coating to discoloration and so on.

As you can see, interns of appearance, can generally be tiny, small as even dot size or large and patchy. Let us look at some of the common causes.

What causes them

A single white spot on the tongue whether harmless or painful may have a consequential meaning attached to oral health and your immunity. To help you know the cause, you can use symptoms. However, certain symptoms are common thus tricky to tell at times unless the causes are well known. So what are some of the common causes?

Oral thrush

Oral thrush is a candida albicans fungal infection that is widely known to form tongue coats. In severe cases, thrush infection is usually painful in babies, children, and adults as well.

Symptoms of oral thrush may develop slowly depending on what causes it. Sometimes the early symptoms may not show up. However, when these symptoms are clear they usually become persistent for a few weeks without showing signs of clearing. They include:

  • White-cream lesions including inside cheeks,
  • Redness in tongue,
  • Difficulty in chewing and swallowing,
  • Bleeding may occur if the lesions are rubbed,
  • Redness and cracks in mouth corners,
  • Loss of taste,

More signs of severe infection can be discovered and experienced during breastfeeding. Mothers will complain of painful nipples or within breasts. There is also small cracks and itchy nipple sensation. If you notice your child having trouble in feeding and has white lesions in the mouth, take him or her for diagnosis.

Patches due to oral cancer (mouth cancer)

According to Mayo Clinic, oral cancer also called mouth cancer is one of the types of cancer categorized under head and neck cancer. Oral cancer is due to (cell) mutations occurring in cell DNA. Those at risk include smokers and tobacco chewers, alcoholics and patients with human papillomavirus, HPV.

A study which confirms it is responsible for white patches on the tongue is attributed to the symptoms (outlined below) which show up when cells in oral organs are affected afterward.

  • A single white patch or patches inside mouth i.e. on or under tongue,
  • Presence of sores that won’t heal,
  • A painful tongue that leads to difficulty chewing and painful swallowing,
  • A sore throat
  • Loose teeth and poorly fitting dentures,
  • Stiff jaw and pain, etc.

STDs and white spots on tongue

To go on, certain sexually transmitted diseases are symptomatic to this spots and potentially lead to other complications at advanced stages. There are two STDs associated with this name, HIV, and syphilis.

a. HIV and AIDS

Basically, persons living with HIV virus can go for a good number of years without showing its signs. As one of the immune compromised STDs in human, symptoms eventually appear at later stages of its developments.

These symptoms comprise “white spots or unusual blemishes on the tongue, in the mouth, or in the throat;” [], swollen lymph glands, in armpits and neck, blotches under skin, eyelids, and nose. Other complications involve neurological disorders such as loss of memory, depression after victims undergo a severe brain damage.

b. Syphilis

It’s a bacterial and infectious STD caused by Treponema pallidum. Syphilis is mainly transmitted through direct contact with (syphilis) vaginal, cervical or anal sores that similarly “occur on the lips and in the mouth.” []

If goes untreated, syphilis can “camouflage” in body. This level is considered a fatal or 3rd stage syphilis since it can damage the brain, nerves, heart and other body organs.

Mouth ulcers

Mouth ulcers is another common reason and it is a cause. These painful sores are due to varied and combined reasons including canker sores, cuts on tongue, inner cheeks, bacterial infections that are by far common in young people and adults.

Symptoms of Mouth ulcers

The following are common symptoms of a mouth ulcer.

  • Presence of blisters; usually fluid-filled and may be causing pain,
  • Small, tiny painful red or white spots on tip, side of tongue and throat,
  • Swollen throat,
  • Difficulty in swallowing food,
  • A painful sensation to spicy or hot foods.

Certain medications

Prolonged use of antibiotics can also result in white spots developing on the tongue. Though they are used to cure infections caused by microorganisms i.e. bacterial ones, antibiotics (oral) may kill beneficial or ‘good’ bacteria in your mouth if they are put into use for a longer period. Additionally, individuals who regularly use steroid inhalers or those under immunosuppressing medications are victims at risk of white spots/patches on tongue too.

Due to smoking

Another reason for the occurrence of white spots or patches on the tongue can be triggered by smoking especially tobacco. This is because the smoke contains toxic tannin that easily irritates its (lining) membrane and on your inner cheeks. Such patches are usually thicker than the normal white tongue coating. They are not painful but may grow and risk of developing and turn cancerous if individuals continue to smoke heavily.

Heavy smoking alters tongue texture making it appear coarse and hairy or furry to (“with fur”).

Smokers of tobacco get a burning sensation due to irritating nature of smoke. Otherwise, “a burning sensation on the tongue may occur in women who are postmenopausal.” []

Other white patches causes

Here is a brief discussion of other causes of white patches (spots) on, under or on the back of tongue, throat, and mouth in addition to what we have looked at.

Oral Leukoplakia

In contrast to oral thrush, this condition characterized by white patches on tongue surface whose lesions cannot be rubbed off. “A white area in your mouth that is flat, painless and smooth may indicate the presence of leukoplakia.” [].

The exact causes of leukoplakia are not well known, making it even hard to identify specific symptoms. Even though, research indicates that presence of whitish to yellow or grey patches on the tongue are connected to it. The whitish appearance is due to the hydrating influence of saliva. Causative factors of this condition include tobacco, excessive consumption of alcohol, bloodroot extracts used in toothpastes among other reasons.

Strep throat

Strep throat is caused by Streptococcal bacteria. Common symptoms include fever, sore throat, inflamed tonsillitis, white patches or spots on back tongue and tonsils; but is not similar to common sore throat (caused by a virus). Other symptoms accompanying them are nausea, headache swollen and tender lymph nodes, etc.

This bacterial infection is uncommon in infants, but children can also complain getting difficulties or pain in swallowing food due to a severe sore throat. In adults, the symptoms could be perceived as being mild, however they may develop in severe cases.

Other causes include spleen disorders, stomatitis, vitamin deficiencies (anemia), certain endocrine disorders, oral lichen planus and foods.

Digestive disorders

If you notice a single white spot located around the top middle surface of tongue, it could be due to this problem which interferes with proper functioning of gastrointestinal tract.

Suppressed immune system

Your body’s defense highly depends on the strength of its immunity to fight and keep infections at bay. Unfortunately, patients whose immunity is compromised by other diseases are at a higher risk of getting a white tongue or whitish spots inside of the mouth. Apart from HIV, and syphilis and other STDs, patients who have been on long-term medication of antibiotics are vulnerable as well.

Geographical Tongue

According to spots (esp. back of tongue) are numerous, smooth, red with white borders, resembling archipelago islands

On tip of tongue

Anyone can have small white spots on tip of the tongue. At times they may appear as tiny dots around the this area. Some are harmless yet others may hurt.

In babies and toddlers, many white spots could indicate oral thrush infection on their tongues. In particular, if mothers to such children have been on a breastfeeding routine for quite a while, these dots are likely to reappear after a reinfection in between breastfeeding.

On side and under tongue

nWhy do I have white spots on side of tongue? There are various reasons why you are most likely to get white spots especially on the sides and under your tongue. Some of the causes can be identified by symptoms closely associated with them.

A common cause for a painful white spot both on side and under tongue is oral cancer. “The sides are the most common sites for oral cancer with the floor of the mouth (under it) coming in second.” [].

Second are ulcers and sores. Put in mind that mouth sores i.e. Canker sores and cold sores can inflict pain on tip, sides, at the back, on the surface and underneath your tongue. They may also be present on tonsils, lips and around nose.

If there is no pain on either side of your tongue, one of the following causes looked at earlier may be associated.

  • Geographical tongue,
  • Leukoplakia,
  • Prolonged use of antibiotic medicines, mouthwash and creams, etc.

On toddler and baby causes

This problem e can also occur in small children, babies or toddlers who are a few months old. Common causes of white spots in children’s oral cavity include oral thrush or candida (yeast) infections, allergic reactions like diathesis and chronic contact stomatitis.

Little babies can get the fungus during delivery by mothers who are infected by vaginal yeast infections. It is therefore important for women who have undergone a positive test for vaginal yeast infections avoid breastfeeding their babies. This is very crucial in preventing reinfection of oral thrush even after your baby is declared free of oral thrush.

Allergic reactions like stomatitis known to cause white blotches on baby’s back of tongue should not be mistaken for a geographic tongue at inception i.e. islets of fur.

How to get rid of White spots on tongue

Most tongue problems clear without any treatments whereas a few will require some form of medication as it may necessitate. Arguably, owing to similarities of symptoms posed by tongue problems, getting a definite treatment before a proper diagnosis process is another challenge.

Secondly, home remedies are of quite significance only if you are aware of what is actually underlying cause of white bumps and spots in mouth. Note that natural home remedies clear symptoms (such as inflamed tongue, burning sensation, irritation) caused by oral thrush (yeast infections). They include applying saline water, Garlic, Clove Oil, aloe Vera juice and Glycerin to mention a few.

Oral care tips

  • Practicing and maintaining oral hygiene on daily basis. Cleaning your mouth reduces bacterial activity thus minimizing rates of multiplication. A clean tongue also means good breath,
  • Controlled or limited use of mouthwash,
  • Avoid smoking or just abandon smoking,
  • Taking a balanced diet including fruits, vegetables and probiotics to boost nutrition and body immunity,
  • Restrict alcohol consumption and take clean and enough water to aid equal distribution of nutrients, hydration and removal of toxins,

Finally, if you have a complicated tongue problem with persistent symptoms, for instance, severe white bumps, numb tongue, skin rashes et cetera, go for tests to seek proper medication from a trusted health facility.

Our Reference Sources
  3. By Dr. Sol Silverman, Jr.