We can also examine the perspective of the Donguibogam through modern science. A white tongue coating, especially the thick layer associated with oral candidiasis, is not merely a cosmetic concern. It indicates that the immune system is under strain. Modern medicine attributes this condition to oral microbiome dysbiosis and decreased immunity. Diverse microorganisms coexist in the oral cavity in a delicate balance. When immunity declines, fungi such as Candida albicans, which normally cause no harm, undergo excessive proliferation. This closely resembles the way the body loses balance when dampness-phlegm accumulates, as described in the Donguibogam.
The causes of decreased immunity are varied. Chronic stress increases corticosteroid secretion, suppressing immune cell function. Irregular eating habits and excessive sugar intake impair gut health, which directly affects systemic immunity. Because the gut and the brain communicate closely, compromised gut function can disrupt stress regulation as well. Medications such as antibiotics or steroids can also reduce beneficial bacteria in the mouth, creating an environment where Candida albicans can flourish.
In addition, endocrine diseases such as hypothyroidism or uncontrolled diabetes, deficiencies in nutrients like iron and vitamin B complex, smoking, and xerostomia with low saliva production all increase the likelihood of oral candidiasis. When immune cells in the oral mucosa, particularly T lymphocytes, cannot function adequately, the fungus adheres to the mucosal lining, forms a biofilm, and triggers inflammation. This can lead to digestive system issues or systemic infection if left unaddressed.
When a white tongue coating is thick and difficult to remove, or when it is accompanied by a burning sensation or white patches, the body is signaling that its defenses are depleted. Just as the Donguibogam recognized that damp-heat and qi deficiency in the spleen and stomach affect the whole body, modern medicine views oral health as an essential window into systemic health. Rather than focusing solely on removing the surface coating, it is essential to identify and address the factors weakening the immune system.
