What Does Your Tongue Say About Your Health?

Stand in front of a mirror. Stick out your tongue. Have a long hard look. Why am I making you do this odd little exercise? Because examining your tongue is something many people don’t take the time to do, yet this small little exercise can be like looking through a viewfinder to get a glimpse of your overall health. What you see on your tongue can tell you a range of different things - from simple things, like that you may have a vitamin deficiency, to indications of significant health threats like cancer.

Ok, so now I have your attention. Are you ready to compare whats going on on your tongue with the following signs? Grab your hand mirror, get comfy at your computer, and read on.

This may get a little graphic, so if you are the squeamish type, please read with caution.

Does your tongue have a white coating or white spots?:

Oral Thrush:

A white “cottage-cheese-like” coating on your tongue could mean you have a yeast infection. When this develops inside the mouth, it is referred to as Oral Thrush. It can lead to taste disturbances, pain, and discomfort, and indicates a weakened immune system. Either a yeast or fungal overgrowth can cause oral thrush, the most common being candida overgrowth. Antibiotics can cause this overgrowth to occur.  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. Dale Amanda Tylor, MD, MPH, General, and pediatric otolaryngologist at Washington Township Medical Foundation. Oral thrush is mostly seen in infants and the elderly or people with a weakened immune system. It can’t be treated with over-the-counter medicines, so see your doctor if you feel you may have a yeast infection.

Leukoplakia:

A condition where thick white patches form on your tongue and inside the mouth.  It is mostly caused by tobacco smoking. While it is not inherently dangerous in itself and often goes away on its own if you quit smoking, it can be a precursor to cancer. If you notice signs of Leukoplakia, then see your dentist right away for a full evaluation.

Is your tongue a bright red color but you haven’t eaten a bowl of beets?:

Vitamin deficiency:

A bright red tongue could indicate you are deficient in vitamins B12 and iron.

“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.” Being low in these vitamins can also cause a host of other symptoms such as low energy, anemia, heart palpitations, muscle weakness, and more.

Geographic tongue:

Geographic tongue is used to describe a tongue that looks like a bumpy terrain. This is a very normal and common condition. Affecting between 1-14% of the population in the USA. The cause isn’t known, but links have been drawn to taste buds: “Taste buds sometimes can randomly shrink away,” says Dr. Tylor. “They can regenerate, so some go away, and some don’t.” Typically geographic requires no treatment and will go away on its own, however, if it’s giving you pain, see your local GP. He may be able to prescribe anti-inflammatory steroid paste or antihistamine paste.

Is your tongue black and hairy?

This could mean you don’t have the best oral hygiene regime and you just need to give your mouth a good old scrub.

“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 a lot like hair; they can grow long making them more likely to harbor bacteria. When the bacteria grows, it can cause the tongue to look black, and the overgrowth of papilla can take on a “hairy” appearance.

A black hairy tongue is not common and most of the time can be corrected by practicing good oral hygiene and care.

Is your tongue sore and bumpy?

Canker sore:

Aka mouth ulcers are punched out sores either on the tongue or inside the cheeks. The exact cause isn’t known, but these lesions are common in people who are run-down, stressed, or have a viral infection. They can be very painful for the first 4-5 days but will slowly disappear within 2 weeks.  Treatments include gargling warm salt water, and eating soft foods until the swelling does down. Also, over the counter, anti-inflammatory creams can help manage the pain.

Oral cancer:

Persistent red lesions on the tongue that don’t go away can be a sign of tongue cancer. Get this checked out immediately by your GP. “With tongue cancer, you often think of an older, unhealthy person,” says Dr. Tylor. “But if you’re young and healthy and you have these, it doesn’t mean you’re OK. I’ve seen it in a 17-year-old girl.” Even if you have no pain still get it checked out as many oral cancers don’t cause pain in the early stages.

Ok so it's time – get in front of that mirror, stick out your tongue and look for the signs. If all is well, give yourself a pat on the back and get on with your day. If you see something a little worrisome then don’t wait to act, take the steps needed to correct the problem, after-all the tongue is a mirror to your health.