When most people think of oral health, they focus on their teeth. However, their tongue may be trying to tell them something about their health. Tongue health is the most frequently overlooked aspect of oral hygiene, so we’re here to educate readers on everything our tongues do for us, and why they require plenty of attention and TLC (i.e. using a tongue scraper).

What’s a Tongue Anyway?

The tongue functions as both a muscle and an organ. It’s the first step in the digestive process, breaking down food via enzyme-containing saliva and facilitating swallowing. More obviously, the tongue also allows people to both talk and taste. Those little bumps all over the tongue are a combination of papillae and taste buds, all working together so the mouth can conduct its regular functions.

The tongue also works as a beacon, giving people a peek into what’s going on inside the body as well as the status of their oral health. By understanding differences in color, coating, lumps, bumps, and cracks, people can assess their health as soon as something comes up rather than waiting for a more drastic sign from elsewhere in the body. 

Tongue Health – The Body’s Mood Ring

As fun as they can be, we all know those trendy little mood rings are only that: fun. However, tongues are an actual “mood” ring, allowing us to get a peek at both our oral and bodily health. The tongue is the only internal muscle we regularly see (because it isn’t covered by skin), allowing us to check in with our bodies. Because of its composition, the tongue will frequently be the first sign that something is wrong in the body, and it almost always begins with color changes. That is, of course, if we’re paying attention. Colors to look out for include:

• Pink – A pink tongue is a healthy tongue. There may be slight changes in the color from person to person, but the color is a relatively uniform pink with a light coating and papillae and taste buds over the surface of the tongue.

• Red – Red tongues are usually a sign of inflammation, either in the tongue itself or due to a specific illness such as scarlet fever. However, a B12 deficiency can also cause a red tongue. If your tongue looks unusually red, you may want to get your B12 levels checked as it’s not uncommon for the deficiency to be misdiagnosed as something else, such as burning mouth disorder.

• Purple – Purple tongues are frequently tied to poor circulation either due to an underlying condition or illness. In 2019, the Korea Institute of Oriental Medicine released a study that found people who suffered from COVID may develop a purple tongue due to issues with microcirculation.[i] Other causes of purple tongues include Kawasaki disease and trauma to the tongue.

• Blue – Blue tongues can be scary if someone has never seen them before. Although frequently tied to a lack of oxygen, blue tongues have also been linked to eczema.[ii]

• Orange – An orange tongue is frequently tied to thrush, poor oral hygiene, and taking certain medications, including antibiotics. However, our favorite cause is too much beta-carotene (the pigment that makes carrots orange), also known as carotenemia. This harmless condition can resolve itself when someone cuts down on how many beta-carotene-rich foods they eat.

Coating Colors

In addition to the color of someone’s tongue, they also need to look at their tongue’s coating. Tongue coatings are normal in small amounts, but an excess of coating or an unusual color can mean a larger health issue is at play.

• Black – Black or dark brown coatings are frequently partnered with a “hairy” appearance. This condition can be benign, but it can also mean the sufferer has diabetes. Other conditions tied to a black tongue include poor oral hygiene, smoking, and the use of antibiotics. [iii] Often, a thorough tongue scraping is all that’s needed to alleviate this discoloration.

• Yellow – Although minor yellowing is usually a sign of a bacterial overgrowth that can be alleviated simply by cleaning the tongue, a bright yellow tongue should be examined by a professional.
• White – A white or thick coating on the tongue is usually caused by poor oral hygiene or sleeping with the mouth open. Another common condition is thrush, an overgrowth of yeast in the mouth. However, a white coating can also signal more serious health conditions, such as leukoplakia or mouth cancer, especially if they appear in patches.

• Green – Just like yellow discoloration, green coatings are frequently tied to poor hygiene or thrush. However, green tongues have also been linked to fungal infections.

What Is This Bump, Crack, Lump?!

Tongues have a unique texture that helps them do their job, but sudden changes may be alarming. The most common causes of changes to tongue texture include: 

• Bump - Bumps in the tongue are usually just papillae and taste buds. They may sometimes become inflamed, resulting in a larger size, but it’s often nothing to worry about unless it’s accompanied by persistent pain. Someone may also develop a bump after injuring their tongue or due to allergies or illness.

• Crack – Cracks are frequently tied to geographic tongue. According to the American Academy of Oral Medicine, a geographic tongue is “an inflammatory disorder that usually appears on the top and sides of the tongue.”[iv] The tongue can take on an appearance of patches that resemble a globe (hence the name) or may feature deep cracks. No one knows exactly what causes the disorder, but it’s suggested as a form of psoriasis. Most people won’t need to treat the condition, but extra care should be taken in keeping the tongue clean.

• Lump – When people think of lumps, their brains tend to go to cancer. Although that is a valid concern, especially if someone is older than 60, lumps can also be caused by benign growths, blocked ducts, infection, illness such as sarcoidosis, and dry mouth. Anyone who gets a lump under their tongue should have it examined by a medical professional.

How to Keep Your Tongue Healthy                 

Prioritizing tongue health is important for a healthy body. By keeping an eye out for changes and giving it the care it needs, you can keep your tongue (and body) looking and feeling great. Here are a few of the best habits for optimal tongue health: 

• Tongue Scraping - We discussed the benefits of regularly scraping the tongue here, but it’s important to emphasize just how important tongue scraping is for tongue health. In addition to brushing the tongue, regular tongue scraping keeps your breath smelling better, reduces the chance of developing gum disease, and even improves the taste of food. Choosing the right tongue scraper can improve one’s oral health in spades.

• Stay Hydrated – We get that it’s irritating to constantly hear about the importance of drinking water, but it’s truly a building block in life. Taking the time to drink plenty of water can prevent your tongue from thinning out as well as cut down on the number of bacteria and fungi that naturally grow in the mouth. If fitting in enough water is a chore, some people have success with drinking green and herbal teas to help them fit in enough water each day.

• Eat Healthy – A proper diet not only helps your body function better; it also helps keep oral care in check. Consuming a diet with plenty of fiber can reduce the tongue’s coating as well as prevent oral issues, like cavities, from developing.
  
  
• Brush Your Tongue – In addition to daily scraping, people should be brushing their tongue with their toothbrush as well. This can help remove or loosen stuck on food particles, bacteria, and sticky tongue coating. Giving the tongue a good scrub before scraping helps tongue scrapers work better as well!

• Monitor – In addition to tongue scraping, the most important thing to do for tongue health is to regularly monitor the tongue. Changes in color and texture as well as new bumps and cracks can signify an underlying health condition. By taking the time to examine our tongues each day, we can potentially ward off serious health conditions.

Keeping a tongue healthy is integral to good health. Although we’re not frequently taught good tongue hygiene when we’re children, taking steps to begin caring for the tongue properly as an adult can help us all to live healthier lives. To get the best care for your tongue, you need to invest in proper oral hygiene supplies. Click here to get everything you need for a happy, healthy mouth!

Sources:

[i]Lehman, J.S., Bruce, A.J. and Rogers, R.S., III (2006), Atrophic Glossitis from Vitamin B12 deficiency: A case misdiagnosed as Burning Mout Disorder, Journal of Periodontology, 77:2090-2092. https://doi.org/10.1902/jop.2006.060169

[ii] Yu, Z., Zhang, H., Fu, L., Lu, X. (2017) Objective research on tongue manifestation of patients with eczema, Technology and Healthcare: Official Journal of the European Society for Engineering and Medicine 25(S1):1-7.

https://www.researchgate.net/publication/317321668_Objective_research_on_tongue_manifestation_of_patients_with_eczema

[iii] Kalkan, G., Bas, Y., Seckin, H.Y., Karahan, S. (2014) Black hairy tongue in a 65-year-old diabetic woman, Selcuk Tip Derg, 30(13) 184-185 https://www.selcukmedj.org/uploads/publications/SUTD-500..pdf

[iv] American Academy of Oral Medicine, (2022), Geographic tongue, aaom.com https://www.aaom.com/geographic-tongue