Dr Reznik, I have had a white, thick coating on my tongue for over one year. I started by scraping the coating off, but it always returns and returns quickly. I went to a dentist who said it didn't look like thrush and gave me a rinse for what he thought was a case of lichen planus. I then went to my General Physician, he also said it did not look like thrush, but he did a culture (which for some reason took a month and a half to come back). He said the culture did not show yeast. Finally, after getting fed up, I went to a walk-in clinic and had another culture (this one came back after only a weekend) and the doctor told me that I had thrush, and a moderate growth on top of it. The doctor prescribed Mycelex troches (10 mg) which he instructed me to take four times a day, the thrush not only did not go away, it got worse after treatment. Now it's thicker than ever and I'm starting to feel as if my throat is affected. I have just tested with an anonymous home kit, but I'm terrified of getting my results. I have risk factors for hiv, (unprotected sex, sex with prostitutes). I have been married for one year and I don't know how I could possibly break this kind of news to my wife.

From what you have described it does not sound as if you have thrush. Approximately 60% of the general population would culture out "yeast", yet we do not see thrush in 60% of the population. In order to develop thrush a person would either be medically compromised, on broad spectrum antibiotics, steroids, etc.

Many times people confuse coated tongue, which is nothing more than an overgrowth of bacteria on the tongue, with thrush. As mentioned in previous messages, the best treatment for coated tongue is gently brushing the tongue. An antimicrobial mouth rinse such as PerioGard may prove to be helpful in conjunction with good oral hygiene.

A note on the use of Mycelex troches: the proper dosage for mild to moderate candidiasis is to dissolve one troche in the mouth 5 times a day for 2 weeks.

Take care,

DR