What does your tongue say about your health?

How do I know if my tongue is healthy?

A healthy tongue is usually pink, ranging from light to dark shades. It should feel moist and have only a thin white coating on top. The top is covered in tiny bumps called papillae, which give it a slightly rough texture, while the bottom should be smooth and shiny. Inside these papillae are thousands of taste buds that help you enjoy the foods you eat.

What are warning signs on your tongue?

Most of the time, changes to your tongue are harmless. They might improve by taking better care of your teeth, or with a quick visit to your dentist for treatment. But sometimes, if your tongue changes colour or texture, or feels sore, it could point to an underlying health condition. If your dentist notices anything unusual, they’ll refer you to a doctor or specialist for some tests. Below are some of the most common changes to look out for.

A white tongue

If you notice white patches or a white coating on your tongue, it may be due to a build-up of bacteria. Often, this can be improved with better oral hygiene.

But sometimes, white spots on your tongue are linked to other conditions, such as:

• Oral thrush. This is a fungal infection that’s common in babies or older people who wear dentures. It causes a creamy white coating. It’s usually harmless and can be treated by your pharmacist or doctor.
• Lichen planus. This is an inflammatory condition that can cause white, lacy patches to form inside your mouth. It should be checked by a dentist who can suggest the next steps to take.
• Leukoplakia. These are thick, white patches that don’t rub off. They’re often harmless but can sometimes develop into mouth cancer. So, it’ important to make an appointment to see a doctor if you notice white patches that don’t get better in three weeks.

A bright red tongue

If your tongue looks smooth and bright red, it could be a sign of a nutritional deficiency. For example, a lack of iron or vitamin B12.

In adults, red spots or patches on your tongue could be harmless. But they can sometimes indicate something called erythroplakia. This is a rare condition that may be an early sign of mouth cancer.

In children, a strawberry-red tongue can be a symptom of scarlet fever or Kawasaki disease.

If you notice your tongue looks redder than usual, or you have red patches for over three weeks, make an appointment to see your dentist.

A black, hairy tongue

A black, hairy or fuzzy tongue can happen when dead skin cells and keratin (a protein that forms on your skin, hair and nails) build up on your tongue. It can also be the result of food or bacteria getting trapped on the papillae of your tongue. This can happen if you don’t clean your mouth thoroughly, smoke heavily, or drink lots of alcohol, tea or coffee. It’s usually harmless and can be improved by brushing your tongue or using a tongue scraper. Sometimes, it can also be caused by:

• certain medications, like a course of antibiotics
• using too much antiseptic mouthwash

A yellow tongue

Your tongue can start to look yellow if you don’t brush it every day to remove bacteria. But it can also appear yellow from smoking and alcohol or become stained from drinking lots of tea and coffee.

A blotchy, geographic tongue

If your tongue develops a pattern that resembles a map, you might have something called geographic tongue.

This happens when the top layer of your tongue sheds in uneven patches. It leaves behind smooth, red areas with a white border. Geographic tongue can affect anyone. It’s a harmless condition, but it may make your tongue more sensitive to spicy or acidic foods.

A painful or burning tongue

There are many reasons your might have a sore tongue. You might have bitten it by accident or burned it while eating or drinking something hot. Some conditions, such as oral thrush and vitamin deficiencies can also cause pain.

Your tongue can also become sore if you:

• eat lots of acidic foods, like pineapple
• have an ulcer or sore on your tongue
• take medications that cause dry mouth, like antidepressants or antihistamines

If you notice a burning or tingling sensation on your tongue without an obvious cause, you might have something called Burning Mouth Syndrome (BMS). This can also change your sense of taste and make your mouth feel dry. BMS is more common if you’ve been through menopause. If this happens, make an appointment to see a dentist. They’ll investigate the cause and refer you to a doctor or specialist if needed.

An ulcer on your tongue

An ulcer is a small, round sore that can form anywhere inside your mouth, including on your tongue. They often look like a blister and are usually caused by a minor injury, like if you:

• bite your tongue
• brush too hard
• wear dentures that don’t fit properly

You can also get an ulcer if you’re run down, stressed, lacking certain vitamins, or from infections such as herpes. Rarely, a persistent ulcer can be linked to mouth cancer.

Most ulcers heal on their own within a few weeks. But some people are prone to recurrent ulcers that appear for no apparent reason. If you have an ulcer that doesn’t heal within three weeks, or keeps coming back, get it checked out by your dentist.

How do you improve your tongue health?

To prevent tongue problems from developing, take good care of your whole mouth – including your teeth, gums and tongue.

• Clean your tongue twice a day with a soft toothbrush or tongue scraper to remove any bacteria.
• Brush your teeth twice a day using a fluoride toothpaste and clean between your teeth at least once a day.
• See your dentist for regular check-ups. They’ll look out for any early signs of problems with your tongue and mouth.
• Drink plenty of water to wash away bacteria and keep your mouth moist.
• Avoid smoking and limit your alcohol intake.

Remember that most tongue problems get better on their own within a few weeks. But if you have severe pain, or your symptoms last longer than three weeks, make an appointment to see a dentist. They’ll be able to suggest a treatment or refer you to a doctor or specialist for further tests if necessary.