Question

Dr.,

COuld there be confusion personally as to whether thrush or normal tongue, ie. if it was thrust, would you pretty much know? I can't tell if thrush or how my tongue always looked. Thin layer of white coating on tongue, can brush off (becomes liquidy thin white) no bleeding or red mark or anything. Is there a thin whitish liquidy coating on everyone's tongue? I've heard thrush looks like cream cheese, what's on my tongue is not anywhere near thickness.

Answer

There often is confusion as to whether a person is presenting with pseudomembranous candidiasis (thrush) on the dorsal surface of the tongue or coated tongue. As mentioned in numerous posts on this Forum, coated tongue is an overgrowth of the normal papillae on the tongue and is not related to HIV disease. Treatment for coated tongue usually involves brushing the tongue which will result in a thin, whitish coating on the toothbrush. Pseudomembranous candidiasis can occur solely on the dorsal surface of the tongue, but this is not usually the case.

For pictures of coated tongue and candidiasis, please visit the HIVdent Picture Gallery of Oral Manifestations of HIV/AIDS which can be found at the following URL: http://www.hivdent.org/slides/index.htm. The picture of coated tongue is located at http://www.hivdent.org/slides/hds001.htm

I hope this helps!

DR