Your eyes may be the windows to your soul, but your tongue may be the closest thing there is to a window to your health. A healthy tongue is pink, the edges are smooth, and the surface is covered with small bumps. Those bumps are called papillae and they’re there for several reasons, one of which is to help the tongue grip your food and move it around inside your mouth. Papillae are also home to the thousands of receptors (which we call taste buds) that allow you to taste what you’re eating. Unfortunately, not all tongues are healthy, pink, and smooth. So every once in a while (at least once a week), get in front of a mirror and give your tongue a thorough once-over, paying close attention to any unusual textures, colors, pain, or discomfort. Sometimes these things are no big deal and will go away on their own, but some tongue symptoms may indicate a larger health issue. So if you see anything that scares you (we’ll talk about that below), the pain doesn’t go away, or your tongue doesn’t return to its normal, pink, smooth self within a week or two, see your healthcare provider. Let’s take a look at some common tongue issues and what they might mean if you see one in the mirror.
There are actually a variety of ways whiteness can show up on your tongue. White lines on the tongue that look kind of like lace are called oral lichen planus. Brush your teeth a little more thoroughly and stop smoking, and they’ll go away. A white coating on the surface of the tongue is usually caused by drinking too much alcohol, smoking, and not brushing well enough. If the white coating looks as thick as cream cheese, you may have a yeast infection or thrush, both of which can be caused by taking antibiotics (which wipe out the “good” bacteria in the mouth), leaving the “bad” bacteria to run wild. This cheesy coating may also be caused by taking inhaled steroids (the kind you take if you’ve got asthma or lung disease). People with diabetes, who have a compromised immune system (such as people with AIDS), or who are on chemotherapy are especially susceptible to developing this condition. If you’ve got white splotches on your tongue, you’ve got something called leukoplakia, which develops when your mouth produces too many cells. It’s also common among smokers. Leukoplakia generally looks worse than it is, but because it’s sometimes a sign of oral cancer, have your dentist take a look at it.
If your tongue is red and you haven’t been drinking strawberry slushies or sucking on cherry lollipops, you may have a deficiency of vitamin B-12, iron, or folic acid. If you’ve also got a high fever, you may have scarlet fever or a condition called Kawasaki syndrome, so get in to see your healthcare provider as soon as possible.
Black, Hairy Tongue
As revolting as this sounds (and looks), it’s rarely serious. Remember those bumpy papillae? Well, they’re constantly growing. Most of the time, they get worn down by our eating, brushing, and so on. But some people’s papillae keep on getting bigger. And the taller they get, the more they get covered with bacteria, which can give the tongue a black, fuzzy coating that looks like hair. As with some of the white tongue conditions, this one is more common among people with diabetes or who are taking antibiotics or are on chemotherapy. Brushing the tongue 2-3 times every day with a soft brush usually takes care of the problem within a week or so.
Cracking or Fracturing
If your tongue looks like it’s got cracks in it, you may be dehydrated or be a mouth breather. Drinking more water will generally help.
Spots, Bumps, and Sores
Do not ignore these. Anything that doesn’t look right or feel right is worth getting checked out by a dentist or your regular provider. Seemingly insignificant sores that don’t go away—even if they’re not painful—could be stress, could be the result of a trauma (such as biting your tongue or burning it by eating something too hot), or they could be signs of cancer.
If the edges of your tongue are scalloped (a series of wavy indentations running along the sides), you may be pressing your tongue really hard against your teeth. That could be because your jaw is narrow and teeth are so close together that they aren’t giving your tongue enough room. Or it could be because your tongue is abnormally enlarged, probably by a thyroid condition. Your dentist should be able to help you figure out the source of the problem.