A healthy tongue is part of good oral health. Unfortunately, sometimes problems show up, in the form of tongue diseases. A lot of people have them. In fact, almost half of the world’s population has some form of oral disease. What types of tongue diseases exist, and how do you recognize them?

In This Article:

1. Anatomy of the tongue
2. Functions of the tongue
3. Oral health and the tongue
4. Tongue diseases: what are they?
   1. Some common symptoms of tongue diseases
5. Types of tongue diseases
   1. Geographic tongue
   2. Oral thrush
   3. Leukoplakia
   4. Oral Cancer
6. The color of your tongue can indicate problems
7. Oral health and tongue diseases

Anatomy of the tongue

The tongue is an important organ that we sometimes take for granted a bit. It actually plays an essential part in your oral health. The tongue is very muscular and has a complex structure involving interlacing muscles, nerves, and a rich blood supply. It’s covered with a mucous membrane. The tongue’s surface is covered with various papillae, or taste buds. The tongue itself is attached to the mouth’s floor. 

A healthy tongue is typically pink, with a thin whitish coating on the surface. The specific shades of pink range from light to dark.

Functions of the tongue

Your tongue has some important functions. We need it to be able to speak. The position of the tongue makes it possible to make specific sounds and form words. 

The organ is also part of eating and the digestive system. Your tongue makes it possible to taste different flavors. The basic taste sensations include sweet, salty, sour, bitter, and umami (savory).

It also maneuvers the food in your mouth to the right place, so you can chew it. The tongue helps portion it, so when it is small enough — and mixed with saliva — we can swallow the food. The tongue also helps oral health in general, as it makes sure food isn’t in contact with your teeth for a long time. Because food is often mildly acidic, contact could cause cavities in the long term.

Oral health and the tongue

As we’ve seen, the tongue helps us chew and digest food. It also makes sure food just doesn’t sit in our mouths for too long.

However, the tongue can also host a significant amount of bacteria. These occur particularly in the areas between the taste buds and other structures, on the surface. These bacteria form a biofilm, a community of microorganisms that stick to the surface of the tongue. This bacterial buildup can lead to halitosis (bad breath) and even tooth damage. Therefore, regular physical removal of these bacteria through brushing or cleaning is helpful.

Tongue diseases: what are they?

Tongue diseases are health conditions that affect your tongue, which is an important part of our oral health. These diseases change the way your tongue looks, feels, or functions. They range from harmless but annoying issues like geographic tongue to more serious conditions like oral cancer.

Some common symptoms of tongue diseases

Tongue diseases can present a variety of symptoms. Some common ones include:

• Pain or tenderness in the tongue, that makes it difficult to eat or drink.
• Smooth, red, irregularly shaped patches on the top or side of your tongue.
• White or grayish patches that you can’t wipe away.
• Unexplained numbness, loss of feeling, or pain and tenderness in any area of the face, mouth, or neck.
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal on their own.

Types of tongue diseases

There are various kinds of tongue diseases. These are some common ones.

Geographic tongue

Geographic tongue, also known as benign migratory glossitis, is a condition that affects the surface of your tongue. It is a harmless inflammation, that shows up as smooth, red patches on the tongue, sometimes with slightly raised borders. These patches often move around the tongue over time. They look a bit like a map, which is also where the name comes from. Sometimes the red spots are sore, especially when you eat spicy food.

The exact cause of geographic tongue is unknown. While it may cause discomfort or increased sensitivity to certain foods, it’s harmless. Treatment is usually not necessary unless symptoms are related to a fungal infection. If that is the case, medication may be prescribed to help ease symptoms.

Oral thrush

Oral thrush, or oral candidiasis, is a yeast infection in the mouth caused by a type of fungus called Candida. It starts with the development of white patches on the surface of the tongue and inside the mouth. Oral thrush is more likely to occur after the use of antibiotics, which can disturb the balance of natural bacteria in the mouth. Other risk factors include a weakened immune system, diabetes, and sometimes wearing dentures. 

If you think you have oral thrush, consult a doctor. The treatment is typically antifungal medications.

Leukoplakia

Leukoplakia is a tongue disease that causes the formation of white or grayish patches inside the mouth. These patches can’t be scraped off and are often quite thick. Leukoplakia is associated with chronic irritation from tobacco use — smoking or chewing. It can also be caused by damaged teeth that scrape the surface of the tongue continuously. 

Hairy leukoplakia, where it seems like there are hair-like growths, can be caused by the Epstein-Barr-virus, and typically occurs in people with a weakened immune system, for example by HIV.

Treatment usually involves removing the source of irritation. If the patches are large, they may need to be surgically removed.

Oral Cancer

Oral cancer can affect various parts of the mouth, not just the tongue. It can also show up on the lips, the gums, the lining inside the cheeks and lips, the floor of the mouth, and the hard palate, as well as the front two-thirds of the tongue.

There are risk factors for oral cancer. These include smoking, heavy alcohol use, excessive sun exposure to the lips, a weakened immune system, and infection with certain types of human papillomavirus (HPV). 

Symptoms of oral cancer vary. They include the appearance of a sore that doesn’t heal, a lump or thickening in the cheek, a white or red patch on the gums, tongue, tonsil, or lining of the mouth, and more. These are symptoms that also appear in other tongue diseases. 

Treatment options for oral cancer include surgery, radiation therapy, and chemotherapy. Oral cancer is diagnosed and treated by medical professionals. As dentists, we can perform the first screening. 

The color of your tongue can indicate problems

The color of your tongue can shift due to a variety of factors and might signal certain health issues. If the color change is persistent, please consult your doctor.

• Red. A red tongue can be a sign of a deficiency in B vitamins, scarlet fever, or a benign condition known as geographic tongue.
• Purple: This hue on the tongue could hint at heart issues or inadequate blood circulation.
• Blue. When the tongue appears blue it could suggest insufficient oxygen circulation in the blood.
• Yellow. Causes of a yellow tongue include smoking, tobacco chewing, jaundice, or psoriasis.
• Gray. A gray tongue might be due to digestive problems or eczema.
• White. White areas on the tongue are typically caused by fungal infections like oral thrush, or benign conditions such as leukoplakia.
• Brown. When there are brown stains on your tongue, it’s generally harmless and can be caused by your diet or certain foods and drinks, like coffee.
• Black. A dark brown to black tongue is most often caused by bacteria from poor oral hygiene habits. Diabetes is another potential cause of a black tongue.

Oral health and tongue diseases

Oral health plays a role in the prevention and management of tongue diseases. A healthy mouth can help prevent some tongue diseases, while poor oral hygiene can increase the risk of conditions such as oral thrush and leukoplakia. 

Your dentist can help with maintaining great oral health. We can give you advice and perform regular dental cleanings. We can also diagnose conditions by examining your tongue and mouth, asking about your symptoms, and sometimes using special tools for further evaluation. Furthermore, we can perform the first screening when there are signs of tongue disease. If it’s necessary, we can refer you to other medical specialists. 

As dentists, we can also help manage oral habits that contribute to certain conditions, such as tooth grinding or TMJ. We also help to relieve dry mouth or treat fungal infections. In some cases, we recommend lifestyle changes, such as improving oral hygiene practices or quitting smoking.