What Your Tongue Is Trying To Tell You About Your Health

For clues about problems in your mouth, stick out your tongue and
look in the mirror. A healthy tongue should be pink and covered with
small nodules (papillae). Any deviation from your tongue’s normal
appearance, or any pain, may be cause for concern.

Family
physician Daniel Allan, MD, discusses why you should watch for changes
that might need to be evaluated by a doctor or dentist.

If your tongue has a white coating or white spots

A white tongue, or white spots on your tongue, could be an indication of:

Oral
thrush – a yeast infection that develops inside the mouth. It appears
as white patches that are often the consistency of cottage cheese. “Oral
thrush is most commonly seen in infants and the elderly, especially
denture wearers, or in people with weakened immune systems,” says Dr.
Allan. “People with diabetes and those who are taking inhaled steroids
for asthma or lung disease can also get it. And oral steroids can
trigger thrush too. Oral thrush is also more likely to occur after
you’ve taken antibiotics.”

Leukoplakia – a condition in which the
cells in the mouth grow excessively, which leads to white patches on the
tongue and inside the mouth. “Leukoplakia can develop when the tongue
has been irritated,” Dr. Allan says. “It’s often seen in people who use
tobacco products. Leukoplakia can be a precursor to cancer, but isn’t
inherently dangerous by itself. If you see what you think could be
leukoplakia, contact your dentist for an evaluation.”

Oral lichen
planus – a network of raised white lines on your tongue that look
similar to lace. “We don’t always know what causes this condition, but
it usually resolves on its own,” says Dr. Allan.

If your tongue is red

A red tongue could be a sign of:

Vitamin
deficiency – “Folic acid and vitamin B-12 deficiencies may cause your
tongue to take on a reddish appearance,” Dr. Allan says. A simple blood
test is available to determine these levels.

Geographic tongue –
This condition causes a map-like pattern of reddish spots to develop on
the surface of your tongue. “These patches can have a white border
around them, and their location on your tongue may shift over time,”
says Dr. Allan. “Geographic tongue is usually harmless.”

Scarlet
fever – an infection that causes the tongue to have a strawberry-like
(red and bumpy) appearance. “If you have a high fever and a red tongue,
you need to see your family doctor,” Dr. Allan says. “Antibiotics are
necessary to treat scarlet fever.”

Kawasaki disease – a condition
that can also cause the tongue to have a strawberry-like appearance. It
is seen in children under the age of 5 and is accompanied by a high
fever. “Kawasaki disease is a serious condition that demands immediate
medical evaluation,” says Dr. Allan.

If your tongue is black and hairy

Much
like hair, the papillae on your tongue grow throughout your lifetime.
In some people, they become excessively long, which makes them more
likely to harbor bacteria.

“When these bacteria grow, they may
look dark or black, and the overgrown papillae can appear hair-like,”
Dr. Allan says. “Fortunately, this condition is not common and is
typically not serious. It’s most likely to occur in people who don’t
practice good dental hygiene.”

He says people with diabetes, taking antibiotics or receiving chemotherapy may also develop a black hairy tongue.

If your tongue is sore or bumpy

Painful bumps on your tongue can be due to:

Trauma
– “Accidentally biting your tongue or scalding it on something straight
out of the oven can result in a sore tongue until the damage heals,”
says Dr. Allan. “Grinding or clenching your teeth can also irritate the
sides of your tongue and cause it to become painful.”

Smoking – Smoking irritates your tongue, which can cause soreness.

Canker
sores – mouth ulcers. “Many people develop canker sores on the tongue
at one time or another,” Dr. Allan says. “The cause is unknown, but
stress is believed to be a factor.” Canker sores normally heal without
treatment within a week or two.

Oral cancer – “A lump or sore on
your tongue that doesn’t go away within two weeks could be an indication
of oral cancer,” says Dr. Allan “Keep in mind that many oral cancers
don’t hurt in the early stages, so don’t assume a lack of pain means
nothing is wrong.”

Watch your tongue!

Dr. Allan says
everyone should check their tongue on a daily basis when they brush
their teeth and tongue. “Any discoloration, lumps, sores or pain should
be monitored and evaluated by a medical professional if they don’t go
away within two weeks,” he says.