Tongue problems – what to look for

Your tongue is good indicator of your body’s health, particularly of your digestive system. If you are healthy, your tongue should be moist, fairly smooth and slightly pink in colour. Variations in its normal colour, texture, or size can indicate tongue problems that can indicate an underlying health disorder. Keeping an eye on your tongue gives you a good early warning system; there are some tongue problems to look out for that mean you need to consult your GP.

This article on tongue problems is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Tongue problems that change the appearance of the tongue

The tongue is a very sensitive part of your body and any change in its size or in its texture and shape are very noticeable:

• Glossitis, the medical term for an inflamed and swollen tongue makes your taste buds become less prominent and your tongue appears smoother than normal. There are many reasons for tongue problems that result in swelling. It could be an infection such as a streptococcal infection in the throat, a hangover, or an allergy to food or medication. Tongue swelling is definitely one of those tongue problems to watch out for because it could be an early symptom of a more serious disease such as an overactive or underactive thyroid, leukaemia or a pituitary tumour.

• Geographic tongue is a condition in which you develop inflamed patches on the top of your tongue that are a different colour and texture to the rest of your tongue. These patches usually change in size and location over time, and give your tongue a map-like appearance. Sometimes, you may also experience accompanying tongue problems such as pain or burning. Geographic tongue problems can be the result of many conditions including increased stress, hormonal changes, or allergies to food or medication.

• A hairy tongue is one of the most harmless of tongue problems. The hairy appearance is actually your papillae (the small bumps on your tongue containing taste buds) that have become enlarged. Brushing the surface of your tongue usually solves hairy tongue problems, but if this doesn’t work, your doctor may prescribe antibiotics to reduce the size of your papillae.

Tongue problems and the colour of your tongue

If your tongue is not a normal pale pink in colour, this may indicate one or more tongue problems related to a disease or dietary deficiency. The following tongue colours may indicate disorders:

• Black: This is usually due to an overgrowth of bacteria in your mouth, which then accumulate on the papillae of your tongue to cause the discolouration. Black tongue problems could also be related to taking medication for an upset stomach.

• Pale: If your tongue is paler than its normal pink colour, this can indicate a deficiency in iron, otherwise known as anaemia. Pale tongue problems can also be an indicator that you are deficient in vitamin B12.

• Red: If your tongue is a dark red in colour, this can indicate the first stages of scarlet fever. In addition, tongue problems where your tongue is smooth as well as red can also mean a deficiency of vitamin B3, vitamin B12, or folic acid. Red tongue problems can also accompany glossitis (a swelling of your tongue).

• White: If your tongue has white patches, this can suggest various illnesses including thrush, leukoplakia (a pre-cancerous lesion on the tongue), the second stage of syphilis, or lichen planus. However, white tongue problems can also indicate that you have something as simple as dehydration. Your tongue can also become whiter if you are a smoker or heavy drinker.

Tongue problems and difficulty with mobility

If you find that you are unable to move your tongue as easily as usual, this may indicate that you have suffered damage to your hypoglossal nerve, which is the main nerve in your tongue. This can also be the result of ankyloglossia, a condition in which the tissue that attaches your tongue to your mouth is too short. If you have a loss of mobility in your tongue, this can result in difficulties with your speech, or difficulty in chewing and swallowing food.

Tongue problems that involve the whole mouth

One of the most common tongue problems is mouth ulcers. If you get a lot of ulcers this usually means you are suffering from stress or have a weakened immune system. Besides ulcers on your tongue, you can also have them elsewhere in your mouth, such as on the inside of your cheek or on your gums. You may also experience mouth ulcers where there has been aggravation to your tongue’s surface, for example if you’ve bitten it.

Many different tongue problems can affect your sense of taste. This can be the result of many things, including damage to your taste buds, side effects of medication, or an infection elsewhere in your body. It’s important to note that your tongue is only responsible for sensing sweet, sour, salty and bitter – other variations of taste come from your sense of smell, so a sinus infection will tend to affect your sense of taste and may make you more prone to mouth ulcers and give you a ‘furry’ tongue for a while.

Genetic tongue problems

Also one the most harmless of tongue problems, a fissured tongue is genetic. Some people are born with it but it may not be too obvious at birth. As they grow up, deep grooves form on the surface of the tongue. This inherited trait is quite common, occurring in roughly ten percent of the population.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors. 

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