No need to feel tongue-tied, thanks to our tongue health guide
We don’t think that much about our tongue – until something feels wrong. But did you know that you can learn lots about your overall health by looking at your tongue? From nutrient deficiencies to possible conditions, learn more with our helpful guide.
Why is my tongue health so important?
Lots of doctors and even dentists use your tongue as an indicator of your overall health – that’s one of the reasons why your GP might tell you to “open wide.” The colour, shape and size can all suggest to your GP different health conditions, deficiencies and infections.
If you look closely at your tongue, you’ll see that it’s covered in small bumps. These are called papillae, and they help you to eat and digest your food. (Papillae are also home to our taste buds!)
What does a healthy tongue look like?
A healthy tongue is pink in colour, moist and slightly rough when you touch it. It also shouldn’t hurt to touch. Different ethnicities might have a slightly purple or brown pigmentation, and there might be a slight white coating – this is the tongue’s keratin coating, which helps prevent it from being scratched whilst you eat.
Let’s take a closer look at your tongue health…
Why is my tongue white?
Bacteria build-up
Sometimes tongues have a faint white coating, which is the keratin coating and is normal. But, a stronger white coating could be a build-up of bacteria, which you can counteract by gently cleaning your tongue after brushing your teeth, either with your toothbrush or a tongue scraper. Sometimes this build-up can be caused by food, drinking too much caffeine or smoking.
Oral thrush
If you can see creamy white spots, it might be oral thrush. This is caused by an overgrowth of a certain fungus, and is common in babies, smokers and people using certain medicine. It’s relatively mild and can be treated with over-the-counter medications, but you might experience some soreness on your tongue. Find out more about oral thrush.
Oral thrush can also sometimes be the sign of something more serious, so if you are concerned, it is important that you speak to a GP.
Leukoplakia
If you have white patches with a slight red outline on your tongue and mouth and they can’t be brushed away, you might have leukoplakia. Although we don’t know the cause, it’s common in smokers, and if you suspect you have this, it’s really important that you go to the GP or dentist. This is because leukoplakia has a small chance of progressing into mouth cancer.
There isn’t a treatment for leukoplakia, and it typically goes away on its own over time, but cutting down or quitting smoking, reducing your alcohol intake and having a healthy diet can help reduce your chances of getting it again.
Mouth cancer
However, one of the symptoms of mouth cancer is white patches in your mouth or tongue. If you’re worried about whiteness on your tongue being cancer, have a look at the NHS’ guidance and visit your GP.
Why is my tongue hairy?
Don’t worry – your tongue isn't actually growing hair. A hairy tongue refers to the tongue’s papillae overgrowing, which makes it look furry or hairy.
Poor oral hygiene
If your tongue has a brown, black or white coating that looks hairy, it might be because of poor oral hygiene, heavy smoking, drinking too much coffee or an extensive use of antibiotics. Make sure to brush your teeth twice a day, including brushing your tongue, and use mouthwash to help give your tongue an extra deep-clean.
Hairy leukoplakia
A hairy tongue can also be a sign of hairy leukoplakia. Like leukoplakia, this causes furry, white patches on the tongue that can’t be cleaned off, but aren’t painful. If you suspect you have this, make sure to go to your GP, who can prescribe you antiviral medicines or treatments you apply onto the white patch. However, unlike other kinds of leukoplakia, this type doesn’t carry the risk of mouth cancer.
Why is my tongue black?
Poor oral hygiene
A black tongue is typically caused by poor oral hygiene, smoking, drinking too much alcohol or stains from food and drinks, and is often paired with bad breath. This condition might make you feel a little self-conscious, but it normally goes away on its own with good oral hygiene, limiting your alcohol intake or cutting down or quitting smoking.
Certain medicines
You can also get the appearance of a black tongue if you use a chlorhexidine mouthwash (these are often uses to treat mouth ulcers or other mouth infections) or the medicine type antacid that has bismuth. If you think your medication may be causing a black tongue, you should continue taking your medication as directed and speak to your GP
Why is my tongue bright red?
Sometimes, our tongues can look more red than pink because our tongue is reacting to the food or drinks we’ve had – a bit like if you splashed hot or ice-cold water onto your arm, your tongue might look redder than usual, and will go back to pink shortly.
Deficiencies
But, if your tongue has looked red for a while, it could be a sign that you have a deficiency in iron, vitamin B12 or folate. You can remedy this by visiting your GP, who can give you injections containing the missing nutrients, prescribe medication or by adapting your diet. You can find vitamin B12 in meat, fish, eggs, dairy products and specially fortified foods (these are foods with extra nutrients added, like some cereals, yoghurts and more) and folate in green vegetables like broccoli, brussels sprouts and peas. Similarly, you can buy vitamin B12 and iron supplements.
Geographic tongue
If your tongue isn’t fully red and instead has blotchy red patches, you might have geographic tongue.
Geographic tongue is an inflammatory, mild condition that affects the surface of your tongue. This happens when patches of your tongue are missing papillae (the pinkish white, hairlike structures on your tongue), so these patches look red and are smooth to the touch. This is called ‘geographic tongue’ because the patches make your tongue look a bit like a map.
This condition is mild, and the red patches are old layers of your tongue that haven’t come off yet. It’s normally painless but if you are experiencing soreness, you can be prescribed anaesthetic mouthwash or lozenges.
You can’t treat geographic tongue, but you can look after your oral health to make the condition easier to manage.
- Avoid spicy or acidic foods (like curries, citrus fruits, carbonated drinks, vinegar and more) as these will irritate your tongue
- Stop or cut down on your smoking
- Limit your alcohol intake
- Visit your dentist regularly, because sharp teeth or broken fillings can irritate your tongue
Kawasaki disease
A swollen red tongue, especially if you also have a high temperature, rash, swollen glands or swollen hands and feet, could be Kawasaki disease. This mainly affects children under five, and it means that the blood vessels become inflamed and swollen, which can cause difficulty in supplying blood to the heart.
If you suspect yourself or your child has Kawasaki disease, it’s really important that you call 111 or visit your GP as soon as possible. This condition can only be treated in hospital and can cause serious health complications if left untreated.
Why is my tongue burning?
Burning Mouth Syndrome (BMS)
We’ve all been there, and accidentally burned our tongue after sipping on a cup of tea that’s too hot. Thankfully mild burns on your tongue heal on their own — but if you have a serious burn, you should always seek medical attention.
If your tongue feels as though it’s burning and you haven’t burned yourself, it could be Burning Mouth Syndrome (BMS). BMS feels like a burning or tingling feeling in the mouth and is often paired with symptoms like a dry mouth or an altered sense of taste. It’s commonly found in people over 60, or those that are post-menopausal.
BMS may be caused by changes in hormones, medications, dry mouth and more. There’s no specific test for BMS; instead, you’ll be diagnosed based on symptoms, and might have to do some tests like blood tests, oral swab tests, allergy tests or more.
There isn’t one treatment for BMS; instead, you may be given different treatments based on what works best for you.
Why is my tongue sore?
Your tongue might be feeling sore for a number of reasons; you could’ve burned it, or you may have one of the conditions we talked about earlier. If you have any other symptoms, like your tongue has turned to a certain colour, make sure to have a look at that section in this article.
There are several things you can do to help relieve pain in your tongue, such as:
- Using a toothbrush to gently brush your tongue, or use a tongue scraper
- Taking paracetamol or ibuprofen, if suitable for you.
- Avoiding spicy, acidic or very hot food, or drinks that might irritate your tongue (like a hot coffee or frizzy drinks)
- Reducing or quitting smoking, and limiting your alcohol intake
Mouth ulcers and canker sores
Soreness on the tongue and in the mouth can also be a sign of mouth ulcers or canker sores.
Mouth ulcers typically clear up on their own after a week or two, and they have several causes, like biting the inside of your cheek, stress, hormonal changes or taking certain medicines. In fact, some people find that they develop mouth ulcers when they first stop smoking.
Canker sores also tend to get better after a couple of weeks (and you should go to your GP or dentist if they persist longer than that) and they look quite similar to mouth ulcers, but they’re caused by an underlying condition called aphthous stomatitis. People with this condition are likely to regularly have canker sores, however this is the only known symptom the condition has.
Aphthous stomatitis doesn’t have any treatment options, but you can reduce the risk of damaging the inside of your mouth and tongue by:
- Avoiding hard, crispy or crunchy foods
- Avoiding spicy, hot, sweet or sour foods
- Avoiding fizzy drinks
- Limiting your alcohol intake
- And of course, practicing good oral hygiene by brushing your teeth and tongue twice a day
Normally, you don’t need to go to the dentists or GP if you have a mouth ulcer or canker sore. But, if they don’t go away after two weeks, of if they’re particularly large and painful, you should visit your dentist or GP because these could be signs of mouth cancer. You should also see your GP if you have more than three mouth ulcers as this is a common symptom of HIV.
Why is my tongue swollen?
Allergic reactions
Sudden swelling of your tongue could mean you’re having an allergic reaction. You should call 999 as soon as possible if this is the case.
Macroglossia
However, if your tongue feels too big compared to the rest of your mouth, you might have macroglossia. This can be caused by several conditions and stressors, but if your tongue has suddenly changed shape, you should speak to your GP to make sure everything’s okay.
How can I look after my tongue health?
The number one way to look after your tongue is to practice good oral hygiene.
Our top tips:
- Brush your teeth for two minutes twice a day, and brush your tongue afterwards or use a tongue scraper
- Drink plenty of water, and drink fizzy or sugary drinks in moderation
- Eat a balanced, nutritious diet, and avoid eating lots of sugary food
- Use mouthwash or rinse your mouth with warm, salty water
- If you wear braces or dentures, make sure they’re cleaned properly
- If possible, visit the dentist regularly so any teeth troubles are spotted as soon as possible
- Limit or quit smoking, and limit your alcohol intake
When should I see a GP or dentist?
We’ve talked about lots of different possible conditions a change in your tongue could mean. Try to use your best judgement with whether you need professional help.
Signs of mouth cancer include white spots on your tongue and mouth ulcers that don’t go away after two weeks. Whilst these don’t always mean mouth cancer, if you’re worried about this or have other symptoms, you should go to your GP. Find out more on the NHS’ website.
Normally, if something feels wrong with your tongue, it isn’t anything to worry about. But, if you’re feeling concerned, it’s always best to visit your GP or dentist to be safe.
