Tongue facts

The tongue is made up of a mobile group of muscles that is attached to the floor of the mouth. The top of the tongue is covered with small bumps called papillae. The majority of our taste buds are in these papillae.
The tongue is used for tasting, swallowing, and chewing food. The tongue is also used to form words for speaking. Typically, a tongue that is pink and moist with a thin slightly white, shiny coating on the surface is considered healthy. There are variations of surface texture that are normal and healthy as well. As many of us have experienced, a tongue injury (such as when we accidentally bite our tongue) can be quite painful since the tongue is such an instrumental part of our daily lives through eating and speaking. Though very few people know it, the tongue is actually a very good measure of the well-being of the body. This is why your doctor may use the tongue depressor to look in your mouth and tongue during an examination.
What are common tongue problems?
Some common problems associated with the tongue include:

discoloration,
increased size,
abnormalities of the surface,
growths (bumps), pain,
taste concerns, and
difficulty with movement.

What causes tongue problems?

There are a variety of causes of tongue problems, ranging from harmless to serious. Individuals can be born with a tongue condition that is harmless. A more serious condition such as tongue cancer can be related to risk factors such as smoking and drinking alcohol. Additionally, a tongue problem may be a result of an underlying medical condition.

What are the risk factors for tongue problems?

Depending on the tongue problem, risk factors may include smoking tobacco, drinking alcohol, poor oral hygiene, viral infections, a weak immune system, and even stress.

White tongue
Color changes related to the tongue can range from a benign concern to one that requires medical attention. Often, a white tongue could be caused by a removable coating of food debris or bacterial plaque. Otherwise, the following are some common causes of white tongue: oral thrush, leukoplakia, oral lichen planus, hairy leukoplakia, and linea alba. Oral thrush (or candidiasis) is caused by an overgrowth of yeast fungus in the mouth. The white patches can be scraped off to expose a red surface on the tongue. Illnesses, medications, stress, and antibiotic treatment can cause oral thrush by throwing off the balance of natural bacteria in the mouth. Those with diabetes are more prone to fungal infections, such as oral thrush. Lozenges, tablets, or liquid antifungals are used for treatment. Leukoplakia is characterized by white patches that cannot be scraped off and may be related to chronic irritation in the mouth, although the cause is not always known. Tobacco use is the most common factor that contributes to leukoplakia. The condition may resolve after smoking cessation. Sometimes the patches are on the sides of the tongue and could be related to constant rubbing next to the lower teeth. Although leukoplakia is usually benign, it can also be the precursor to oral cancer. The risk of cancer increases with the age of the individual, size of the lesion, and number of lesions present. A biopsy may be recommended after clinical evaluation by the doctor. Sometimes, the area can be monitored for changes by the doctor. Monitoring is usually performed during routine dental visits or during visits with an ear, nose, and throat (ENT) specialist. Oral lichen planus on the tongue is a chronic inflammatory condition caused by an autoimmune response (the body's immune system attacking its own tissue). It is characterized by a white lace-like pattern called reticular lichen planus. (There is an erosive form that presents as shallow ulcerations and can be treated with topical steroids.) Regular monitoring of this condition is recommended for any changes that (although rare) could lead to oral cancer. A biopsy may be recommended. Hairy leukoplakia is a white patch on the side of the tongue that appears hairy or rough. This condition is caused by the Epstein-Barr virus and is usually related to immunocompromised individuals. HIV testing should be considered if hairy leukoplakia appears without a known immune-compromising condition. Antiviral medications such as acyclovir (Zovirax) may be used. Recurrence of hairy leukoplakia is common. Linea alba is a benign condition that is characterized by a thin white line at the lateral (side) borders of the tongue. It is caused by the thickening of the epithelium due to trauma or irritation from chewing. No treatment is necessary for linea alba.

Red tongue

There are obvious causes of red color change of the tongue, such as something you ate (strawberries or red-colored foods). Some acidic foods can cause temporary redness and discomfort. However, a discolored red tongue can be a sign of an underlying medical condition. Some red color changes on the tongue ("strawberry tongue") could be related to a vitamin deficiency, Kawasaki disease, or a strep infection (scarlet fever).

Erythroplakia is a red area or lesion that cannot be rubbed off on the tongue (except for the color, it is similar to leukoplakia). A lesion with a combined white and red appearance is called erythroleukoplakia. These lesions are all considered to have premalignant potential. Erythroplakia and erythroleukoplakia have an increased risk of premalignancy compared to leukoplakia. In addition to appearance, there is concern if the lesion or sore does not go away or grows in size. A biopsy is recommended by an oral surgeon or an ENT specialist to rule out oral cancer.

Black tongue

Readers Comments 1
Share Your Story
A black tongue is usually a harmless condition that can be caused by medications, smoking, poor oral hygiene, soft diet, or dry mouth. A black tongue is usually associated with elongated tongue papillae and thus, it is called "black hairy tongue" (lingua villosa nigra). The cause is thought to be a change in the normal bacteria in the mouth after antibiotic treatment or use of products that contain bismuth such as Pepto-Bismol. ("Hairy tongue" by itself can also be white or tan.) Treatment may involve improving one's diet, smoking cessation, and improved oral hygiene (including gently brushing or scraping the tongue).

ncreased size or tongue swelling

Swelling or enlargement of the tongue, referred to as macroglossia, can be caused by allergies, medications, injuries, or an underlying medical condition such as amyloidosis. Addressing the underlying condition is the usual treatment for macroglossia.

Allergic reaction to medications, food, or even a bee sting can cause swelling of the tongue. In the case of sudden and rapid onset of swelling of the tongue, one should seek emergency care as breathing can become compromised.

Tongue swelling can also be a side effect of medication. Some medications that have this side effect are ACE inhibitors (to treat high blood pressure) and NSAIDs (nonsteroidal anti-inflammatory drugs) such as Aleve, Advil, and aspirin.

An injury from hot food or liquid that burns the tongue or simply biting the tongue can irritate the tongue to cause swelling.

Conditions such as oral thrush or oral herpes viruses can cause the tongue to swell due to inflammation. Other medical conditions include tumorous cancer, acromegaly (giantism), amyloidosis, sarcoidosis, hypothyroidism, and Kawasaki disease. Tongue swelling can also be found in individuals with Down syndrome.