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Tongue
Tongue  

Tongue
Tongue  
Sir,

What causes dry, white tongue? I am susceptible to canker sores every now and then and I recently got over a cold. I attached a picture. Just can't tell if it is Thrush or if it's normal. I tryed using a tongue scraper, Orajel mouth rinse with peroxide and swished with warm salt water. What can cause this and how can I get rid of it? Thank you

Answer
Hi Sam and thanks for your question.

Let me start by saying that from the pics you have sent, your tongue looks completely normal - no signs of thrush.  The mouth is a very complex environment and due to the anatomy of the tongue itself, it is a very easy and rough surface for the accumulation of broken down food particles, saliva, shed cells and bacteria. The surface is rough due to the millions of taste buds and filament-like structures called papillae which protrude from the surface of the tongue. Given the large surface area on which debris can be accumulated throughout the day, and especially during the night when we are asleep and the mouth becomes a closed area for increased deposition on the tongue, we all need to clean a certain amount of build-up off our tongues in order to keep it clean. This varies from person to person, but in no way is regarded as pathology. This is all totally normal, and part of the oral hygiene practices we should all do daily to ensure healthy and fresh mouths. I hope this helps and wish you all the very best further.

Kind regards
Dr Craig Peck

Dentistry

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above those of intervention treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient on every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossibile to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. There is no restriction on what you may ask me - if you feel comfortable with my advise and trust my judgement, please feel free to empty your head. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is a once-off, hassle free event where the treatment that has been done, is going to last them their lifetime.

Experience

I have worked for many years in the UK as a general dental practitioner, in 2 separate practices - one servicing the low-middle income groups, offering treatments within the NHS regulations and the other practice servicing a more affluent group of society, treating many television and radio personalities. I am successfully certificated for the administration of Botox for facial lines and wrinkles, ensuring the maximum benefit from cosmetic work. Subsequently, I have attended further courses in minimally invasive facial cosmetic procedures, utilizing Botox and Dermal Fillers to improve facial symmetry, skin tone and complexion and revert the skin to a more youthful appearance. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias. In the past, these patients were referred to the sedation clinic for assessment and treatment, without consideration of possible rehabilitation. By these patients having all their treatments done under sedation, they never recover or allow their affliction to start healing, spending the rest of their lives with a fearful dread of the profession. Consequently, they are at risk for a quicker deterioration in their oral health with any treatment plan often being more complicated, lengthy and costly, which aggravates the situation further (they often never returning again). So, I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The main key is good, effective, concise and understandable communication, shifting control from the dentist to the patient. People vary in their grades of fear, which is assessed pre-operatively in a non-clinical patient interview appointment - which can be at a location and setting chosen by the patient. The aim is to slowly but confidently, regain their trust back in dentistry, giving them the feeling of achievement and this self-empowerment drives them to the next level.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement. Certificate for highest achievement in the subject "Dental Materials". Received the medal from 3M and the Radiological Association of South Africa for excellence in the subject "Dental Radiology and Imaging". Received the Periodontal Association of South Africa's medal for excellence in the subject "Periodontology". Certificate for excellence in "Oral Medicine". Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student in the country throughout the 5 1/2 years of the Degree, with an aggregate average of 73.5%. Passed the subject, Clinical Dentistry with Cum Laude in final year.

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