Did you know that your tongue is one of the strongest muscles in the body? Not only that, your tongue is a vital part of daily living because it makes it possible to taste food, swallow, and talk. But, another important characteristic of the tongue is that it is a very good gauge of your body’s health; it can tell you a lot about your health. Your tongue can get diseases that may or may not be serious. A discolored or painful tongue may indicate serious health issues such as vitamin deficiencies, AIDS, or oral cancer.

Because your tongue is such an important indicator of other health issues in your body, at Sninski & Schmitt Family Dentistry we pay very close attention to your tongue when you are here for any kind of appointment, whether it is a dental cleaning and exam or for another dental issue in order to catch problems early. In this article, we cover common tongue diseases and what these may indicate for your general health.

A Healthy Tongue

A healthy tongue is typically pink in color, but can also vary slightly in dark and light shades. It is moist and may have a thin white coating on the surface. The top of the tongue is covered with small bumps called papillae. The majority of our taste buds sit on the papillae. There are some variations of texture of the surface of the tongue that are considered normal and healthy.

An Unhealthy Tongue

One of the first symptoms that is noticed when a tongue is unhealthy is a significant change in color from the normal pink shade. Other signs of concern include pain when eating, drinking, and swallowing as well as new lumps and bumps. Sores, discoloration, pain, swelling, burning, and noticeable changes in the texture or taste are a few signs and symptoms of tongue diseases.

Causes of Tongue Problems

There are a variety of things that cause tongue problems. Risk factors may include smoking, drinking alcohol, poor oral hygiene, viral infections, or a weak immune system. Most often, a tongue problem is a result of an underlying medical condition elsewhere in the body. 

Be concerned when you have these problems with your tongue:

  • Pain
  • Sores
  • Swelling
  • Changes in taste
  • Changes in color
  • Changes in texture

The Color of Your Tongue and Possible Tongue Diseases

Below are possible causes of tongue abnormalities based on the color. This is simply a guide. Be sure to consult with your doctor or dental professional immediately when you see any of these changes.

White Tongue

Thick white patches or lines on the tongue are one of the most common issues that affect a healthy tongue. Some of the causes are harmless while others need medication and attention.

Oral Thrush

Oral thrush is the Candida albicans fungus which creates thick white to green cottage cheese-like patches on top of the tongue as well as the insides of your cheeks.

Oral thrush is most common in these groups:

  • Infants and toddlers
  • Older adults
  • People with diabetes
  • People who wear dentures
  • People who use inhaled steroids for asthma and COPD
  • Smoking
  • Patients with a weakened immune system from having chemotherapy or radiation treatment for cancer


Leukoplakia is a condition that causes cells in the mouth to grow excessively. This, in turn, leads to the formation of white patches inside the mouth and on the surface of the tongue. Note that a major difference as compared to oral thrush is these white patches can’t be scraped off. A dentist usually diagnoses leukoplakia. Some cases are benign but others can lead to cancer. You need to have a biopsy performed to differentiate non-cancerous and cancerous leukoplakia.

Oral Lichen Planus

Oral lichen planus consists of a network of raised white lines on the tongue and inside the cheeks with a lace-like appearance. Sometimes the cause isn’t known, but generally, it is considered that lichen planus is a chronic inflammatory condition caused by an autoimmune response. It requires monitoring and typically it gets better on its own. Very rarely does this condition lead to oral cancer.

Red Tongue

The following conditions may cause your tongue to appear red or purple rather than pink.

B Vitamin Deficiencies

A red tongue can indicate B vitamin deficiencies, especially with folic acid (vitamin B-9) and cobalamin (vitamin B-12). Improving these deficiencies will improve the appearance in your tongue.

Kawasaki Disease

Kawasaki disease is a serious condition that is most common in children under 5 years of age. It causes a high fever and the tongue has a strawberry-like appearance. Not all cases are life threatening but Kawasaki disease may increase the risk of heart complications if not treated. 


Erythroplakia is a red area or lesion on the tongue that can’t be rubbed off. Except for the color, it is similar to leukoplakia. Erythroplakia has an increased risk of cancer as compared to leukoplakia. Therefore, a biopsy is recommended to rule out oral cancer.

Scarlet Fever

Scarlet fever often accompanies strep throat. It is a serious condition and requires prompt treatment. Like Kawasaki disease, scarlet fever can make the tongue look like it has strawberries on top of it. You may also see large bumps on the tongue.

Yellow Tongue

Yellow is usually a less serious tongue color. Bacterial overgrowth primarily causes yellow tongue. Other causes may include:

  • Smoking
  • Chewing tobacco
  • Taking certain vitamins
  • Psoriasis
  • Jaundice (rare)

Black and Hairy

A black and hairy tongue is not serious although it looks really bad. Usually, this is caused by a change in the normal bacteria in the mouth after antibiotic treatment. Other risk factors include poor oral hygiene, smoking, diabetes, dry mouth, and chemotherapy treatments.

Other Tongue Problems Not Related to Color

Here are some other problems that are not related to tongue color.

Tongue Pain and Soreness

There are many reasons why you may have tongue pain and/or soreness.

Injury or Trauma

If you injure your tongue, like biting it, you may develop a sore that lasts for several days and is quite painful. You may also experience soreness after eating or drinking something hot. Grinding or clenching your teeth can irritate the sides of the tongue and cause it to be sore.

Canker Sores

A canker sore is a common cause of pain on or under the tongue. Canker sores can occur anywhere in the mouth but are very common on the underside of the tongue. These sores typically appear as yellow-white round or oval and can have a red halo. Canker sores can come when you accidentally bite your tongue, use abrasive ingredients in toothpaste or mouthwashes, experience food allergies, or have vitamin deficiencies. Stress, anxiety, and hormonal changes can also cause canker sores. Canker sores are different from cold sores, which are caused due to the herpes virus. These usually go away without treatment after one to two weeks.

Burning Tongue Syndrome

Sometimes postmenopausal women develop this syndrome, making the tongue feel as though it has been burned. Other symptoms include increased thirst with a dry mouth and a change in taste.

Oral Cancer

Oral cancer causes pain in the latter stages. You should always consult a doctor when you have a lump or sore on your tongue that doesn’t go away after a week or two. Many oral cancers don’t hurt in the early stages.

Oral Herpes

The herpes virus causes pain and appears as fluid-filled lesions. It can occur anywhere in the mouth and usually heal in two or three weeks. Treating with antiviral medications can reduce the duration of the symptoms.

Contact Sninski & Schmitt Family Dentistry

If you have seen a change in the appearance of your tongue or are experiencing pain and soreness of your tongue and/or mouth, contact us at Sninski & Schmitt Family Dentistry. Our professional dental team is knowledgeable when it comes to the appearance of your tongue and how it relates to potential underlying health issues. Call us at our Holly Springs dentist office at 919-600-6262 and our Cary, NC dentist office at 919-467-2203 or fill out our contact form below to schedule an appointment.

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