The tongue often times gives clues to a person's general health. It's one of the first ways to know that something is wrong.
Most tongue changes noticed by patients are normal and not a cause for concern.
However, many diseases affect the tongue, such as:
Cancer: squamous cell carcinoma, melanoma
Anemia
Vitamin and mineral deficiencies
Infectious diseases: HIV, herpes, genital warts, varicella zoster
Autoimmune disorders
Gastrointestinal disease
Common issues affecting the tongue:
Canker sores: one of the most common causes of sores in the mouth
More common in adolescence and young adulthood
Becomes less frequent in adulthood
Not contagious
If recurrent sores occur, this may be a sign of underlying disease
Tongue Fissures:
Grooves in the tongue
can lead to a build-up of bacteria and bad breath
Tongue discoloration (example, Black Hairy Tongue):
Caused by foods we eat
Tobacco
Antibiotics
Pepto Bismal
Dehydration
Treatment: good oral hygiene, cleaning of the tongue with scraper or toothbrush
Tongue changes that should not be ignored:
Thrush: Thick white coating or white plaques on the tongue which may be associated with burning. Caused by a build-up of yeast in the mouth
Compromised immune system from HIV/AIDS or other illnesses
Certain medications, such as oral steroids, steroid inhalers for asthma, antibiotics
Cancer and its treatment
Diabetes: when it is poorly controlled or a person doesn't know they have it, there can be an overabundance of sugar in the saliva which can cause the overgrowth of yeast on
Older adults are more prone to thrush than young adults
Tongue Mass:
Tumors
HPV infection
Cancer
Most common: squamous cell carcinoma
Risk factors: smoking, chewing tobacco, heavy alcohol consumption
Pigmented lesion: melanoma
Ulcers:
Inflammatory bowel disease: Crohn's Disease, ulcerative colitis
Celiac disease
Behcet's Disease
Infectious disease: Herpes, syphilis
Glossitis: acute or chronic inflammation of the tongue; can be a primary tongue disorder or a symptom of another disorder
Allergic response to food, toothpaste, mouthwash, breath fresheners
Spicy foods, hot foods or beverages, tobacco, alcohol
Certain vitamin and mineral deficiencies: iron deficiency, vitamin B deficiencies
Mechanical irritation from injury, dental appliances
Bacterial or viral infections: herpes simplex, syphilis, HIV
Skin disorders, such as psoriasis
Symptoms:
Beefy red appearance of the tongue
Soreness of the tongue
Smooth appearance
Difficulty with eating or speaking
Benign Migratory Glossitis (also known as Geographic Tongue):
Benign condition of unknown cause
Bald patches on the tongue surrounded by a white border
The patches can change in appearance over the course of the day
Can cause tongue discomfort
No treatment available
Needs to be distinguished from: thrush, herpes, psoriasis, drug reaction
Who should you go to if you have noticed changes on your tongue:
Dentist
ENT physician
Primary care physician
Abnormalities in tongue appearance should be evaluated by one of these clinicians and never ignored!
Examples of tongue issues:
Geographic tongue
Thrush
Canker sore
Squamous cell carcinoma
Anemia
About /*Dr. Leah Millheiser*/:
Dr. Millheiser oversees the Female Sexual Medicine Program, which is available to women of all ages in the discreet surroundings of our Stanford Hospital office. This clinic provides treatment for the following disorders: decreased libido; decreased arousal; anorgasmia; dyspareunia and vaginismus. We take a multidisciplinary approach to female sexual medicine, working in conjunction with a licensed sex therapist, pelvic floor physical therapist, as well as alternative health practitioners.
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