The appearance of your tongue can indicate a lot about your health. It’s a good idea to take a look at it on a daily basis, even if it feels fine. Bumps, patches, and spots can be harmless. But, sometimes the color and texture of your tongue can point to a possible vitamin and mineral deficiencies or illness. Such health issues as diabetes, deficiencies in vitamins and minerals like folic acid or iron, yeast infections, and cancer can be shown by the appearance of your tongue. Sninski and Schmitt make checking your tongue part of their dental checkups so they can address anything your tongue shows them. If you see any of the appearances in this article, contact your dentist for a checkup.

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Here are some appearances that can show up on your tongue and the conditions that can cause them.

Hairy-Looking Tongue

If your tongue has a hairy appearance, you might have “hairy tongue.” These hairs are proteins that change normal, small bumps into longer strands where food and bacteria get caught. They should disappear when you brush and scrape your tongue. If your tongue has hairy, white patches that you can’t scrape off, you may have oral hairy leukoplakia that affects people infected with viruses like Epstein-Barr, HIV, or cancer.

White Patches

If your tongue has creamy white spots, you might have thrush. Thrush is a fungal infection that often happens after having an illness or taking medications that can disrupt the balance of bacteria in your mouth. If the white patches look lacy, it could be lichen planus, which means your immune system is attacking the tissues in your mouth. If you see hard, flat white areas that can’t be scraped away, it could be leukoplakia, which is linked to cancer.

Black Tongue

Hairy tongue can appear black in color. However, your tongue can turn black after taking an antacid that contains bismuth. This is harmless, although shocking to see, and goes away after you stop taking the medicine.

Bright Red Tongue

A bright red tongue with raised spots like a strawberry can indicate an early sign of Kawasaki disease. Kawasaki disease is a rare serious illness that inflames blood vessels all over the body and is most often in children. A red tongue can also be a symptom of scarlet fever. If your red tongue is smooth and you have pain in your mouth, it could be a sign that you don’t have enough vitamin B3.

Burning Tongue

If your tongue feels like you scalded it with hot coffee and tastes metallic, you could have burning mouth syndrome, which is a problem with the nerves in your tongue. A burning tongue can also be caused by dry mouth, infections, acid reflux, and diabetes.

Smooth Tongue

Your tongue is supposed to have small raised bumps on it. If your tongue is smooth and looks red, you may not be getting enough nutrients like iron, folic acid, or B vitamins. Certain infections, celiac disease, and some medications can also cause this.


Bumps under the tongue can be canker sores which are small, painful, reddish bumps that pop up and then go away. If you have a single, painful bump on the side or tip of your tongue, you may have simply irritated the tongue with acidic food or from biting your tongue. A virus can also cause lots of little bumps on the tip and sides. These are not very significant. However, if you have a lump on or under your tongue that hurts and doesn’t go away after a few days, let your doctor or dentist know. They will check you for oral cancer.

Sore Tongue

There are many nerve endings in your tongue that can hurt if you bite or injure it. Canker sores, lichen planus, thrush, and geographic tongue can cause pain. Medications and infections can also make your tongue sore. Sometimes pain in your tongue can be a sign of cancer, especially when you also have a lump or red or white patches. Be sure to see your doctor or dentist if this is the case.

Overly Large Tongue

When your tongue is too big as compared to the rest of your mouth, it is called macroglossia. Your tongue can be so large that you can have imprints of your teeth on the sides. This could be due to hypothyroidism, infection, or allergies.

Fissured Tongue

A tongue that is fissured has deep grooves in it. This can come from aging, Down Syndrome, psoriasis, and Sjogren’s syndrome. Basically, these fissures are harmless and can improve after the doctor treats the condition that is causing them. Gently brush your tongue to clear food and bacteria that will get caught.

Signs of Oral Cancer

Many of the spots, bumps, and colors on your tongue are innocuous. But sores that don’t heal, lumps, tongue pain, trouble chewing or swallowing can indicate cancer. If you have any of these symptoms and they last more than two weeks, see your doctor or dentist.

See Sninski & Schmitt Family Dentistry

If you are experiencing a different appearance on your tongue, not your usual, see us at Sninski & Schmitt. If you are looking for a dentist in Cary or Holly Springs, contact us. We take a wide variety of insurance plans and are currently accepting new patients. Reach us at our Holly Springs dentist at (919) 600-6262 and our Cary, NC dentist office at (919) 467-2203. Or, you can also fill out our contact form to schedule an appointment.