Белый налёт на языке у взрослых: причины, лечение, фото

Немало людей озабочены такой проблемой как появление белого налета на языке. В большинстве случаев он образуется к утру и является признаком деятельности бактерий, которые скапливаются в полости рта из-за того, что во время сна у человека слюнные железы функционируют не столь активно, как во время бодрствования.

Это совершенно нормальное явление. Но существует и ряд других причин, по которым у взрослых может появляться налет белого цвета на языке. Некоторые из них могут быть свидетельством о наличии проблем со здоровьем.

Серьезным поводом для беспокойства считается, если на языке постоянно скапливается толстой слой налета с неприятным запахом, который трудно удаляется и быстро восстанавливается. Ниже мы постараемся разобраться, почему у взрослых на языке появляется белый налет, поговорим о причинах вызывающих его появление, и не забудет упомянуть эффективные способы лечения в домашних условиях.

Причины налета на языке белого цвета

Белый налёт на языке есть у всех взрослых людей. Появление его утром – нормальное явление. Но если он возникает сразу после очистки ротовой полости, и начинает становиться толще – это может свидетельствовать о появлении и прогрессировании какого-то заболевания. 

Причины появления белого налета на языке у взрослых многообразны:

1. Поражения языка при различных заболеваниях — инфекционных, внутренних органов, гиповитаминозах, дисбактериозах, онкологии и других.
2. Острые и хронические поражения самого языка: воспаление, инфекции, воздействие медикаментов.
3. Не связанный с заболеваниями: плохая гигиена, употребление пищи белого цвета, алкоголь, курение, не подходящая зубная паста и ополаскиватель.

Что это значит? Место расположения налета позволяет достаточно точно определить орган, который нуждается в лечении:

• Язык обложен белым налетом в центре. Такое расположение налёта, сопровождающееся мелкими трещинками, свидетельствует о развивающемся гастрите или каком-то сбое в работе желудка. Если других симптомов не ощущается, а сам налёт тонкий и не очень густой, то заболевание находится в самом начале зарождения. Скорректируйте диету и режим дня, ограничьте физические нагрузки, и вскоре всё наладится.
• Средняя часть языка: на левый край проецируется печень, на правый поджелудочная железа, на середину желудок.
• Основание языка: края соответствуют почкам, область посередине кишечнику. Скопление белизны у основания может сигнализировать о наличии значительного количества токсинов и шлаков в кишечнике. Это признак начинающегося гастрита, язвы желудка или двенадцатиперстной кишки, особенно если имеются трещины или налет приобрел сероватый оттенок. Для лечения стоит скорректировать рацион питания.
• Если же налёт находится по бокам языка, но близ кончика, то он повествует о наличии лёгочных заболеваний, верный сигнал для курильщиков «пора бросать, а то будет поздно». Ну а если такой же краевой налёт сдвинут к корню языка, он предупреждает о развивающихся нефритах, говоря: «пора посетить уролога».

Если налет на языке тонкий и светлый, его не много, то не о чем беспокоиться. Норма — это когда сквозь белую пелену видно цвет языка. Если же этот орган обложен плотным слоем белого отложения, то это сигнал тревоги. По цвету, локализации и толщине налета определяют, что именно у человека не в порядке.

• Толщина — небольшой налет свидетельствует о начале стадии заболевания, подобный дефект является частым спутником ОРВИ. Толстый слой белой слизи говорит о хронических болезнях или серьезном инфекционном процессе.
• Цвет — варьируется от белого к желтому или серому, чем темнее цвет, тем опаснее патология.
• Форма — налет бывает жирным или сухим, творожистым, влажным.
• Месторасположение — язык может обложить полностью или локализоваться пятнами по поверхности.

Также физиологическое побеление в пределах нормы допускается после употребления чая, кофе, некоторых блюд. Изменение цвета вызывают свекла, черника, сладости с красителями, молочные продукты. Нужно знать, что это допустимое явление, и через 2-3 часа все придет в норму.

Бело желтый налет на языке

Если налет на языке бело-желтого цвета это явно говорит о заболеваниях печени и желчного пузыря. Возможно у вас холецистит, застой желчи, дискинезия желчевыводящих путей. Застой желчи нужно обязательно лечить во избежании появления камней в желчном.

Может быть наличие камней в желчной. Может быть вирусный гепатит. Желтый цвет языка у основания также может быть признаком желтухи. Причем нередко желтый налет на языке сопровождается горечью во рту и тошной, может быть горьковатый привкус во рту, а порой и рвота.

Какие белые отложения на языке считаются нормой?

Не стоит сильно беспокоится, если язык обложен белым налетом в следующих случаях:

1. Покрывается вся поверхность языка тонкой, полупрозрачной пленкой.
2. Орган обладает естественной подвижностью и гибкостью.
3. Нет сильного неприятного запаха, напоминающего гнилую рыбу.
4. Пленка легко удаляется во время чистки зубов.
5. Сквозь пленку просвечивает розовая поверхность.
6. Нет неприятного чувства дискомфорта либо боли.
7. Общее состояние здоровья в порядке, отсутствуют разнообразные патологические заболевания.

Язык можно назвать индикатором состояния человеческого организма. Если характер налета изменился: стал густым, с каким-либо оттенком, трудно удаляется, появился неприятный запах, следует обратить внимание на свое здоровье. Недостаток витаминов, перемена климата, изменение характера питания могут влиять на состояние ротовой полости.

Кандидоз в полости рта

Грибковое заболевание, возбудителями которого являются дрожжевые грибки — кандиды. Второе называние болезни — молочница. Белый налет на языке — самый частый симптом молочницы.

Быстро исчезает, как и другие симптомы болезни, после корректных терапевтических схем, включающих противогрибковые лекарственные средства. Характерным признаком молочницы является отделяемость белой пленки на языке, под которой обнаруживаются точечные изъязвления.

Нажмите для просмотра фото

[свернуть]

Стоматит

Генерализованное воспаление всех поверхностей в ротовой полости, в том числе десен, щек, языка, губ, горла, обладающее благоприятным прогнозом. Одним из первых характерных признаков этого состояния является появление язв на языке, щеках, губах, небе и так далее.

На языке, кроме белого налета, обнаруживают различные по размеру, от 1 до 10 мм в диаметре, мелкие язвочки, зачастую кровоточащие. Стоматит часто поражает детей, даже младенцев.

Нажмите для просмотра фото

[свернуть]

Диагностика

Чтобы помочь врачу установить причину образования белого налета, необходимо подготовить ответы на несколько вопросов:

1. Изменился ли вкус?
2. Курите ли вы?
3. Есть ли болезненные ощущения в ротовой полости?
4. Какие заболевания беспокоили в последнее время?
5. Когда вы заметили белый налет на языке впервые?
6. Изменения внешнего вида языка, включая его отечность и образование язвочек.
7. Список медикаментов и биологически активных добавок, которые вы принимаете.

В некоторых случаях требуется дополнительная консультация инфекциониста, гастроэнтеролога и эндокринолога. Помимо этого, рекомендовано сдать анализ крови и мочи, а также бакпосев.

Белый налет на языке: фото

Как выглядит белый налет на языке у взрослых, предлагаем к просмотру подробные фото.

Бело желтый налет на языке

Как лечить белый налет на языке?

Белый язык у взрослых чаще всего свидетельствует о болезнях желудочно-кишечного тракта, поэтому не рекомендуется относиться к его появлению легкомысленно, лучше всего сразу же обратиться к врачу за консультацией, своевременное лечение избавит от проблем в будущем.

В случае появления налета из-за физиологических факторов в лечении необходимости нет. Достаточно пересмотреть свой режим питания и перестать есть на ходу, питаться фастфудом и изнурять себя различными диетами. Следует отказаться от употребления острой, щедро приправленной специями и пряностями пищи, прекратить увлекаться слишком горячим питьем, бутербродами вместо полноценной еды, побороть тягу к крепким алкогольным напиткам. Отказ от курения также не помешает.

Если же налёт густой, цвет его темно-желтый, да и располагается он не равномерно, а в определённых участках языка, стоит подумать о сбоях в работе организма. Определить истинную причину в данном случае поможет только врач, он же даст соответствующие случаю рекомендации. Главное, не тяните с походом в поликлинику. Следите за собой сами, и всё у вас будет хорошо.

Народные средства

Популярным способом является удаление белого налета с помощью растительного масла. Он зародился еще во времена Древней Индии. Для этого нужно набрать в рот немного растительного масла, примерно одну чайную ложку, далее хорошо прополоскать полость рта и совершать движения языком, будто вы что-то перемешиваете ним.

Время данной процедуры должно длиться не менее десяти минут. Масло глотать не рекомендуется, поэтому постарайтесь его выплюнуть куда-нибудь. При необходимости повторить процедуру, если налет полностью не исчез.

(Visited 68 042 times, 27 visits today)

90000 Leukoplakia: Symptoms, causes, and prevention 90001 90002 Leukoplakia is a condition that causes white patches or plaques to develop on the tongue and mucosa in the mouth. 90003 90002 Mouth irritants and irritating activities, such as smoking, often cause leukoplakia. Doctors can usually differentiate leukoplakia from other similar benign plaques and patches in the mouth by doing an exam. 90003 90002 Doctors consider leukoplakia a precancerous lesion and may recommend a biopsy to rule out cancer.90003 90002 The World Health Organization (WHO) define leukoplakia as «A predominantly white patch or plaque that can not be characterized clinically or pathologically as any other disorder.» 90003 90002 Different organizations use various names for the tests and terms that can identify leukoplakia. 90003 90002 In this article, we explain the symptoms, when to see a doctor, and the risk factors of the condition. We also cover how healthcare professionals diagnose and treat leukoplakia. 90003 90002 Leukoplakia causes white plaques and patches on the mucous membranes of the mouth.Sometimes, a lesion may contain speckles of reddish discoloration. 90003 90002 The patches and plaques seen with leukoplakia are often painless. However, people who have an underlying condition, including cancer, may experience some pain. 90003 90002 Leukoplakia typically develops in the following places: 90003 90020 90021 inner lining of the cheeks 90022 90021 gums 90022 90021 bottom of the mouth under the tongue 90022 90021 tongue 90022 90029 90002 In some cases, leukoplakia patches also affect other regions of the body, most often the genitals.90003 90032 When to see a doctor 90033 90002 Many instances of white patches in the mouth are nothing to worry about. However, anyone who develops oral white plaques should see a doctor for a full evaluation. These plaques can sometimes be a symptom of a more severe health complication that requires medical treatment, such as cancer. 90003 90002 Although leukoplakia is not cancer, specialists often consider leukoplakia precancerous. Sometimes, oral tumors develop within persistent, painful, or severe leukoplakia patches or plaques.90003 90002 According to WHO, around 657,000 people globally receive a diagnosis of oral cancer each year. 90003 90002 People should see a doctor to check for oral cancer if they notice the following symptoms: 90003 90020 90021 white patches speckled with raised, red regions 90022 90021 white lumps with dark or red patches 90022 90021 patches with an irregular texture 90022 90021 pain or difficulties when eating, swallowing, or moving the jaw 90022 90021 sores that last for longer than 2 weeks without healing 90022 90021 changes to surrounding tissues in the mouth 90022 90021 ear pain 90022 90029 90002 Research continues into the causes of leukoplakia development.90003 90002 For most people with leukoplakia, chronic irritation, such as that caused by tobacco, seems to play a significant role. On-going damage to oral tissues appears to cause enlargement and thickening of the skin. The thickening may represent hyperkeratosis (or increased thickening of the outer layer of the skin) as well as atypical skin cells present in the skin. 90003 90002 There are several other causes of harmless white patches in the mouth. These include linea alba of the oral mucosa, which develops due to the friction or pressure of the teeth against the skin in the mouth.90003 90002 Another cause of benign white plaques in the mouth is white sponge nevus. This is usually present from a young age. 90003 90002 There is no single or definitive cause for leukoplakia. Tobacco use of any kind is the most common influencing factor in the development of the condition. People who smoke are six times more likely to develop leukoplakia. 90003 90002 In general, any damage or chronic irritation to the tissues of the mouth may increase a person’s risk of developing leukoplakia.90003 90002 Other factors that might play a role in the development and progression of leukoplakia include: 90003 90020 90021 human papillomavirus (HPV), which might increase the risk of leukoplakia becoming oral cancer 90022 90021 poor oral hygiene 90022 90021 repeated cheek or tongue biting 90022 90021 excessive alcohol use 90022 90021 chewing certain nuts and leaves, such as betel leaf and areca nut 90022 90029 90002 Hairy leukoplakia, which is another type of leukoplakia, is common among people with weakened immune systems.People with HIV and the Epstein-Barr virus (EBV) may develop hairy leukoplakia. 90003 90002 The condition causes leukoplakia patches that have a fuzzy appearance. Hairy leukoplakia lesions are painless and do not increase the risk of oral cancer. 90003 90002 A doctor will usually diagnose leukoplakia by ruling out all other potential causes. This often includes a physical exam and a review of a person’s medical history. 90003 90002 If the doctor suspects leukoplakia, they are likely to request a biopsy to rule out cancer.90003 90002 A doctor may request the following types of biopsy: 90003 90020 90021 90096 Oral brush biopsy: 90097 A doctor uses a small, spinning brush to collect cells from mouth patches. They will then send the cells for examination. 90022 90021 90096 Excisional biopsy: 90097 A surgeon removes patches of leukoplakia for examination. An ear, nose, and throat (ENT) specialist often becomes involved in the treatment at this point. 90022 90029 90002 If cancer is not evident in the results, doctors typically recommend that a person stops using tobacco products.Doctors also advise good oral hygiene. 90003 90002 If the patches do not clear up without treatment, a person may need an operation to remove leukoplakia. 90003 90002 Doctors recommend frequent follow up appointments for on-going leukoplakia. If leukoplakia has resolved, a person may require yearly checkups. 90003 90002 When the patches develop due to conditions such as HIV, a doctor might prescribe antiviral medications. 90003 90002 If a doctor discovers precancerous or cancerous cells, they will carry out additional testing measures to determine the extent of the condition.Treatment will depend on which type of cells are present. 90003 90002 Experts estimate that about 5% of oral leukoplakia may lead to oral cancer. 90003 90002 Learn more about biopsies here. 90003 Share on PinterestA person can help prevent leukoplakia by attending routine dental exams. 90002 Practicing good oral hygiene and stopping activities that damage or stress the mouth lining are the easiest ways to manage and prevent leukoplakia. 90003 90002 Recommended ways to prevent leukoplakia and its complications include: 90003 90020 90021 avoiding tobacco products of any kind 90022 90021 avoiding inhaled or smoked products, including cannabis, cloves, and resin 90022 90021 reducing or stopping alcohol consumption 90022 90021 routine self-exams and checkups with a doctor 90022 90021 attending routine dental exams and maintaining dental hygiene 90022 90021 avoiding abrasive dental hygiene products, such as whiteners and rinses 90022 90021 filing the teeth correctly to make sure that cavities are not rough or uneven 90022 90021 ensuring that dental devices, such as dentures and braces, fit well without rough or exposed edges 90022 90021 keeping mouth wounds clean 90022 90021 waiting for hot drinks or foods to cool before drinking 90022 90021 avoiding candies or chewing products that have rough edges or cause mouth irritation 90022 90021 following a healthful, balanced diet to avoid nutrient imbalances or defic iencies 90022 90021 practicing safe sex to reduce the risk of HPV transmission, including the use of a condom or dental dam during oral intercourse 90022 90029 90002 Trying to quit smoking? Read more on the best ways to stop.90003 90002 More often than not, white patches in the mouth should provide very few reasons to worry. 90003 90002 However, if the patches do not resolve or become painful and persistent, they may be due to leukoplakia. Only a doctor can diagnose this condition. Leukoplakia can increase the risk of oral cancer. 90003 90002 Doctors do not know what causes leukoplakia, although smoking and HPV infection are major risk factors. People with reduced immunity might also develop leukoplakia. 90003 90002 Avoiding or quitting smoking and maintaining good oral hygiene are effective methods for reducing the risk of the condition.90003 90032 Q: 90033 90002 Does leukoplakia of the genitals also turn into a form of cancer? 90003 90032 A: 90033 90002 Doctors generally diagnose leukoplakia in the oral mucosa. They usually regard it as a precancerous lesion. 90003 90002 If a doctor makes a diagnosis in the genital region, the same may be true. However, findings in the genital area are more likely to represent another precancerous disorder, such as vulvar intraepithelial neoplasia. 90003 90002 A discussion with your doctor will help clarify the cause of white patches or plaques in your genital region and the risk of cancer associated with them.90003 90172 Owen Kramer, MD 90173 90174 Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice. 90175.90000 How to Get Rid of a White Tongue 90001 90002 The tongue is not only the strongest and but also an essential muscle in the body. Some of the most basic functions, such as tasting the food, swallowing, and speech, depend on it. 90003 90004 90002 Thus, it is important to ensure that it remains in the pink of health. 90003 90002 90008 The appearance of your tongue is reflective of your inner health 90009. When everything is running smoothly inside, your tongue gives off a natural pinkish hue without any signs of erratic pigmentation.90003 90011 90002 On the other hand, 90008 if your tongue appears to be covered with a grayish-white coating 90009, either entirely or in patches, 90008 it is generally due to some underlying health issue 90009. 90003 90002 This discoloration, commonly referred to as «90008 white tongue 90009,» may seem alarming but is mostly harmless and temporary. 90003 90002 In rare cases, however, this condition can be symptomatic of a more serious ailment, such as an infection or cancer. 90003 90024 Common Causes of White Tongue 90025 90002 90008 Improper oral hygiene / care is one of the major reasons for your tongue to turn white 90009.90003 90002 Over time, bacteria, fungi, food debris, and dead cells can all get trapped between the papillae or tongue nodules, causing them to get inflamed and turning the tongue white. 90003 90002 Because the tongue dorsum is replete with fissures, crypts, and papillae, it is convenient for debris and microorganisms to get stuck within these anatomical niches and become resistant to getting flushed by saliva. 90003 90002 In fact, a single epithelial cell attached to the tongue dorsum is known to have more than 100 bacteria adhered to it, while a cell found in any other part of the oral cavity usually has no more than 25 bacteria attached to it.[1] 90003 90002 Other usual culprits that lead to white tongue include: 90003 90038 90039 90008 Dry mouth 90009 caused by sleeping with your mouth open or breathing through your mouth 90042 90039 Dehydration 90042 90039 90008 Oral lichen planus 90009, which is a chronic inflammatory disease that can trigger the appearance of white patches, papules, or plaques inside the mouth 90042 90039 90008 Excessive alcohol intake, smoking, or tobacco use 90009, which can irritate the lining of your mouth and lead to the development of thick, stubborn, premalignant lesions on the gums, the floor of the mouth, inside of the cheeks, and even tongue 90042 90039 Could be a case of what is known as 90008 geographic tongue 90009 90042 90039 Fever 90042 90039 Reaction to 90008 certain medicines 90009 90042 90039 90008 Skipping on brushing or flossing your teeth regularly 90009, which can lead to the buildup of bacteria, food, and other kinds of debris within the oral cavity.90042 90039 Severe diseases such as 90008 oral thrush (yeast infection) or syphilis 90009, which can manifest as a white tongue and call for immediate medical attention. 90042 90071 90024 Conditions Related to White Tongue: Signs and Symptoms 90025 90002 A white tongue is a common problem and can bring about signs and symptoms such as bad breath or a bitter taste in the mouth. 90003 90002 Poor oral hygiene is primarily responsible for plaque accumulation in the oral cavity, including the surface of the tongue.A white tongue is, thus, often the result of inadequate brushing, flossing, and rinsing of the mouth. 90003 90002 However, a white tongue can also manifest as a symptom of other oral problems rather than as a condition by itself. 90003 90002 A specific set of accompanying symptoms characterizes each oral condition that can lead to this type of tongue discoloration. 90003 90002 Thus, you can identify the underlying cause responsible for your white tongue by considering the symptoms that come along with it.90003 90002 Here are the common signs and symptoms of the white tongue according to its cause: 90003 90002 90008 Leukoplakia: 90009 If the 90008 white / gray striations 90009 in your mouth are caused by leukoplakia. They are usually very stubborn in the respect that they can not be removed by scraping. 90003 90002 The patch tends to 90008 appear raised 90009 and is usually 90008 painless 90009. 90003 90002 Most cases of leukoplakia are non-threatening and tend to resolve once you limit your alcohol intake, quit smoking, and adhere to a stringent oral hygiene routine.90003 90002 However, if the lesions fail to subside despite the recommended care, you are advised to visit your dentist to rule out the risk of oral cancer or any other serious concern. 90003 90002 90008 Oral Lichen Planus 90009: A mild case of oral lichen planus is characterized by the appearance of 90008 white discoloration on the gums, tongue, or insides of the cheeks, 90009 which may go unnoticed at first as it usually develops painlessly. 90003 90002 However, when the degree of underlying inflammation is more severe, the patient may experience considerable symptomatic discomfort in the mouth, especially when eating or drinking.90003 90002 The most noticeable symptoms include: 90003 90038 90039 The appearance of sore patches on the inner walls of the cheeks. 90042 90039 Burning sensation in the mouth 90042 90039 Unusual redness in the gums which may be tender to touch 90042 90071 90002 90008 Geographic Tongue: 90009 The patches associated with a case of geographic tongue characteristically appear on the upper surface of the tongue or along its sides in the form of 90008 red, inflamed lesions surrounded by an uneven white-colored border.90124 90009 90124 In some cases, the patches may develop on the underside of the tongue, as well. This condition has no permanent cure. However, cutting down on spicy, acidic foods may reduce the sensitivity and provide some relief. 90003 90002 90008 Oral Thrush: 90009 In a typical case of oral thrush, your oral cavity is covered with superficial white patches that can usually be scraped away, leaving the underneath skin exposed and sometimes even bloody. 90003 90002 This kind of yeast infection makes 90008 your mouth or tongue feel like they are on fire and often leads to a blunted sense of taste or an unpleasant taste in the mouth 90009.90003 90002 You may even notice red areas inside your mouth and throat and cracking of the skin around the corners of your mouth. 90003 90002 90008 Syphilis: 90009 If you contract syphilis through oral sex, a tiny painless sore may appear on the tongue, anywhere between 10 days to 3 months after initial exposure to the infection-causing bacteria. 90003 90002 If the condition is left untreated, it can advance to syphilitic leukoplakia, which is characterized by the formation of white plaques on the tongue.90003 90002 Syphilis-induced tongue discoloration may be accompanied by other discomforting symptoms such as: 90003 90002 The signs and symptoms of the white tongue, regardless of the cause, tend to continue until the condition is treated. 90003 90002 If the condition is allowed to go out of hand without proper and timely treatment, a case of the white tongue can just as easily escalate into a more serious infection and spread to other areas of the body. 90003 90024 Standard Medical Treatment for White Tongue 90025 90002 The treatment for the white tongue is determined according to its cause.For instance, if your white tongue is due to a yeast infection such as oral thrush, 90008 antifungal medicines 90009 are the way to go. 90003 90002 Doctors usually recommend 90008 oral drops 90009 to arrest the fungal growth in your mouth. These antifungal meds should be taken for at least 1 to 2 weeks until the infection has run its course. 90003 90002 Oral lichen planus is a chronic inflammatory condition that is commonly treated with 90008 corticosteroids 90009 if it acquires a severe form.90003 90002 A physician may be consulted to determine if there is an underlying health condition that triggered the lichen planus. However, in most unthreatening cases, it is simply monitored by a doctor or dentist. 90003 90002 If the white patches are a manifestation of leukoplakia, your healthcare professional will keep a close eye on your oral cavity to make sure that the symptoms are not getting any worse. 90003 90002 The health professional may identify and advise you to eliminate any possible irritants that may contribute to this condition, such as tobacco.90003 90002 The standard treatment for syphilis involves the use of 90008 antibiotic penicillin 90009, which eliminates the bacteria from which the infection springs. 90003 90002 People with a white tongue, regardless of the origin, are usually suggested to reduce irritants in the mouth, such as alcohol and tobacco, to promote unimpeded recovery. 90003 90024 Ways to Treat a White Tongue at Home 90025 90002 Here are some safe remedies to help get rid of a white tongue. 90003 90180 1. Self-Care Tips 90181 90182 90038 90039 90008 Regularly gargle 90009 90008 with warm water 90009, especially after meals, to flush out the remnant food particles on your tongue.90042 90039 90008 Include more crunchy fruits and vegetables in your diet 90009. 90124 Chewing these hard foods gives your oral cavity a bit of additional cleaning to eliminate plaque buildup. Apples, strawberries, guavas, celery, and carrots are all good options to naturally clean a white-coated tongue. 90042 90039 Given that 90008 alcohol abuse, tobacco consumption, and cigarette smoking are some of the prime culprits 90009 for the development of white plaque on the tongue, it is essential to eliminate these unhealthy habits.90042 90039 90008 Visit your dentist every 6 months 90009 for a checkup to ensure optimal oral health and so that corrective measures can be undertaken if needed. 90124 Professional dental cleaning will help you stave off a whole range of oral health issues. 90042 90039 90008 You must be completely committed to your oral hygiene 90009 90008 routine 90009, which stipulates that you brush your teeth at least twice a day with a fluoride-containing toothpaste. It is recommended that you 90008 use a soft-bristled, angled brush 90009, which enables you to clean the inner surfaces of your teeth.90042 90039 90008 Flossing can help 90009 you dislodge the food particles stuck in the hard-to-reach corners of your mouth and the crevices between your teeth. Thus, flossing your teeth once a day can help deep clean your oral cavity. 90042 90039 Another important but often neglected step that completes your oral hygiene regimen is 90008 rinsing your mouth with a fluoride-containing mouthwash 90009 every day. 90042 90039 90008 Avoid dairy products and sugary foods 90009 that trigger mucus production and coat the tongue.90042 90039 90008 Certain oral hygiene products can be too harsh 90009 for your already irritated tongue and 90008 must be avoided 90009. These include alcohol-containing mouthwash and toothpaste that contain sodium lauryl sulfate. Similarly, rinsing your mouth with undiluted hydrogen peroxide can further aggravate your condition and is strictly ill-advised. 90042 90039 90008 Limit your intake of spicy foods 90009 to avoid any further irritation to your oral cavity. 90042 90039 90008 Keep yourself sufficiently hydrated 90009 by drinking at least 8 glasses of water in a day.It is best to meet your daily fill of fluids by drinking water throughout the day. This keeps your mouth moist at all times and thereby 90008 helps 90009 90008 prevent bad breath and other oral issues 90009 .Water helps flush away the food debris from your mouth, which is otherwise used by the oral bacteria as fodder to grow. 90042 90071 90180 2. Practice Regular Tongue Cleaning 90181 90002 Maintaining proper oral hygiene is vital to a healthy tongue. In addition to brushing and flossing your teeth, one complementary step that you should include in your oral hygiene regimen is tongue scraping.[4] 90003 90002 This method is especially 90008 effective in reducing and removing any debris and bacteria 90009 that settle in the oral cavity. 90003 90002 A randomized examiner-blind crossover study published in 90252 BMC Oral Health 90253 found that tongue cleaning reduced the amount of bacterial accumulation in the tongue coating. [1] 90003 90038 90039 Scrape your tongue gently but thoroughly, from back to front using a tongue cleaner or a soft toothbrush. 90042 90039 Do not overdo it by applying too much pressure, which can lead to open wounds, making you susceptible to infection.90042 90039 Also, do not insert the scraper so far back that it causes a gag reflex. 90042 90071 90002 While there are specific tools manufactured for this function, some toothbrushes have an inbuilt tongue scraper at the back of their brush head. 90003 90002 Conclusion: 90003 90002 Complete oral hygiene should include regular scraping of your tongue along with the standard brushing, flossing, and rinsing routine. Your tongue accumulates food debris, dead cells, bacterial plaque, and other impurities overtime unless cleaned properly.This oral care measure carries a lot of scientific support and is a highly recommended practice to address conditions such as the white tongue. 90003 90180 3. Gargle with Salt Water 90181 90002 You can make your own chemical-free mouthwash at home by simply mixing salt in water. 90003 90002 When you rinse your mouth with a saline solution, the coarse granules of sea salt or kosher salt provide a gentle scrubbing action against the tongue. 90003 90002 Swishing this solution in your mouth helps dislodge the plaque, food particles, and dead cells that have accumulated on your tongue, which are eventually spit out.90003 90002 Using a saline gargle to 90008 flush out the impurities from your oral cavity 90009 may help 90008 improve your overall oral well-being 90009 in general, making you less prone to problems such as the white tongue. 90003 90002 According to a 2015 single-blinded, randomized, parallel-group clinical trial conducted on 45 children, saltwater may work as an antiseptic solution that can help eliminate the oral bacteria responsible for foul breath when used as a mouth rinse. [5] 90003 90002 Another double-blind, stratified comparative study suggested that a saltwater rinse can be used as an additional curative measure along with the traditional mechanical plaque control techniques to curb oral diseases.[6] 90003 90287 90039 Mix a few teaspoons of salt in a glass of warm water. 90042 90039 Gargle with this salt water thoroughly and then spit it out. 90042 90039 Repeat several times a day until you are satisfied with the results. 90042 90294 90002 90008 Note: 90009 Salt water rinses are not indicated for people with hypertension unless they first consult with their general physician. 90003 90002 Conclusion: 90003 90002 Saltwater can serve as a safe, non-toxic, and naturally antiseptic mouthwash that can help preserve and improve your oral health.ENT specialists routinely recommend it as a self-care measure to relieve the discomforts associated with the white-coated tongue. 90003 90180 4. Consume Probiotics 90181 90002 Probiotics are generally considered important agents for the improvement of gut health as they aid digestion, but they are also a good remedy for a white-coated tongue. 90003 90002 According to the findings of one literature review, probiotics may help improve your oral health by inhibiting the growth or colonization of disease-causing pathogens in the mouth.[2] 90003 90002 This beneficial effect can be attributed to the presence of 90252 L.acidophilus 90253 and 90252 B. lactis 90253 cultures in fermented products such as probiotics, but such an effect needs to be verified by further scientific investigation. [3] 90003 90002 A number of dietary sources can supplement your probiotic needs, which largely include fermented foods such as yogurt, kefir, sauerkraut, kimchi, miso, and tempeh. 90003 90002 You can also speak with your doctor about starting on a probiotic supplement if you fail to meet your requirement of good bacteria through food.90003 90002 Conclusion: 90003 90002 Substantial research is available that supports the use of probiotics as a means to better oral health, but the extent and efficacy of its antibacterial function need to be examined further by way of additional randomized clinical trials with long-term follow -up periods. 90003 90024 When to Consult Your Doctor 90025 90002 Seek medical help if you experience any of the following as these may indicate a more serious underlying cause of white tongue: 90003 90038 90039 Pain or burning sensation in the tongue 90042 90039 Development of open sores 90042 90039 Difficulty in chewing, swallowing, or talking 90042 90039 Sudden weight loss 90042 90039 Fever 90042 90039 Skin rashes 90042 90039 The white plaque coating persists for longer than 2 weeks 90042 90071 90024 Expert Answers (Q & A) 90025 90002 90008 Answered by Dr.Wessam Atteya, BDS, FRACDS (Dentist) 90124 90009 90003 90002 90008 Can certain antibiotics lead to a white-coated tongue? 90009 90003 90002 Yes, long-term use of broad-spectrum antibiotics could lead to white-coated tongue. 90003 90002 90008 Is white-coated tongue a sign of tongue cancer? 90009 90003 90002 No. However, chronic conditions require some investigations, as in rare cases they can be precancerous. 90003 90002 90008 Can dehydration lead to a white tongue? 90009 90003 90002 Yes, it is the most common cause of a white tongue.90003 90002 90008 What is the best way to get rid of white-coated tongue? 90009 90003 90002 A white tongue may not always require treatment. In most cases, it tends to clear up on its own. To get rid of the problem, you can gently brush your tongue with a soft toothbrush. 90003 90002 Or you may even run a tongue scraper on your tongue. Also, drink ample amounts of water to flush out the bacteria and debris from your mouth. It may, however, still require more treatment if caused by issues such as: 90003 90002 — dry mouth 90124 — dehydration 90124 — breathing through the mouth 90124 — irregular or improper brushing and flossing 90124 — eating a lot of soft foods 90124 — irritation to the tongue from sharp tooth edges or wearing dental instruments 90124 — smoking or tobacco use 90124 — drinking alcohol 90124 — fever 90003 90002 90008 Can oil pulling help reduce white coating on the tongue? 90009 90003 90002 Yes.However, regular hygiene is more important. 90003 90002 90008 How to prevent and treat a white-coated tongue? 90009 90003 90002 — Basic oral hygiene, such as brushing teeth twice daily and using floss at least once daily, can help prevent white coating on the tongue in many cases. Nevertheless, in some cases, it is not possible to avoid the problem. 90003 90002 — Clean the tongue with a tongue scarpers or gently run the toothbrush through the tongue. 90003 90002 — Avoid tobacco and alcoholic beverages to help prevent a white tongue.90003 90002 — Eat a nutrition-rich diet. 90003 90002 — Get a dental check-up by your dentist every 6 months. Report any bothersome symptoms to your dentist early on. 90003 90002 A white-coated tongue may be distressing to see but in most cases, it is harmless and can be treated easily. 90003 90002 You may not find instant relief though, so a continued emphasis on maintaining oral hygiene and lifestyle choices is important. 90003 90002 In rare cases: 90003 90002 — The white tongue could be a symptom of a serious hidden condition.In such cases, the best course of action is to follow the specific treatment plan set by your doctor. 90124 — For white tongues caused by oral thrush, take antifungal medicines preferably in the form of oral drops for a couple of weeks or as prescribed. Take the full course of your medication. 90124 — For oral lichen planus, it is simply to be monitored by your doctor or dentist. In some cases, corticosteroids may be needed. 90124 — Leukoplakia also needs to be monitored by an expert professional to keep it in check.90003 90002 If it is the result of a syphilis infection, treatment would include the use of antibiotic penicillin to kill the bacteria. 90003 90002 90008 About Dr. Wessam Atteya, BDS: 90009 Dr. Atteya has almost 20 years of experience treating patients which he gained in public and private practices both in Melbourne and in Cairo. He practices almost all facets of dentistry with a special interest in Implant Dentistry and Oral Surgery, as well as Cosmetic Dentistry. 90003 90002 Dr. Atteya worked at the Royal Dental Hospital of Melbourne and lectured for the Clinical Training Unit of the Dental Health Services of Victoria.He is also a Mentor for the Royal Australasian College of Dental Surgeons — Sydney and serves on the Continuing Professional Development Committee of the Australian Dental Association — Victorian Branch. 90008 90124 90009 90003 References 90287 90039 Matsui1 M, Chosa2 N, Shimoyama3 Y, Minami1 K, Shigenobu, Kishi1 M. Effects of tongue cleaning on bacterial flora in tongue coating and dental plaque: a crossover study. BMC Oral Health. https://www.ncbi.nlm.nih.gov/pubmed/24423407. Published January 14, 2014.90042 90039 Allaker RP, Stephen AS. Use of Probiotics and Oral Health. Current oral health reports. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688201/. Published 2017. 90042 90039 Seminario-Amez M, López-López J, Estrugo-Devesa A, Ayuso-Montero R, Jané-Salas E. Probiotics and oral health: A systematic review. Medicina oral, patologia oral y cirugiabucal. https://www.ncbi.nlm.nih.gov/pubmed/28390121. Published May 1, 2017. 90042 90039 Van der Sleen MI, Slot DE, Van Trijffel E, Winkel EG, Van der Weijden GA.Effectiveness of mechanical tongue cleaning on breath odor and tongue coating: a systematic review. International journal of dental hygiene. https://www.ncbi.nlm.nih.gov/pubmed/20961381. Published November 2010. 90042 90039 Manju M, Prathyusha P, Joseph E, Kaul RB, Shanthraj SL, Sethi N. Evaluation of the effect of three supplementary oral hygiene measures on salivary mutans streptococci levels in children: A randomized comparative clinical trial. European journal of dentistry. https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC4745225/. Published 2015. 90042 90039 Aravinth V, Narayanan MBA, et al. Comparative evaluation of saltwater rinse with … Journal of the Indian Society of Pedodontics and Preventive Dentistry. http://www.jisppd.com/article.asp?issn=0970-4388;year=2017;volume=35;issue=4;spage=319;epage=326;aulast=Aravinth. Published 2017. 90042 90294 90038 90039 Was this article helpful? 90042 90039 YesNo 90042 90071.90000 What causes white spots on the tonsils? 90001 90002 If you buy something through a link on this page, we may earn a small commission. How this works. 90003 90002 When someone has a sore throat, one of the first things they may do is check the back of their mouth. 90003 90002 The tonsils, which are part of the lymphatic system, are located on the back of the throat. If white spots are present on the tonsils, it is understandable to be concerned. 90003 90002 The good news is that several conditions can cause white spots on the tonsils.Most of them are easily treated. When white spots appear on the tonsils, they may present as blotches or streaks. They may also contain pus. 90003 90002 The most common symptom that occurs is a sore throat. White spots on the tonsils usually indicate an infection. Treatment varies depending on the cause. 90003 90012 Fast facts on white spots on tonsils: 90013 90014 90015 White spots may be confined to the tonsils or located throughout the mouth. 90016 90015 If the white spots do not go away in a few days, or are accompanied by a sore throat, it is advisable to see a doctor.90016 90015 Treatments vary, but gargling warm salt water several times a day may help ease the pain. 90016 90015 A doctor may diagnose the cause of white spots after a review of symptoms and a physical exam, or blood tests. 90016 90023 90002 The most common cause is an infection. Infections may be due to bacteria, a fungus, or a virus. 90003 90002 Although anyone can develop an infection that leads to white spots on the tonsils, having a weakened immune system puts a person at a higher risk.90003 90002 Some of the more common infections that can cause white spots include: 90003 90012 Strep throat 90013 90002 Strep throat is a bacterial infection caused by 90033 Streptococcus 90034. 90003 90002 Complications of strep throat can develop if the bacterium causing the infection spreads to other parts of the body, such as the heart. Complications include rheumatic fever and ear, and sinus infections. 90003 90002 Additional symptoms that may indicate strep throat include: 90003 90002 Strep throat is a common infection, especially in children.According to the Centers for Disease Control and Prevention (CDC), up to 6 out of every 20 children with a sore throat have strep throat. 90003 90012 Oral thrush 90013 90002 Oral thrush is a fungal infection in the mouth. Oral thrush can develop in anyone but is most common in babies. It can also occur as a side effect of medications, such as oral steroids. 90003 90002 People with a weakened immune system are at an increased risk of a fungal infection, including oral thrush. 90003 90002 White spots may be the only symptom of oral thrush, but when additional symptoms develop they may include: 90003 90014 90015 sore throat 90016 90015 pain when swallowing 90016 90015 loss of taste 90016 90023 90002 White spots may also appear on the cheeks, tongue , and roof of the mouth.90003 90012 Viral tonsillitis 90013 90002 Tonsillitis involves inflammation or swelling of the tonsils. Although the 90033 Streptococcus 90034 bacterium can lead to tonsillitis, it is not the only cause. 90003 90002 Tonsillitis can also develop due to a viral infection. Symptoms may include: 90003 90014 90015 swollen tonsils 90016 90015 painful swallowing 90016 90015 fever 90016 90015 ear pain 90016 90015 nasal congestion 90016 90023 90002 Common viruses that may cause tonsillitis include rhinovirus, adenovirus, and respiratory syncytial virus.90003 90012 Infectious mononucleosis 90013 90002 Mononucleosis is a viral infection caused by the Epstein-Barr virus, which affects certain blood cells. 90003 90002 Along with white spots on the back of the throat, symptoms may include: 90003 90002 Infectious mononucleosis spreads easily from person to person. 90003 90012 Tonsil stones 90013 90002 The tonsils have several crevices. Bacteria and mucus can become stuck in them. When this material gets trapped, the debris may harden and calcify, which causes white spots.90003 90002 Symptoms may include: 90003 90002 Some people may not even notice they have tonsil stones, especially if the stones are small. 90003 90012 Rare causes of white spots 90013 90002 There are also other causes that are less common than those listed above. Additional causes include a pre-cancerous condition called leukoplakia, oral herpes, and oral cancer. 90003 90002 A medical exam will aid diagnosis and may include looking in the back of the throat and feeling the lymph glands in the neck.90003 90002 In some cases, doctors may recommend blood tests and a throat culture. Blood tests indicate if certain antibodies are present, which helps identify specific infections. 90003 90002 A throat culture involves rubbing a cotton swab across the back of the throat to collect a sample from the tonsils. 90003 90002 The cells and secretions collected are analyzed to identify the presence of bacteria and determine the type of infection. 90003 90002 There are a variety of causes of white spots, so there is a range of treatments.For example, if spots are due to tonsil stones, treatment may include removal of the stones. 90003 90002 Spots due to strep throat require an antibiotic. White spots on the tonsils due to an oral yeast infection may need antifungal medication. If recurrent infections of the tonsils are an issue, surgery may be recommended to remove the tonsils. 90003 90002 A doctor will not usually prescribe antibiotics for white spots on the tonsils due to a viral infection, such as mononucleosis or viral tonsillitis.90003 90002 Recommended treatment at home may include: 90003 90014 90015 drinking warm liquids to decrease throat pain 90016 90015 taking over-the-counter pain relievers. Many popular pain relievers, such as ibuprofen, are available to buy online. 90016 90015 getting plenty of rest, which allows the body to fight an infection 90016 90015 using a humidifier to reduce throat swelling and irritation. Various humidifiers are available to purchase online. 90016 90015 sucking on throat lozenges to ease discomfort.Search different brands online and compare their benefits. 90016 90023 90002 The time it takes for white spots to clear up may vary based on the cause and treatment used. Most of the causes of white spots on the tonsils are treatable or clear up on their own in a few weeks. 90003 90002 Hand-washing is one of the most important ways to reduce the spread of viral and bacterial infections that may lead to white spots. 90003 90002 Keeping the immune system strong by getting enough rest, eating a well-balanced diet and getting regular exercise can also decrease a person’s chances of developing an infection.90003 90002 Covering the nose and mouth when coughing, and limiting close contact with others until their symptoms have cleared up will also help prevent the infection spreading. 90003 90002 Read the article in Spanish. 90003.90000 White spots and sores on gums: Causes, treatment, and symptoms 90001 90002 White spots on the gums can have many different causes. These can range from mild issues to more severe health conditions. 90003 90002 The white spots may be accompanied by other symptoms such as pain or discomfort. The spots can occur individually or in a cluster. 90003 90002 In this article, we address the causes and symptoms of white spots on the gums and list some treatment options. 90003 90002 Some of the most common causes of white spots on the gums include: 90003 90010 Canker sores 90011 Share on PinterestThe most common cause of white spots on gums are canker scores, more widely known as mouth ulcers.90002 Canker sores develop on the soft tissues of the mouth and around the gums. Also known as mouth ulcers, they tend to: 90003 90014 90015 be oval or round 90016 90015 have red edges 90016 90015 have a white or slightly yellow center 90016 90021 90002 The cause is unclear, but they may be triggered by: 90003 90014 90015 injury or irritation of mouth tissue 90016 90015 dietary deficiencies 90016 90015 bacteria 90016 90015 stress 90016 90021 90002 Canker sores can be minor or major.Minor sores are relatively widespread and usually heal within 2 weeks. Major sores tend to be deeper and more painful and can take up to 6 weeks to heal. 90003 90002 People with canker sores that persist for more than 14 days should consult a doctor or dentist. 90003 90010 Leukoplakia 90011 90002 Leukoplakia is characterized by thick, white patches in the mouth that can not be scraped off with a toothbrush. 90003 90002 Doctors do not know what causes leukoplakia. But, it is likely that smoking or chewing tobacco contributes to its development.Ill-fitting dentures or long-term alcohol use may also cause leukoplakia. 90003 90002 Most cases of leukoplakia are benign, but some can be precancerous. However, it is areas with red lesions (erythroplakia) that are more likely to be cancerous or precancerous, according to the American Cancer Society. 90003 90010 Oral lichen planus 90011 90002 Oral lichen planus is an autoimmune condition that involves inflammation of the mucous membranes in the mouth. It tends to cause white, lacy patches. 90003 90002 There is no cure for oral lichen planus, but symptoms can be managed.Oral lichen planus can increase the risk of secondary infections and oral cancer. It can also cause nutritional deficiencies, as some people may avoid a variety of healthful foods that aggravate their symptoms. 90003 90002 As a result, people with oral lichen planus should organize regular check-ups with their doctor. 90003 90010 Oral thrush 90011 90002 This oral infection is caused by an overgrowth of the 90057 Candida 90058 fungus. It presents as slightly raised sores that are creamy white in appearance.They often have the texture of cottage cheese. 90003 90002 Babies and older adults are most commonly affected due to reduced immunity, but oral thrush can occur in anyone. People with uncontrolled diabetes or who are taking certain antibiotics are also more likely to get the infection. 90003 90002 Symptoms that accompany white spots on the gums vary depending on the underlying cause. 90003 90002 Canker sore symptoms include: 90003 90014 90015 red edges to the sores 90016 90015 stinging pain, especially when eating or talking 90016 90015 tingling or burning before onset 90016 90021 90002 Leukoplakia patches may: 90003 90014 90015 appear with red lesions (erythroplakia) 90016 90015 be flat or irregularly-shaped 90016 90015 get thicker or harden over time 90016 90015 lead to discomfort or pain when swallowing in severe cases, although it is not typically painful 90016 90021 90002 Oral lichen planus symptoms include: 90003 90014 90015 bleeding when eating or brushing the teeth 90016 90015 burning pain 90016 90015 open sores 90016 90015 redness 90016 90015 sensitivity to hot or acidic food 90016 90015 swelling 90016 90015 white, lacy patches in the mouth 90016 90021 90002 Oral thrush may cause: 90003 90014 90015 a cotton-like sensation in the mouth 90016 90015 cracking or bleeding at the corner of the mouth 90016 90015 creamy, white sores 900 16 90015 irritation or pain under dentures 90016 90015 loss of taste 90016 90015 minor bleeding 90016 90015 pain 90016 90015 redness 90016 90021 90002 People should see a doctor or dentist if they experience any of the above symptoms alongside white spots on the gums.90003 Share on PinterestVisit a doctor or dentist if you have white spots and redness, bleeding or swelling of the gums. 90002 A doctor or dentist will diagnose the cause of white spots on the gums by: 90003 90014 90015 visual examination 90016 90015 medical history 90016 90015 blood tests 90016 90015 biopsy 90016 90021 90002 Sometimes a doctor may take a small sample of tissue from oral lesions to diagnose oral lichen planus or to check for cancerous or precancerous cells associated with leukoplakia.90003 90002 Treatment depends on the underlying cause. 90003 90010 Canker sores 90011 90002 Minor canker sores typically resolve within 1 to 2 weeks. Major canker sores often require treatments such as: 90003 90014 90015 oral rinses, ointments, and gels 90016 90015 pain-relieving medication 90016 90015 salt water rinses 90016 90021 90002 A doctor can treat severe cases by sealing the sores or prescribing oral steroids. Lasers can also help to reduce pain and promote faster healing. 90003 90010 Leukoplakia 90011 90002 Doctors will advise people with leukoplakia to stop using tobacco products, as these contribute to the condition.The white patches may be removed with a scalpel, laser, or frozen off. 90003 90002 If a weak immune system causes the condition, a doctor may prescribe antiviral medications. 90003 90010 Oral lichen planus 90011 90002 There is no cure for this condition, so treatment aims to reduce symptoms and improve quality of life. Treatment can include corticosteroids for inflammation and numbing gels to reduce pain. 90003 90010 Oral thrush 90011 90002 Doctors usually prescribe an antifungal medication for oral thrush.It is available as a tablet, lozenge, or rinse. Persistent or widespread 90057 Candida 90058 infections may require a stronger antifungal medication. 90003 Share on PinterestMaintaining good oral hygeine by brushing your teeth, flossing and using mouthwash on a daily basis may be the best prevention method. 90002 The best method of prevention is good oral hygiene. 90003 90002 Suggestions include: 90003 90014 90015 brushing twice daily, flossing once a day, and using a mouth rinse 90016 90015 using oral hygiene products that are free of sodium lauryl sulfate, as this can contribute to canker sore development 90016 90015 avoiding using a very firm toothbrush as it may irritate the gums and soft tissues in the mouth 90016 90015 visiting a dentist for regular check-ups and cleanings 90016 90015 using a tongue scraper to remove plaque, food particles, and bacteria from the tongue 90016 90015 practicing stress-reducing techniques, such as exercise, meditation, and progressive muscle relaxation 90016 90015 eating a balanced diet and limiting the intake of sugar, salt, and alcohol 90016 90015 avoiding the use of tobacco and any products containing it 90016 90015 addressing underlying health conditions promptly 90016 90021 90002 Although it is rare, white spots in the mouth can be caused by an allergic reaction to dental products.People should immediately stop using any new products that cause an allergic reaction. 90003 90002 The outlook for people with white spots on the gums depends on the underlying cause, the overall health of the person, and how quickly a person received treatment. 90003 90002 Careful monitoring and regular dental screenings can ensure oral conditions get prompt treatment. Early detection can prevent the problem from progressing and may reduce the risk of complications. 90003 90002 If anyone notices white spots or any other mouth sores that do not disappear within 2 weeks, it is essential they schedule an appointment with a doctor or dentist.90003.