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Our tongue is an instrumental and vital part of the daily life. Because we use it constantly, it can be frustrating when we experience tongue problems, such as pain and soreness, swelling or changes in taste and color. Moreover, a discolored or painful tongue can indicate a more serious condition. Check out our simple guide so you can easily diagnose your condition and learn what you should do to improve the situation and prevent further complications.

Tongue Diseases, a complete guide

Last Updated: 12.09.2023

Author: George Ghidrai, MD  

The tongue is an instrumental and vital part of our daily life.

It is often hailed as "the strongest muscle in the body", as it is made up of a group of muscles that is attached to the floor of the mouth.


The tongue allows us to taste food, swallow and talk, and it can actually be a very good measure of the well-being of the body.

Because we use our tongue constantly, it can be frustrating and uncomfortable when we experience tongue diseases, including soreness or swelling, changes in taste or color and pain.

Many of these problems are not serious and most can be resolved quickly. However, in some instances, a discolored or painful tongue can indicate more serious conditions, such as vitamin deficiencies, AIDS, or oral cancer. For this reason, it is important to seek medical advice if you notice any annoying problems with your tongue.

The healthy tongue

A healthy tongue is pink and moist; sometimes, it may have a thin white coating on the surface. The top of the tongue is covered with small bumps called papillae. The majority of our taste buds sit on these papillae. There are some variations of surface texture that are considered normal and healthy as well.

What causes tongue problems ?

A variety of causes may lead to tongue diseases. Depending on the tongue problem, risk factors may include smoking, drinking alcohol, poor oral hygiene, viral infections or a weak immune system.

Some individuals are born with a tongue condition that is harmless while other tongue problems can be injury related. Additionally, a tongue problem may be a result of an underlying medical condition elsewhere in the body.

Generally, problems that can affect the tongue may be:

Next, let's look more carefully at the most common tongue diseases:

jump to tongue diseases infographic

White tongue

There are a number of things that can cause a whitish coating or white spots to develop on the tongue; the following are the most common causes of white tongue:

Red tongue

There are multiple factors that can cause a normally pink tongue to turn red. The first obvious cause may be something you ate, such as strawberries or red-colored foods or some acidic foods that can also cause a temporary discomfort. However, a red tongue can be a sign of an underlying medical condition. Some local conditions may also cause a red tongue:

Black hairy tongue

Generally, a black hairy tongue is nothing serious. Apart from the appearance, the condition is harmless and it typically causes no pain.

black hairy tongue

black hairy tongue

The small bumps on the surface of the tongue are called papillae. In some people, the papillae become excessively long which makes them more likely to harbor bacteria. When these bacteria grow, they may look dark or black and the overgrown papillae appear hair-like.

It is considered that one of the main causes of this condition is the change in the normal bacteria in the mouth after antibiotic treatment. Other risk factors include a poor oral hygiene, smoking, diabetes or a dry mouth.

Treatment may involve improving the diet, quitting smoking, and improved oral hygiene (including gently brushing or scraping the tongue).

Tongue pain and soreness

There are many things that can cause tongue pain or that can make your tongue to become sore:

Tongue swelling

When the tongue swells very suddenly, the likely reason is an allergic reaction. Allergic reaction to medications, food, or even a bee sting can cause swelling of the tongue, which can result in difficulty breathing. If this occurs, you should get medical help right away.

A swollen tongue may be a symptom of a disease or medical condition, such as Down syndrome, tongue cancer, an overactive thyroid or leukemia. Tongue swelling can also be a side effect of medication. For example, some medications used to treat high blood pressure (ACE inhibitors) or nonsteroidal anti-inflammatory drugs can have this side effect.

An injury from hot food or liquid that burns the tongue, or simply biting the tongue can irritate the tongue to cause swelling. Local conditions, such as oral thrush or oral herpes can also cause the tongue to swell due to inflammation.


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