What can your tongue tell you about your health?

09 December 2022

If a doctor asks you to "stick out your tongue", do you know what they're looking for?

In medicine, the tongue is regularly referred to as an indicator for overall health. The size, shape, coating, and colour of your tongue can impart lots of useful information about your health.

It could, for example, be an early indicator of a vitamin deficiency, an infection, or even oral cancer. That's why part of a dental check-up generally includes the dentist inspecting your tongue for cancerous warning signs.

Did you know?

Acupuncturists often check patients' tongues thoroughly because the back, middle, and front are thought to be linked to the lower, middle, and upper parts of the body.

What does a normal tongue look like?

When was the last time you looked at your tongue? If it's been a while, it might be worth checking it out in the mirror now. In the ideal world, it will be moist and slightly rough to the touch, pink in colour, and free of pain.

Did you know?

The little bumps on the surface of your tongue are called papillae and are home to your 2,000-4,000 tastebuds.

Why is my tongue white?

There are several reasons why your tongue could turn white. These include:

  • A build-up of cells on the surface, caused by food, caffeine/tobacco debris, or irritation from bacteria - this can often be gently removed by brushing with a soft toothbrush or tongue scraper designed for the job. It is important to keep well hydrated as this helps to keep debris from building up on the tongue.
  • Leukoplakia, often caused by smoking and characterised by slightly raised painless patches that cannot be scraped off - this is worth getting checked out by your GP as there is a small risk it could develop into oral cancer.
  • Lichen planus, a chronic condition that can come and go and which involves a white, almost lacy build-up on your tongue, coupled with soreness or a burning feeling - it can be treated with medication available from the pharmacy, but could last for several months. It is wise to see your doctor to make sure of the diagnosis and there are several treatments available.
  • Oral thrush, which is common in babies, smokers, people using steroid asthma inhalers (rinse the mouth with water after use), those who have taken antibiotics or chemotherapy drugs and people with dentures - this relatively harmless condition can lead to soreness and difficulty eating and drinking, but can usually be treated with over-the-counter medications and should clear up after a week.

Why is my tongue red?

If your tongue appears red rather than pink in colour, it could be a sign that you have a deficiency in iron, vitamin B12, or folate.

These minerals are important for your body, so if you notice your tongue is redder than usual, it's a good idea to make an appointment to see your GP.

Smooth red patches surrounded by a white outline, meanwhile, can indicate a condition called 'geographic tongue'.

This common condition has no ill effects as such; however, there are also no treatments available, and it may make you less fond of certain foods such as chilli.

Strawberry tongue is an indicator of scarlet fever, which can also cause a rash, a sore throat, and flushed cheeks (hence the name). It is important to get antibiotic treatment in these cases.

Know your numbers

Vitamin B12 or folate deficiency affects one in 10 people aged 75 or over and one in 20 people aged 65 to 741.

My tongue feels swollen - what does it mean?

An allergic reaction can make your tongue swell up rapidly. If this is the case, it's important to seek medical assistance quickly, as it could swell inside your throat and cause breathing difficulties.

Did you know?

Tongue inflammation is called "glossitis" and there are lots of different types.

Why do I get mouth ulcers?

Despite being sore and uncomfortable, mouth ulcers are mostly harmless, although they can indicate that your immune system is struggling, for example because you are fighting off a virus, you have an undiagnosed food allergy, or are very tired or stressed.

You can also get ulcers if you burn your mouth eating or drinking something hot, or if you bite your lip or tongue or scrape the inside of your mouth on braces, dentures, or rough fillings.

In children, larger yellow-grey mouth ulcers with red edges can be a symptom of hand, foot, and mouth disease, especially when accompanied by a high temperature, loss of appetite and/or a rash.

Importantly, an ulcer that does not heal after a few weeks and has no obvious cause should be seen by a doctor to rule out a cancer.

Can my tongue tell me I have oral cancer?

When diagnosed early, nine in 10 cases of mouth cancer can be completely cured through surgery without the need for further treatment such as chemotherapy.

So, it's worth keeping an eye out for early signs, many of which affect your tongue.

These include persistent lumps, loose teeth, numbness, and ulcers or red or white patches that last more than three weeks.

Factors that increase your risk of developing oral cancer include:

  • Smoking cigarettes or cigars.
  • Drinking more than the recommended 14 units of alcohol per week.

Know your numbers

Research suggests that around 25% of mouth cancers in the UK are caused by smoking, and around 35% by drinking alcohol. Around 25% of cases are cause by HPV2.

Six steps to good oral hygiene

  • 1 Drink plenty of water.
  • 2 Use a mouthwash or rinse with warm, salty water.
  • 3 Brush your teeth for two minutes twice a day with fluoride toothpaste and a soft brush.
  • 4 Gently brush or scrape the tongue with a soft toothbrush or tongue scraper.
  • 5 If you use an inhaler, rinse the mouth with water after use.
  • 6 Ensure braces and dentures are cleaned correctly and in good condition.

Fact or fiction?

Saliva keeps your mouth healthy.

Fact. So if your mouth is dry, try sucking sugar-free sweets or chewing sugar-free gum to activate the saliva glands. The most important way to prevent a dry mouth is to keep well hydrated.