See something funky in the mirror? From white spots to red bumps, a number of diseases can show up on your tongue. Here’s what to know about tongue pain and tongue disease.
You see: Strawberry Red
It could mean: You have a vitamin deficiency. A glossy, bright red tongue may be a sign your body is lacking iron or B12. “Vitamin B12 and iron are needed to mature papillae on the tongue,” says Naomi Ramer, DDS, director of Oral & Maxillofacial Pathology at Mount Sinai Hospital. “If you are deficient in those vitamins, you lose those papillae, which can make your tongue appear very smooth.”
In severe cases, this “balding” can cause pain when eating hot liquids or spicy food. Vegetarians are especially prone to low levels of B12, which is found in certain meats. “If you notice your whole tongue is a strawberry red color, and you are a vegetarian, ask your doctor about taking supplements,” says Dale Amanda Tylor, MD, MPH, general and pediatric otolaryngologist at Washington Township Medical Foundation. Notable vitamin deficiencies can also be associated with an autoimmune disease in the GI tract, in which the stomach doesn’t absorb vitamins.
You see: Brown or Black Fuzz
It could mean: You don’t have the best oral hygiene or tongue health. A tongue covered in dark hairs (actually called “black and hairy tongue”) may look nasty, but doctors agree that it’s not cause for major concern. “We have papilla, small bumps on the surface of our tongue, which grow throughout our lifetime,” explains Ada Cooper, DDS, an American Dental Association consumer advisor spokesperson and practicing dentist in New York City.
Papillae are normally worn down by chewing and drinking, but sometimes they can become overgrown, which makes them more likely to harbor bacteria or become discolored from food. This can cause bad breath or taste abnormalities. “Typically [black and hairy tongue] is brought on by smoking, drinking coffee and dark teas, or poor dental hygiene,” says Jack Der-Sarkissian, MD, a family physician with Kaiser Permanente in Southern California. “Removing the offending cause, like smoking, and brushing the tongue or using a tongue scraper, may be all you need.
You see: Cottage Cheese White
It could mean: You have a yeast infection. A lumpy, white-coated tongue could be thrush, an oral yeast infection caused by overproduction of candida. The condition is often linked to antibiotics. “Your tongue is home to naturally occurring bacteria and yeast. When you take an antibiotic, which selectively kills off bacteria, it can allow yeast, which is not killed by antibiotics, to take over,” says Dr. Tylor. Thrush, which might cause taste disturbances or a bit of pain, can also occur in those with weakened immune systems. Typical in young children, thrush also affects people with autoimmune diseases, people with diabetes that isn’t well controlled, chemotherapy patients, and the elderly. If you suspect you might have thrush, see your doctor. Unlike other yeast infections, thrush can’t be treated with over-the-counter products.
You see: Wrinkles
It could mean: You’re getting older (yes, even our tongues show signs of aging). Fissures and cracks in the tongue are typically harmless, but problems can arise if poor dental hygiene leads to infection within the crevices. “Once in a while a fungal infection can develop inside the clefts,” says Dr. Ramer. “You will suddenly have pain, a foul smell, and sometimes burning.” Often the infection is treated with a topical antifungal medication. Some dental appliances, like dentures, can also cause indentations on the tongue. “Make sure your dental fixtures fit well, drink enough water, and practice good oral hygiene like brushing your tongue,” says Dr. Der-Sarkissian.