Black hairs and yellow coating: The tongue can tell a lot about your health. But you should also keep an eye on subtle changes
It's not for nothing that the doctor asks you to stick your tongue out at him during the check-up. In fact, this organ can point out a variety of diseases and other health problems. And even if such difficulties could otherwise be detected only by a more detailed medical examination. "Like the rest of the body, the tongue can be affected by systemic diseases," says otolaryngologist Bridget Burgess. "Unlike some bodily changes that can only be detected by blood or a specialized examination by a doctor, diabetes or immune deficiencies, for example, can manifest as changes in the tongue that can be noticed even by looking in a mirror."
Paying attention to your tongue has an added benefit, because "there are diseases that show up on the tongue almost immediately," as Mark Wolff, M.D., Ph.D., dean of the School of Dental Medicine at the University of Pennsylvania, explains. So you shouldn't just notice your tongue when you're not feeling well, but on an ongoing basis.
To recognize changes in your tongue, you need to know what a healthy tongue looks like. Fortunately, it's nothing complicated. A healthy tongue is pink and has tiny bumps on it - taste buds. Its shade can vary from person to person, both lighter and darker, as can its texture. It is therefore important to know the normal state of your tongue. And you can know that by paying attention to it continuously.
Colour changes in the tongue
If the colour of your tongue changes from the normal reddish pink, you probably have a health problem. This can be related to the tongue itself, the oral cavity or even the whole body.
- Dark red to purple - When your tongue starts to turn a darker shade of red or even purple, the cause may be a common deficiency of certain vitamins, but also a fever or infection. In more serious cases, it could also be a streptococcal infection known as scarlet fever or Kawasaki disease. The latter mainly affects children and its typical symptom is a deep red, so-called raspberry tongue.
- Yellow - A yellow tongue, or yellow coating on the tongue, can result from a bacterial infection in the oral cavity, poor oral hygiene or, for example, the consumption of alcohol, coffee or cigarettes.
- White - A white coated tongue is the main manifestation of oral candidiasis, a disease formerly known as powdery mildew - after the powdery texture of the coating. It is a yeast infection of the oral mucosa caused by an overgrowth of yeast. It occurs when there is a local or general breakdown of immunity, so you should definitely pay attention to it. It can be a concomitant of, for example, diabetes or blood diseases.
- Blue - A bluish tongue can indicate poorly oxygenated blood. This can occur, for example, with lung problems.
- Black - A black tongue sounds scary, but can be completely harmless. Most often the tongue turns black when something stains it black. Food dyes, activated charcoal can do this, but so can heartburn medications that contain bismuth (more specifically, bismuth subsalicylate). But a black tongue can also cause harmless bacterial oral disease. Bacteria that overgrow on the papillae (protrusions) of the tongue produce a dark dye. Sometimes the infection also disrupts the shedding of the outer layer of cells, the surface of the papillae grows and the tongue appears hairy.
Changes in the surface and shape of the tongue
In addition to the colour of the tongue, the surface and sometimes the entire shape of the tongue can change as a result of a change in health. These are various pimples, protrusions, boils and similar phenomena.
- Bumps on the tongue - Painful bumps and sores that are white in colour and sometimes bordered in red are most likely aphthae. They are characterized just by strictly local burning and hurting, and also by a pronounced annoyance - you constantly know about them. Smoking, biting yourself in the oral cavity or perhaps stress have an influence on their occurrence. They don't need medical attention, just increased oral hygiene or help with topical products from the pharmacy. However, you should see a doctor if they appear frequently or persist for a long time.
- Smooth and shiny tongue - The cause of an abnormally smooth and shiny tongue is often a vitamin and mineral deficiency. "All of a sudden your tongue starts to shine and lose texture," explains Dr. Wolff. "The tongue is a great place to see nutrient deficiency diseases right away." The missing substances in this case are vitamins D, B, iron or folic acid, for example.
- Scalloped edges and teeth marks - Scalloped and sort of "frayed" edges on the tongue are perfectly normal for some people, so it's important to know your tongue and notice changes over time. Similarly, tooth marks are often simply due to the way the tongue lies in the mouth. But they can also be caused by abnormal tongue size, which can have a variety of causes, from allergies to reduced thyroid function.
- "Cracked" tongue - If the surface of your tongue appears cracked, with deep fissures (not bleeding), the cause may be psoriasis but also the more serious Sjogren's syndrome, an autoimmune disease affecting the salivary, lacrimal and other glands. Cracked tongue is also associated with Down syndrome. And it also comes with age.
- Lesions and growths - Any growths, lesions, lumps, bumps, painful and sensitive areas or problems with swallowing and biting that do not improve or even worsen over a period of weeks require urgent medical attention. They may be harmless, but they can also be the early stages of tongue cancer. And it's just as serious as it sounds.
So take care of your tongue and pay attention to it, not just when it's in someone else's mouth. When you notice changes, whether in color, coating or texture, your first response should be great oral hygiene. And if the problems don't go away, then a visit to the GP and dentist.
