19th January 2017

How Healthy Is Your Tongue? Common Tongue Health Problems

Your tongue can reveal a lot more than you might think about the health of your mouth. For clues about your oral health issues, you should be checking your tongue.

A healthy tongue should be a pink colour and covered with small bumps, which are called papillae. Any abnormalities in your tongue’s appearance, or any pain or soreness, could be a cause for concern about your overall health.

So, what are the common things to look out for on your tongue? Here is a guide to some of the signs you might spot that can signal oral health problems.

If you suspect you may have any of the conditions below, simply give your dentist a call so that they can assess your tongue for you.

What your tongue says about your health

To start with, you need to know: what does a healthy tongue look like? While healthy tongues may vary in the lightness or darkness of their shade, they should all be pink in colour.

There should also be small nodules all over the surface of the tongue, which are commonly known as the taste buds – these are papillae, which also help you to chew, swallow, and speak.

That’s how a healthy tongue should look, but what does an unhealthy tongue look like? Here are some examples of when the condition of your tongue may be concerning:

Your tongue has a white coating or white spots

Sometimes, tongues can develop a white build-up on the surface, but if this doesn’t go away after brushing, it could indicate a more serious oral health issue, such as:

Oral thrush

Oral thrush is a fungal infection that develops in the mouth. It appears as white patches that are often the consistency of cottage cheese, which can spread to the inside of the cheeks.

Oral lichen planus

Oral lichen planus is a network of raised white lines on the tongue. This inflammatory condition may look like a lace pattern on the tongue, and can sometimes clear up on its own.


Leukoplakia is a condition in which the cells in the mouth grow excessively, which leads to thick white patches on the tongue and inside the mouth. This cell overgrowth may be benign, but it can also be a precancerous condition, so it should be assessed by a doctor.

Your tongue is red in colour

It’s not unusual for a dark pink tongue to look light red, but if you have a bright red tongue, or a ‘strawberry tongue’, then it could be due to the following conditions:

Vitamin B deficiency

Not getting enough of certain vitamins, especially Vitamin B-9 (folic acid) and Vitamin B-12 (cobalamin) deficiencies, can cause your tongue to take on a reddish appearance.

Geographic tongue

Named for the map-like pattern of reddish spots that grow on the surface of the tongue, geographic tongue is usually a harmless condition. These red patches can have a white border around them, and their location on the tongue may shift over time.

Scarlet fever

Scarlet fever is a serious infection that causes the tongue to have a strawberry-like red and bumpy appearance. If you have a high fever and a red tongue, you need to see your doctor.

Kawasaki disease

Another condition that can also cause the tongue to have a strawberry-like look, Kawasaki disease demands immediate medical evaluation. It usually affects children under 5, causing high fevers and swollen, bumpy, red tongues, and can lead to heart complications if left untreated.

Tongue health

Your tongue is an unusual colour

Tongue discolouration can be common, often caused by the foods and drinks you consume – but if it doesn’t disappear after brushing, it could be something more serious.

Yellow tongue

A greenish yellow coating on the tongue can be caused by bacterial overgrowth, which occurs when you aren’t cleaning your teeth and mouth properly. Yellow or brown tongue discolouration can occur after smoking or chewing tobacco, or result from dehydration.

Orange tongue

Not as common as a yellow tongue, but similarly caused by poor oral hygiene or dry mouth in most cases, orange tongues can also result from taking antibiotics or eating a lot of foods that are high in beta-carotenes, like carrots and tomatoes.

Grey or black tongue

Conditions like geographic tongue or eczema can sometimes cause the tongue to turn grey, whether all over or around the edges. A grey tongue or dark grey-to-black tongue may also be an indicator of digestive issues like peptic ulcers or even diabetes.

Purple or blue tongue

Less common is a tongue with a purple-ish or blue tinge. A purple tongue may be seen with Kawasaki disease, but a blue tongue generally indicates lack of oxygen and poor circulation to the area, which can be a sign of heart, blood, or kidney disease. You should call your doctor or go to A&E if your tongue turns blue for no reason.

Your tongue is sore or bumpy

Painful lumps and bumps can develop from accidents like biting your tongue or burning it with hot food or liquid. However, if the bumps don’t heal within a few days, or the pain gets worse, it could be worth seeing a doctor or dentist to identify whether the cause is:

Mouth ulcers

The most common type of sore bumps on the tongue or gums are mouth ulcers, also known as canker sores. They can be caused by poor diet and stress, among other factors, but should heal by themselves within a couple of weeks.


Smoking cigarettes, vaping, or chewing tobacco can all irritate your tongue and the soft tissues inside the mouth, which can cause soreness. Smoking is also the leading cause of mouth cancer, which can develop in the tongue and throughout the oral cavity.

Oral cancer

Mouth cancer or oral cancer is a serious condition that can spread through the body if left untreated, which can be fatal. It’s worth getting chronic tongue lumps or sores checked out.

It’s crucial to catch it early, but many oral cancers don’t hurt in the early stages. A lack of pain doesn’t necessarily mean that nothing is wrong, so if you have a lump or sore on your tongue that doesn’t go away within a couple of weeks, this could be an indication of oral cancer.

Tongue health and oral cancer

Your tongue is black and furry

In the same way that your hair grows, the papillae on your tongue grow throughout your lifetime. Some people’s papillae can grow excessively long, which makes them more likely to collect bacteria that builds up over time.

When these bacteria grow, they may look dark or black, and the overgrown papillae can appear hair-like. Luckily, this condition is very rare, and is most likely to occur in people with poor dental hygiene, which is fairly simple to rectify.

While having a black hairy tongue is usually benign, you should still see your dentist as soon as you suspect anything is wrong with your oral health or your tongue. It may be nothing, but it’s always best to be safe rather than sorry.

When to see a doctor or dentist about your tongue health

Not only can tongue problems cause other symptoms like dry mouth and bad breath, but unusual tongue changes can also reflect your overall health. You should go to see your GP (primary care doctor) or dentist if you notice signs of an unhealthy tongue, like:

  • Long-term colour changes from normal pink to anything else
  • Swelling, thinning, lumps, or other changes in size and shape
  • Excessive dryness or a thick film developing on the tongue
  • Tongue pain when eating, drinking, swallowing, or speaking

The sooner you see a doctor or dentist, the sooner they can identify particular issues with your tongue, and you can receive any necessary treatment for them – such as:

  • Vitamin supplements for Vitamin B deficiency
  • Anti-fungal treatment for oral thrush
  • Antibiotic treatment for scarlet fever
  • Anti-inflammatory treatment for Kawasaki disease

In many cases, you can restore a healthy tongue simply by improving your oral hygiene.

Maintaining a healthy tongue

Tips to maintain a healthy tongue

With discolouration such as a yellow or white tongue or black hairy tongue typically caused by a build-up of bacteria from poor oral hygiene, the best way to keep your tongue healthy is to keep it clean and look after it as you would your teeth:

Brush your tongue

Just as you should be brushing and flossing your teeth daily to get rid of food debris and prevent plaque from forming, you should also be brushing your tongue.

Use a tongue scraper

To clean your tongue even more effectively, try a tongue scraper – a flexible plastic tool that helps to gently scrape away any residue gathered on your tongue.

Rinse and hydrate

Whenever you brush your teeth and clean your tongue, make sure to rinse your mouth out thoroughly – and keep drinking plenty of water throughout each day.

Monitor your tongue

If you know what your healthy tongue looks like as a baseline, you can look out for the signs in this guide to recognise when you should go to the dentist or a doctor.

Visit your dentist regularly

It’s important to attend regular check-ups with your dentist, at least once or twice a year, so they can examine your teeth and mouth and identify any concerns.

You should also be visiting a dental hygienist every 6 months to a year, who can professionally clean your teeth and tongue and recommend improvements.

Most dental practices also provide oral cancer screenings, which are available here at Dental Solutions. To book an appointment with us, please call 01925 756 565, or send an email to [email protected] and we will respond as soon as possible.

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