The tongue helps you eat, taste, and speak. But there is more to it. Your tongue is a mirror of your health and disease. For centuries, physicians have emphasized how tongue color, texture, and size can dictate if a person suffers from a systemic disease or deficiency. Interestingly, your tongue is one of the first organs to help decode certain diseases before other symptoms become evident. We bring you details on the link between the tongue and your body, and how the tongue can speak volumes about how healthy (or sick) you really are.
Tongue and health: what’s the link?
The tongue is a window to your systemic health. Here is the science behind it.
The dorsal surface of the tongue, made up of papillae, taste buds, and a mucosal coating, goes through consistent physiological changes. These changes are evident in its look, texture, or color and are often impacted by both local and systemic causes. Moreover, the bacterial composition of the tongue reflects the internal state of the body. Imbalances have been linked to systemic disorders, such as heart disease, diabetes, and respiratory infections. Interestingly, these imbalances frequently present as tongue discolorations and unusual textures.
Exploring tongue colors: in health and disease
A healthy tongue color can range from pale pink to pink-red, with a thin coating.
The color can vary between races and ethnicities. It also has tiny bumps (called papillae), giving it a coarse texture. Let's explore the common color changes, and what they indicate.
A fungal infection, such as oral thrush (also called candidiasis), can cause the tongue to pale and develop white, thick, and creamy patches. These patches are often described as cotton or cheese-like and can be painful. If you notice lacy white patches, it can be leukoplakia or lichen planus. Leukoplakia is a pre-cancerous lesion, while lichen planus is related to immune response.
Fever is a leading cause of a bright red and swollen tongue. It can be due to an underlying infection, an allergy, mouth ulcers, or even a continuous traumatic bite. A red and blanched tongue can indicate a vitamin deficiency, too. Red, irregular patches with a white border that come and go are characteristic of a harmless condition known as geographic tongue. In rare cases, if the tongue appears red and bumpy, just like a strawberry — your dentist can suspect Kawasaki disease. This disease involves inflammation in the blood vessels of the tongue and is seen in kids.
You can get a blackish tongue from coffee, black tea, smoking, or certain medicines. A buildup of keratin can cause the tongue to turn black, too. If the normal shedding cycle of the papilla cells is disrupted, they grow and appear as a hairy tongue. Foods, bacteria, and debris collect in these areas; with time, it turns black and smelly. So, a black tongue can indicate many things — from poor oral hygiene to more serious conditions like diabetes and human immunodeficiency virus (HIV) infections.
It might be due to poor circulation or cyanosis, a condition in which a shortage of oxygen in the blood causes a bluish or purple hue. Excessive cold can constrict the blood vessels, resulting in a transient purple tint on the tongue.
The yellow tongue color can be caused by bacterial accumulation as a result of poor dental hygiene or dry mouth conditions. Health conditions, like diabetes and jaundice, have also been linked to a yellow tongue.
A blue tint on the tongue may indicate low blood oxygen levels. These can be caused by a number of conditions, including renal disease, blood problems, and inadequate oxygenation from the lungs. Low blood oxygen levels need prompt medical care.
Consuming foods or beverages containing strong green pigments, such as colored sweets or dyed drinks, can tint the tongue green. Another typical reason for a green tongue is a chronic bacterial buildup on its surface.
Geographic tongue and oral lichen planus are two conditions that can cause uneven, greyish-white patterns on the tongue. Regular smoking and taking certain drugs can cause changes in tongue color, potentially resulting in a greyish tint.
Importance of tongue size
Your tongue should feel comfortable in your mouth. From a dentist's perspective, it should be long enough to just touch the tip of your palate at rest. While there is no standard size for a tongue, certain traits can ensure if it's too large or short.
A large tongue is called Macroglossia it can trap between teeth edges while chewing or talking. At times, it can also feel uncomfortable to keep your tongue inside your mouth. You also run the risk of gasping and choking for breath at night. Large tongues can run in your family or be due to diseases. Down syndrome, acromegaly, and congenital hypothyroid are frequent causes of this. Sudden, severe allergic reactions can also cause a swelling of the tongue, which might appear as enlarged. This condition needs immediate medical attention.
A small-sized tongue, called microglossia, can be due to developmental anomalies, like a small lower jaw (as in Pierre Robin syndrome). This happens because the tongue muscles grow as the jaw develops.
Whether the size is too large or too small, it can cause difficulties in your daily activities. It can turn into a constant embarrassment and limit a good quality of life.
Tips to keep your tongue healthy
Some tongue changes need medical attention, others get better with good oral health practices. Here are a few tips to keep your tongue healthy:
- Maintain good oral hygiene. Brush regularly. Use the back of your toothbrush to brush off your tongue, too.
- Drink water. Water cleanses your mouth. It's best to swish your mouth with water after meals. Every time you drink water, it washes away the loose debris and remaining food particles.
- Use a tongue scraper. If you suffer from frequent tongue patches and build-ups, try a tongue scraper.
- Quit tobacco. Tobacco is cancerous, and it's best to quit smoking it.
Foods to keep your tongue healthy
Other than these habits, here are some foods to keep your tongue healthy.
Probiotics, like yogurt, help maintain a healthy oral microbiome, often crucial for a healthy-looking tongue.
Leafy greens and colored vegetables are rich in vitamins and antioxidants. Enough vitamins help prevent deficiency, which is often manifested as a pale, swollen tongue prone to recurrent ulcers.
Carrots, apples, and guavas that have a crunchy and coarse texture act as a cleansing agent for the tongue. Eat them often and chew them well.
Celery is high in vitamin K. It also acts as a natural cleanser, prevents infections, and stimulates salivation. When saliva flow increases, it washes away food debris and bacterial germs from the mouth and keeps the tongue healthy.
Coconuts, chopped garlic, ginger, and onions fight the bad bacteria on your tongue.
Try to include foods high in iron in your diet. Spinach, shellfish, and poultry can improve the health of your tongue.
Grapes, oranges, and other citrus fruits contain vitamin C, which strengthens the blood vessels and connective tissue within the mouth. They are good for keeping the tongue muscles strong and healthy.
Keeping tongues healthy in children: for parents
For parents, maintaining a healthy tongue for their child can be challenging. Here is a 3-step breakdown to help you in the process.
- Educate and make aware. Teach your child the value of tongue health and how it affects overall health.
- Monitor their oral hygiene routine. Help your kid with their oral hygiene regimen until they can manage it on their own. Once they can, keep track of their habits.
- Encourage regular dental checkups. Here you can lead by example. Make it a habit to visit your dentist every 6 months for the family; see your child imbibe the same.
Tongues tell a lot about your health. It's important to be aware of the indications when you see color or texture changes in your tongue. See a dentist when you suspect something amiss. That is the best way to prevent complications and detect diseases early on.
What are the warning signs on tongue?
Your tongue may reveal a lot about your overall health. White tongue can indicate leukoplakia, lichen planus, or oral thrush. A dark and hairy tongue might indicate poor dental hygiene or diabetes. If your tongue is brilliant red, like a strawberry, it might indicate folic acid, vitamin B12, or iron deficiency.
How can I improve my tongue health?
Brush regularly. Drink plenty of water and consume leafy veggies. Use a tongue scraper to clean the back of your tongue. Quit smoking and tobacco. Be aware of any changes in your tongue and seek medical support.
What does stress tongue look like?
Stress tongue or anxiety tongue is unique. Excessive stress might manifest itself on your tongue as red blisters and ulcers (canker sores). Also, if your tongue looks to have marks around the margins, this might indicate that you bite your tongue often to control stress.
Your tongue is a mirror of your health conditions.
Changes in the tongue color, texture, and size can indicate related health issues. They can be minor or serious.
Proper oral hygiene, good food habits, and enough water can help maintain a healthy tongue.
Talk to your dentist if you suspect anything unusual about your tongue.
- Journal of Chemical Health Risks. What Your Tongue Color Can Tell You: Understanding Your Health.
- Hygiene. Microbiota of the Tongue and Systemic Connections: The Examination of the Tongue as an Integrated Approach in Oral Medicine.
- National Institutes of Health (NIH). Macroglossia.