In many of our discussions of oral health we emphasize the importance of brushing and flossing all sides of your teeth. But what if you begin to notice that your tongue is looking different? Did you know that brushing your teeth should include a semi-regular brushing of your tongue as well? Your tongue can become overgrown with bacteria just like your teeth. Let’s look at some common issues that can happen to your tongue, and what they mean.

A healthy tongue is light pink, flexible, and strong. It should have lots of small, regular sized domes- your taste buds- which are fairly uniform in size and do not change in size or shape. It should not have deep cracks or large raised bumps.

It’s fairly common to get a white coating across your tongue. Usually this is a build-up of bacteria or yeast in your mouth. Brush your tongue regularly and it should clear up your tongue of bacteria build-up. If your tongue continues to have a white coating, ask your dentist for their opinion. Some white coatings could suggest a fungal infection or an autoimmune condition.

It is normal for grooves in your tongue to get deeper as you age, but very deep cracks, especially those that appear suddenly, could be signs of an injury or underlying condition. Deep cracks have been connected to conditions such as Down syndrome, psoriasis, and Sjögren’s syndrome. If the underlying cause can be treated, treatment may help heal the fissures.

There are actually several potential causes of a tongue that appears to be scalloped, or have ripples along the edges. Generally, this happens to your tongue when it swells and becomes inflamed ( Macroglossia ), or when you (consciously or subconsciously) press your tongue against your teeth. Dehydration is a common cause, and is not serious. Hypothyroidism can also cause a swelling of the tongue which causes the scalloped appearance. If you believe your health is good and you are properly hydrating but your tongue continues to be scalloped, check with your dentist to see if anxiety, sleep apnea, TMJ, or something else might be causing it.

Your tongue may often be tender after an accidental bite, or if you have a developing canker sore. Usually localized tenderness is not cause for concern, unless they persist for weeks or don’t seem to heal. Tenderness or irritation all over your tongue can be a sign that you have a food allergy and have eaten something problematic for your body. As with any condition, if it worsens it is best to seek advice from a medical professional.

Flat white patches on your tongue that cannot be scraped off could be a sign of an oral cancer called leukoplakia. If you have these patches, it’s important to get in to see your dentist as soon as possible. It is always important to catch cancer as early as possible and treat it quickly.

A bright red, and especially a bumpy, tongue is an early sign that you may have Kawasaki’s disease. This is when you have inflammation all over your body and it can be a serious condition if you do not receive prompt medical attention.  A bright red tongue can also be a symptom of scarlet fever. If your tongue is bright red but very smooth and tender, consult with a doctor about your vitamin B3 levels.

Sometimes proteins on your tongue swell, causing food particles to get stuck. In that situation, your tongue takes on an appearance of hair- sometimes white, sometimes brown or black. A vigorous scrubbing of your tongue with a toothbrush or tongue scraper should remove these food particles. If you are unable to remove them yourself, see a dentist to evaluate whether they are a form of leukoplakia.  Those with an underlying condition such as Epstein-Barr or HIV are more likely to experience “hairy” tongue.

Cleaning your tongue should be a part of your regular hygiene routine, and examinations of your tongue are included in your semi-annual hygiene exam. Make sure to keep regular appointments with your dental hygienist!

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