Who knew that saying "Ahhh" could be so educational? You might think that a symptom on your tongue—such as an unusual color or texture—is no big deal, but what happens in your mouth can often be a helpful glimpse into your overall health. Sometimes symptoms that show up on your tongue can signal other health conditions, such as diabetes, vitamindeficiencies, and even scarlet fever.
To help you make sense of what you see in the mirror, we talked to two experts—Jeffrey Gallups, MD, medical director of The Ear, Nose & Throat Institute in Atlanta and Jamie Flohr, MD, an otolaryngologist atMidwest Ear, Nose & Throat Specialists in Woodbury, Minnesota. Take note: If any of these symptoms last for at least two weeks or if you're inpain, see your doctor.
If you notice this discoloration, "first try brushing your tongue each morning and evening for a week or two to make sure it's not an oral hygiene issue," says Flohr. If it lingers, it might be an overgrowth of candida (a.k.a. yeast or thrush). You're at a higher risk of developing this condition if you're on antibiotics, have diabetes, are on chemotherapy, inhale steroids to treat asthma or COPD, or have a compromised immune system. Candida is usually very treatable with an anti-fungal swish-and-spit liquid or pill. White patches could also be a sign of leukoplakia, which is often caused by tobacco or chronic alcohol use.Oral cancer can sometimes develop on or near these patches; if your doctor is concerned she'll perform a biopsy.
A Webbed or Striped Look
An appearance like this could signal a chronic condition called oral lichen planus, which occurs when the immune system attacks cells in the mouth. Middle-aged women are most commonly affected. If you're not experiencing pain, a doctor probably won't treat it, but he will likely monitor your symptoms, because you might be at higher risk of developing oral cancer in those areas. If you're experiencing pain, you might be given a drug, such as a corticosteroid, a retinoid, or an immunosuppressant.
Ridges or Indentations
Does your tongue have scalloped edges all of a sudden? These ridges may simply be due to the way your teeth press into your tongue, which often happens while you sleep. Those types of ridges are no big deal and will go away on their own, says Gallups. You might also see ridges if you have a fissured tongue. What's that? It's a long crack down the middle of the tongue, and it's just something you’re born with. "You can also have radiating fissures going perpendicular to the long axis," says Flohr. "It's normal; the problem is that sometimes food can get stuck in the fissures if they're deep enough." So don't forget to brush your tongue when you brush your teeth and avoid sticky foods when possible.
Seeing red? A rosy tongue can sometimes go hand-in-hand with a sore throat. "You could have scarlet fever, which is a bacterial condition that occurs in some people who have strep throat, and develop a strawberry tongue. This is usually associated with a really high fever and has to be treated with antibiotics," says Gallups. A red tongue could also be caused by atrophic glossitis (a.k.a. lost taste buds) due to a vitamindeficiency in folic acid, B12 or iron—in this case, the tongue is usually shiny. If your doc determines that's the problem, taking supplements that contain those particular nutrients may lead to an improvement of the condition. Another possible trigger: "We often see red tongues in people who have very dry mouths," says Flohr. "The tongue can feel sensitive and tender. For that, I recommend any over-the-counter product for saliva replacement, sipping on water often, and using sugar-free lozenges."
"Toward the back of your tongue there are taste buds that are bumpier and larger than the ones that hang out in front," says Flohr, and they're not usually a cause for concern. "Sometimes taste buds can be temporarily inflamed and get bigger if you eat something hot." Other common causes of bumps include canker sores and herpes (cold sores), both of which go away on their own but can be treated to speed healing and ease discomfort. For canker sores, you can use an over-the-counter ointment, avoid spicy and acidic foods, and gargle with baking soda and water. For herpes, a prescription anti-viral pill is needed. If you bite your tongue repeatedly, a lump called a fibroma could develop, which needs to be removed by a doctor. Any ulcer that sticks around and is firm could be a cancerous legion and should be biopsied. The good news is that more and more dentists are now monitoring patients' mouths for potentially cancerous lesions. (Here's how to prevent cold sores in the first place.)
Black and Hairy-Looking
Take a deep breath: This alarming-looking condition is actually benign. It's sometimes associated with antibiotic use, a yeast infection, diabetes,cancer therapies, or poor oral hygiene. It happens when "the cells on your tongue grow faster than your body can shed them," says Gallups. But rest assured that this condition generally goes away on its own. And don't worry—you don't have to shampoo your tongue. "The tongue isn't actually hairy. It just looks hairy," says Flohr.
Some people have a geographic tongue, which looks like a mixture of red and white spots (and sometimes like continents on a world map, hence the name). And these people will likely have it for life. "You have areas on your tongue where some taste buds have been worn down," says Flohr. "The spots might even seem to move, but it's not anything to get concerned about. There's no treatment for it, and it's actually pretty common." Some medical research has shown an association between geographic tongue and celiac disease, a condition in which the body's immune system attacks the small intestine when it ingests gluten—a protein found in wheat, rye, and barley.