Yellow tongue

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015
StartSymptomsYellow tongue

A yellow tongue can manifest in two different forms: either the tongue can appear to be coated in something with a yellowish coloring, or the flesh of the tongue itself can appear to have turned yellow. The yellow coloring will typically materialize gradually, giving the person time to notice and treat the causes. Both types of yellow tongue can be early indicators of different conditions, which makes understanding the difference between the two important.


Definition & Facts

A yellowish film in the surface of the tongue is usually the first stage in the disorder known as black hairy tongue. This can affect both children and adults, and can be more prominent when a woman is pregnant. It can be accompanied by a variety of other symptoms including dry mouth, sore throat, bad breath, a fever, swollen taste buds, and soreness or sensitivity of the tongue.

The yellowish residue is not confined to the top of the tongue; it can spread to the sides of the tongue, the bottom of the tongue, and even to the cheeks, gums, and roof of the mouth. The more the infection spreads throughout the mouth, the more irritating and pronounced the symptoms will become.

If the flesh of the tongue itself appears as if it has turned yellow, it can be an indicator of several different causes, some of which are benign. These include dehydration, fever, acid reflux, post-nasal drip, excessive tobacco use, chronic dry mouth, strep throat, and in rare cases jaundice.


The most common reason for the tongue to develop a yellow coating is due to food residue and dead skin cells building up on the papillae, or the bumpy surface of the tongue. The cause of this buildup is almost always poor oral hygiene, resulting from the tongue not being cleaned properly.

The mouth contains yeast, or bacteria, that when combined with this residue creates the yellow pigmented coloring. This buildup results in additional bacteria and food partials getting caught in the film, which leads to the development of black hairy tongue. Once the buildup becomes too great, the papillae cannot shed like they normally would. Instead, they start to lengthen in order to stretch out past the film, creating the hair-like extensions.

Contrary to its name, black hairy tongue can also appear orange, tan, brown, white, or green, depending on the types of bacteria inside of it. If the tongue appears to be stained yellow, it is likely from excessive tobacco use, acid reflux, or post-nasal drip. All of these introduce materials into the mouth that are yellow, brown, or green in coloring, which can stain the surface of the tongue. Fever and dehydration can also turn the tongue yellow because they restrict blood-flow to the tongue. This decreases the pigmentation in the flesh and can makes it take on a more yellowish hue.

When to see a doctor

Deciding when to see a doctor depends on what type of yellow tongue is being observed. If it is a yellow coating signaling the beginning of black hairy tongue, it is advisable to see a doctor shortly after it appears in order to begin the proper treatment.

If there are any other symptoms of jaundice, such as yellow pigmentation in the whites of the eyes, a doctor should be consulted immediately. If it is likely that the yellow tongue is being cause by something more benign, like a fever or acid reflux, it is best to wait for these conditions to subside to see if the yellow tongue coloring also dissipates. It is also advisable to increase water consumption to make sure that it is not being caused by dehydration or dry mouth.

If several days to a week have gone by with no change and/or worsening of the yellow tongue, it is advisable to see a doctor. They will be able to run a series of tests, including a tongue scraping and blood work, to determine the cause. If the yellow tongue persists after trying a doctor-prescribed treatment, return to the doctor immediately to explore other avenues of treatment.

Treatment & Therapy

Treatment for yellow tongue depends on its underlying cause. If it is the beginning stages of black hairy tongue, antibiotics will be used to treat the infection growing on the surface of the tongue. The most common antibiotics used for this treatment are amoxicillin, ampicillin, and doxycycline monohydrate.

If it is being caused by another treatable condition, such as acid reflux, strep throat, or post-nasal drip, a doctor will prescribe medication to treat the cause—not the symptom of yellow tongue. However, once the proper medication has been taken long enough to address the underlying issue, the yellowish tinge in the tongue should disappear. Treatments for these conditions typically include prescription-strength antacid, antibiotics, or a nasal spray. If it is being caused by something that medication cannot treat—such as excessive tobacco use—the doctor will recommend stopping the use of all tobacco products in order to prevent the tobacco from staining the flesh of the tongue.

While it is rare, if the cause does happen to be jaundice, the doctor will assess the best course of treatment for the individual person. These treatments vary depending on the severity of the condition from medications for liver to ultra-violet light therapy for the skin.

Prevention & Prophylaxis

Regardless of the cause of yellow tongue, there are several treatments that most doctors will recommend that can also prevent yellow tongue from reoccurring.

  • Brush the tongue with a soft tooth brush every day as part of normal oral hygiene.
  • Quit the consumption of tobacco products, particularly the use of chewing tobacco.
  • Stop drinking extremely hot beverages as these can burn the tongue, stunting papillae shedding.
  • Drink a lot of water to prevent dehydration and dry mouth.

It is very important to know when the color of the tongue fluctuates, as it can indicate a severe underlying problem. Following these preventive measures will help people to know that if yellow tongue occurs, it is for a reason worth talking to their doctor about.

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