What your tongue says about your health
From colour changes to painful sores, a dental expert explains what to look for when checking to see if your tongue is healthy.
We all know how important looking after our teeth and our gums are, but have you ever stopped to consider the health of your tongue? It may be common practice to brush your teeth twice a day, but many of us are missing out on cleaning the rest of our mouth. In fact, one study found that only 18% of respondents cleaned their tongue every day, despite it being a vital part of oral hygiene.
And although this may not sound like a big deal, your tongue is in fact an extremely important indicator of your health, and we should be taking more notice of it. It’s not just there to help us chew, talk and taste, but can be a fantastic indicator of our overall health.
The tongue has a high density of blood vessels and a rapid cell turnover, making it highly responsive to changes in your body. It also interacts closely with the digestive and respiratory systems, so issues in these areas often manifest in changes to the tongue. Plus, small changes in colour and texture can highlight issues with your immune system and vitamin deficiencies.
And all of that aside, brushing your tongue can help with preventing bad breath and reduce your risk of cavities and gum disease. Still need more convincing?
With the help of Dr Sam Jethwa, founder of Bespoke Smile and President of the British Academy of Cosmetic Dentistry, here’s everything you need to know about your tongue and how to look after it.
Inspecting your tongue
Remember, no tongue is the same, however a healthy tongue should be pink in colour with small bumps on the surface which feel slightly rough. “These small bumps are called papillae,” says Dr Jethwa. “They have many functions including gripping food when eating and also contain your taste buds.”
The biggest things to look out for then is any changes to what your tongue usually looks like. “This includes abnormal patches that are raised or changed in colour, a swollen tongue, changes in texture, pain and a loss of taste,” he explains.
So, if you’re not already, start getting familiar with what your tongue looks like as this will make it easier to monitor any changes.
Things to look out for on your tongue
With your tongue’s ability to reveal important insights into your health, it’s important to take note of any changes in texture, colour and pain, and the appearance of any lesions or swelling. Here are some things to look out for on your tongue, and what they might indicate:
Colour changes
“Certain medications and foods can change the colour of your tongue, for example blueberries and red wine can leave a blue tint, but this should only be temporary,” he tells us. “Good oral hygiene and sipping water between mouthfuls when eating can help this.”
However, different changes in tongue colour could be an indicator of an underlying health condition. The most obvious one is a yellow tongue, which is often caused by smoking, or is a sign of poor oral hygiene. It is a result of a build-up of dead skin cells on the surface of the tongue and is often resolved by improving your oral hygiene.
A bright red tongue may indicate a vitamin deficiency like Vitamin B, or something called Kawasaki disease, known as ‘strawberry tongue’. Primarily affecting children under the age of five, this presents itself as a red, swollen tongue covered in small lumps and may also coincide with swollen or peeling lips.
“A red tongue with raised white patches can also be what we call a geographic tongue,” says Dr Jethwa. “This is a harmless condition and affects a small percentage of the population.” A geographic tongue may have red patches with white borders that migrate, and can be linked to things like allergies, or even stress.
Texture changes
If you notice grooves or cracks in your tongue, known as fissured tongue, this is usually a harmless condition, and treatment isn’t often necessary. However, according to the American Academy of Oral Medicine, good oral hygiene is really important to maintain if you have a fissured tongue, as the grooves can make you more susceptible to infections and irritation, while food getting trapped in the grooves can cause bad breath.
It's also important to be aware of something called ‘hairy tongue’, although Dr Jethwa assures us your tongue isn’t actually hairy. “It’s just referred to as this but instead the texture feels furry. This is caused when there is an overgrowth of papillae and a build-up of dead skin cells on the surface of the tongue. This can be caused by treatments like chemotherapy, diabetes, certain medications and poor oral hygiene.”
Lesions, swelling and pain
If you have a sore or bumpy tongue, with patches or spots on them, this can be caused by a multitude of things from trauma and burns to ulcers and canker sores.
Dark spots, white and red patches that don’t heal and persistent sores, are all important to take note of. While they are often harmless, they can be an indicator of other rarer conditions. For example, white patches could be a sign of oral thrush, while persistent sores could indicate an infection like herpes, or mouth cancer.
“If you have a tongue which is both persistently sore and bumpy after a few weeks, this may be a symptom of cancer, and you should seek medical advice,” advises Dr Jethwa.
What does it mean if I always get tongue sores?
Recurrent aphthous stomatitis (RAS), commonly known as canker sores, is the repeated formation of painful ulcers in the mouth and tongue, and is thought to affect 25% of the world’s population according to a 2023 study.
While irritating and painful, these are often benign but might signal an underlying health issue.
“Canker sores and ulcers are small patches which can occur on the tongue, inside of the mouth and on the gums,” explains Dr Jethwa. “Although small they can be very painful depending on the placement of the sore. They can occur due to trauma in the mouth, for example biting your tongue, braces, dentures, stress, anxiety, hormonal imbalances, food sensitivities and acidic foods. Bleeding canker sores and ulcers can be a sign of infection, especially when bigger than usual and last longer than 2 weeks.”
Possible reasons include:
- Nutritional deficiencies, particularly iron, vitamin B12 and folate.
- Stress and hormonal changes, especially when your immune system is weakened, or you’re menstruating.
- Food sensitives and allergies, particularly spicy, acidic or salty foods.
- Trauma and irritation from biting your tongue, braces or poor-fitting dentures and even aggressive brushing.
- Gastrointestinal disorders like Crohn’s disease or ulcerative colitis.
- Viral infections like the herpes simplex virus, hand food and mouth, or fungal infections.
Most ulcers and canker sores resolve themselves within a week to 10 days, but it’s important to go and get them checked out by your dentist if they recur multiple times a month, they are unusually large, painful and take longer than two weeks to heal, or they’re accompanied by other symptoms like a fever, or fatigue.
If you’re someone that that suffers with recurring sores, it’s important to understand what’s causing them, and work at trying to prevent them by avoiding trigger foods, managing stress and staying hydrated.
How to keep your tongue healthy
“Brushing your tongue whenever you brush your teeth is very important, this will remove food debris and dead particles,” says Dr Jethwa. “Plus, not doing so can cause bad breath. Tongue scrapers are a popular choice but be careful you are only using light pressure to avoid damage to the taste buds. A healthy diet and avoiding foods high in sugar and caffeine is also important for optimal tongue health.”
So, how important is a healthy tongue?
The health of your tongue is a vital yet often overlooked aspect of oral hygiene. While most people focus on brushing their teeth, cleaning the tongue is just as important with its ability to harbour bacteria and reveal early signs of potential health issues. While all tongues are different, a healthy tongue is typically pink with small bumps, and any changes in texture, colour, or the appearance of lesions can indicate underlying problems like infections, nutritional deficiencies, or rarer conditions.
Therefore, being aware of what a healthy tongue looks and feels like is crucial for monitoring your overall wellbeing. By incorporating tongue cleaning into your daily oral hygiene routine and addressing any abnormalities early, you can take proactive steps toward maintaining both oral and overall health.
And remember, any changes that you’re concerned about, or persist, should always be checked out by your dentist, or GP.
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All health content on goodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other healthcare professional. If you have any concerns about your general health, you should contact your local healthcare provider. See our website terms and conditions for more information.
