What does your tongue say about your health?

Dental exam of a patient's tongue

You may not pay much attention to your tongue, but its appearance can give clues about your health, and not just your oral health. There are a lot of blood vessels in the tongue, so changes there can indicate high blood pressure, for example. During annual examinations, dentists often examine the tongue for engorged, or widened, vessels and may refer a patient for a check with a cardiologist.

The tongue generally should be pink and smooth with some small, shallow grooves and tiny bumps. Taste buds can collect bacteria and change their form or color. Generally, people can fight normal bacteria, but if you have a weakened immune system or other health concern, this can lead to certain issues.

Read on for some things to look for that might warrant a trip to the dentist or another health care provider.

Change in tongue color

Dark red

A dark red tongue could mean you're deficient in certain vitamins, such as folic acid or other B vitamins. These deficiencies can reduce your red blood cell count, which can make your tongue appear more red.

White

White on the tongue could mean a candida infection, also called a yeast infection or thrush, a fungal infection that generally doesn’t cause pain.

Leukoplakia also leads to white spots on the tongue and can be caused by tobacco, alcohol or friction from dentures.

Lichen planus is an autoimmune disease, meaning it causes antibodies to attack healthy cells, and can lead to white lines on your tongue and cheeks. Some similar autoimmune diseases can also affect the rest of your body, including your skin and eyes, so it’s important to get it checked.

Black

Black hairy tongue is caused by changes in the bacteria composition on your tongue and is usually not a cause for concern. Some bacteria consume iron and can appear black on the tongue.

Other colors

Different bacteria can lead to different discolorations on the tongue. If you notice something unusually, it’s always good to get a check to make sure there's nothing wrong.

Health issues a dentist can identify by looking in your mouth

Tongue bumps, sores or lesions

A tongue sore is usually related to trauma, like a bite or irritation from dentures.

Irritation from recurring trauma, like the rubbing of dentures, could cause a bump-like area of scar tissue to form, and that should heal within two weeks.

Also, lipomas, although not common on the tongue, may have yellowish color. These masses are loose from the tongue, will move when you push on them and generally are not concerning.

But if you have a hard sore that’s fixed to the tongue and it doesn’t heal within two weeks, it’s time to get to the dentist or doctor. That’s when we start to get concerned about squamous cell carcinoma, or other oral cancer. Cancer in the tongue can spread quickly due to the number of blood vessels there. So, if a sore isn’t healing up or getting smaller, make an appointment to get it looked at or biopsied.

Tongue cracks or grooves

Cracks or grooves in the tongue may be due to genetics or may be something certain people are born with and are usually of no concern. Sometimes, we see changes that could be due to different types of bacteria on the tongue.

Caring for your tongue

Take a look

Do a regular inspection. Once in a while, when you’re brushing your teeth, take a look at the color and feel for bumps.

Brush

When you brush your teeth, brush the surface of your tongue, not too hard and reaching as far back as possible with the toothbrush. Bacteria can accumulate in grooves and cause bad breath. Ten to 20 seconds of gentle brushing should be enough.

Visit your doctor or dentist

Visit your dentist regularly. And, if you ever experience anything concerning for two weeks or longer, make an appointment with your doctor or dentist right away.

Healthy teeth start here

Ohio State offers complete general and specialty dental care, including emergency care for patients of all ages.

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