Why Is Miley Cyrus’ Tongue White?

Miley Cyrus’ tongue has appeared on stages, magazine covers, social media feeds, and red carpets. It has even inspired a dialogue between Atlantic Wire writers on its symbolic import (“embarrassing unsexy sign of a girl who is trying too hard” or “brilliant sendup of prepackaged coy femininity that is genius in its grossness?”). As a cultural touchstone, this band of flesh waggles with enough conflicting meanings and interpretations to make a grad student in anthropology salivate—but before we even start that conversation, can we just confirm that Miley’s not dying of rabies?

Her tongue looks white. Like, dusted with inclement weather. Like she was just licking the inside of a goose feather pillow. And while, yes, we know, the world does not need another post about Miley Cyrus, our previous posts have led us to feel genuine concern for her. Dentists who blog have also expressed misgivings. Is there a chance Miley might actually have some kind of health problem?

According to the Mayo Clinic, white tongue is usually “the result of inflammation of the finger-like projections (papillae) on the surface of your tongue. The appearance of a white coating is caused by debris, bacteria, and dead cells getting lodged between the inflamed papillae.”

Luckily, though, the inflammation that leads to white tongue is often “harmless and temporary.” Typical causes include (per the Mayo Clinic) dehydration, dry mouth, excessive alcohol use, fever, and smoking. But there are scarier culprits too. Leukoplakia is a condition that “causes cells in the mouth to grow excessively” and “can develop when your tongue has been irritated,” especially by “tobacco products.” The complaint may be precancerous. Another possible cause is oral thrush, which sounds like an exotic bird but is actually a yeast infection, one that occasionally results from taking steroids or antibiotics. Oral lichen planus, an autoimmune disorder, can sometimes turn the tongue white, as can syphilis.

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So what should Miley do? The best person for her to consult is her dentist, who will be able to diagnose her condition and determine whether it’s harmless. I was unable to reach Miley’s dentist (or her agent or manager), but I did manage to float her case by Robert Mantoni, a DDS in the Washington, D.C., area. After poring over some Internet images, Mantoni concluded: “In many of these pictures, the tongue looks normal: pink, moist and healthy. But there are a few that would cause me some concern if she walked into my office. Looking at the white color on the top of the tongue, and knowing her wild lifestyle, I would start thinking alcohol, drugs, or maybe bulimia, since all those things can compromise the immune system and inflame the papillae. Alcohol in particular is such an irritant to the mouth.”

How would he treat it? “Well, the first thing is not to freak out. I’ve seen this many times, much worse, and it’s usually very, very benign. You can get it to resolve with warm salt water rinses and sometimes peroxide cleanses. Or you might just need to switch toothpastes to something blander. I’d recommend she buy a tongue scraper or gently brush her tongue as well. In short, eliminate potential causes and practice more aggressive hygiene. And then come back in two weeks to make sure everything’s cleared up.” (Other dentists agree that she could pay a little more attention to her oral health.)

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Sure, but what if it hasn’t cleared up? “That’s when we request a biopsy. I’d be very surprised if that were necessary, though. White anywhere else in the mouth or even on the sides of the tongue would concern me. Not white on top.”

Phew. Good news, Miley. You can go back to “experimenting with the shape of pop stardom” now. Your tongue is probably fine.

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