Infection, stress, nutritional deficiency, anemia, dehydration, neurological dysfunction, malignancy …all these conditions show up on the tongue FIRST!
By Dona Suri
The Bible mentions just about every part of the body, from your toenails to the top of your head. Most mentions are sort of neutral and matter-of-fact. Except for the tongue. Scripture is packed with warnings about the tongue’s potential for wickedness. Of course, what the biblical writers had in mind is not the tongue proper, but rather the tongue as the enabler of lies, manipulations, seductions, hurtful comments spoken inadvertently and vicious abuse calculated to wound.
“Mind your tongue” is good advice from a moral and social point of view. But it’s also good advice from a medical point of view. Of course, we are talking about a part of your anatomy that you can see in the mirror when you open your mouth. It looks relatively uncomplicated, but it’s not.
First of all, your tongue has about 4,000 taste buds. Buds contain specialized sensory cells. If a bud picks up on sweet, it gets nothing on salty. sour, bitter, and umami. (The last one is a highly refined receptor that lights up for glutamate — amino acid found in vegetables, losinate — primarily found in meat, and guanylate – found in plants.)
Each individual taste bud sends taste signals to the brain – which explains why we can enjoy combination tastes. Think of salted caramel custard.
The business of tasting is also more complicated than you might suppose. Taste and smell are separate senses with their own receptor organs, BUT they are intimately entwined. At the same time that taste buds are sending their “reports” to the brain, smell receptor cells in the nose are picking up on airbourne odor molecules and transmitting their reports. Taste signals reach the gustatory cortex, smell signals reach the olfactory cortex; these two terminals lie side by side in the brain and this area is where taste and smell reports converge.
Close association of taste and smell makes sense. You take milk out of the fridge. It looks okay, but the instant you taste/smell it, you know “Oh-oh! This is off. Throw it away.”
If the tongue did nothing but enable us to talk and to taste, that would be quite a lot, but thanks to the tongue, we are able to chew, swallow and breathe. The tongue is also home to numerous varieties of bacteria – a few trouble-makers but the majority meshing with our digestive and immune systems.
And that’s not all.
On the dashboard of your car you find little lights that blink on to warn you when something’s not right – the battery’s down, oil or water is low, the car is overheating, a door is not closed or the brakes have gone wonky. If you don’t understand what the warning light means—or choose to ignore it—a small problem could turn into a bigger, more expensive, and potentially dangerous issue.
Want to check your body’s warning lights? Open your mouth and look at your tongue. But you already know this. Medical examination: What’s the first thing the doctor says to you? “Open your mouth and say aaah.”
If you know what to look for, the tongue signals a variety of conditions — infections, stress, nutritional deficiencies, anaemia, weak immune system, dehydration, neurological dysfunction, malignancies. In fact, the tongue is so sensitive, it can show what’s going on internally BEFORE other symptoms develop, and, if you are under treatment for something, changes in the tongue can show if the treatment is succeeding.
You can see this for yourself. Next time you are down with a cold or have a bout of stomach flu, take a careful look at your tongue (before brushing). Look at it before you start taking medication and again after a day or two on medicine.
If you are sick, the tongue shows it. Or … Your properly pink, plumpy, moist tongue can truthfully testify “This body is doing fine, thanks.”
The first thing you want to notice about your tongue is its color. It should be a nice, rosy pink with a thin, slightly white coating.
A BRIGHT RED tongue can mean:
- Deficiency of Vitamin B, Vitamin B12, folic acid, iron. (Very likely if tongue is also overly smooth or glossy)
- Bacterial infection, including scarlet fever (goes along with rash on body, fever and sore throat)
- Celiac disease. (Gluten triggers the immune system to attack the small intestine.
- Dysfunctional small intestine fails to absorb vitamins and minerals.)
- Reaction to some medication
- Reaction to stress (accompanied by sores/ulcers)
- Early symptom of Kawasaki disease, a rare, serious illness that inflames blood vessels all over the body, most often in children.
A WHITE tongue can mean:
- Weakened immune system
- Dehydration: A thick white coating on the tongue means that you are producing less saliva so the body is trying to conserve fluid. It can be caused by certain medications.
- Yeast infection: Babies are susceptible to a yeast infection called oral thrush. White spots appear on the tongue. (Easily treated with over-the-counter antifungal medicines.)
- Lichen planus: This is an idiopathic condition (meaning nobody knows what causes it) in which your immune system attacks the tissues in your mouth. It isn’t dangerous or contagious, and it usually goes away on its own.
- Leukoplakia: This takes the form of flat, thick white areas that can’t be scraped away. It has a number of possible causes, including repeated injury or irritation. It is most commonly caused by smoking. Can also indicate virus infections (notably Epstein-Barr or HIV) or it can indicate precancerous changes in the mouth or mouth cancer.
A BLACK tongue can mean:
- Poor oral hygiene: The tongue’s papillae trap bacteria and food remnants. When dead skin cells build up on the tips of these dirty papillae they soon start looking black, brown or gray. The build-up may reach the point where the bacteria start growing out – in which case the tongue gets a furry look. Simple cure: brush teeth, scrape tongue, floss twice a day and eat a healthy diet
- Tobacco smoke can discolor the tongue: Simple cure: stop smoking.
- Reaction to certain antibiotics or to antacids containing bismuth: Black color will disappear when person stops taking the medicine.
- Fungal infection: Possibly brought on by an underlying condition (such as diabetes) messing with your immune system.
A YELLOW tongue can mean:
- Poor oral hygiene; build up of bacteria. Simple cure: brush teeth, scrape tongue, floss twice a day and eat a healthy diet.
- Discoloration caused by tobacco, alcohol or coffee. Improve color by improving habits.
- Reaction to products containing thymol, menthol, witch hazel, peroxides or eucalyptus. Accompanied by dry mouth.
- Yellow tongue accompanied by yellow eyes and yellow tinge to complexion: Possibly caused by liver or gallbladder problems.
A BLUE tongue can mean:
Blood disorders or blood vessel disease.
Poor circulation, possibly due to lung problems.
Next, check out the “topography” or your tongue. Is it smooth or bumpy.
BUMPY TONGUE
Bumps on the tongue are normal. These are just papillae, which are essential to the normal function of your tongue. However, your bumpy tongue should not feel painful. Pain can mean:
- Infection or inflammation caused by trauma. If you bite your tongue or burnt it on a hot drink or food, it will feel sore.
- A canker sores are painful but not contagious. They have many causes, including folic acid, iron, or vitamin B12 deficiencies, hormonal changes (menstruation or pregnancy), food allergies. Canker sores usually heal without treatment within two weeks. Canker sores are different from fever blisters which are caused by herpes simplex virus, usually type 1, or HSV-1. Canker sores may be an indication of stress, anxiety and depression.
- Sores (along with dryness) may indicate celiac disease.
- A single, painful bump at the tip could be transient lingual papillitis, “lie bumps,” which can pop up if your tongue gets irritated.
- Many small bumps on the sides and tip of the tongue may be caused by a virus.
- “Geographic tongue” is the name for smooth patches next to bumpy ones. The spots can come and go, and sometimes they hurt or burn. It’s harmless, but it could be linked to psoriasis or lichen planus.
- A red or white sore on or under the tongue that hurts and doesn’t go away may mean cancer.
Common sense: if you have a canker sore or mouth ulcer don’t eat foods that are spicy, salty or acidic. Don’t use toothpaste containing sodium lauryl sulphate.
BURNING MOUTH SYNDROME
You have not drunk anything hot but your tongue feels scalded. Plus, you have a metallic or bitter taste in your mouth. This is neuropathic condition. Something has damaged your nerves. The nerves in your mouth are sending messages to your brain in the normal way but the brain is misinterpreting the signals. This condition is called Burning Mouth Syndrome. People who have it can’t taste anything. The burning sensation is “all in the mind” … skin surface temperature is normal, the tongue and mouth are not inflamed. No one knows exactly what causes BMS. However, some possible causes include:
- Hormone changes.
- Stress, anxiety or depression.
- Immune system problems.
- Nerve damage.
- Reaction to certain toothpastes/mouthwashes or foods (notably pineapple).
- Badly fitting dentures or being allergic to the materials used to make dentures.
- Other causes: dry mouth, infections, acid reflux, and diabetes.
SWOLLEN TONGUE:
The medical term is glossitis. It can happen because of:
- Allergic reaction
- Nutritional deficiency
- Injury
THIN TONGUE:
- Dehydration. Perhaps you have not drunk enough water, or perhaps you are dried out on account of fever or vomiting.
SCALLOPED EDGES:
- Stress. If you grind your teeth at night, this is how it shows up on your tongue.
- Temporo-Mandibular Joint disorder. Temporary, not a serious problem. May be due to injury, or appear for no obvious reason.
Eat soft foods, use ice packs and avoid extreme jaw movements (wide yawning, gum chewing).
Over-the-counter pain medicines provide relief.
Avoid treatments that cause permanent changes in the bite or jaw (crown and bridge work, orthodontics, occlusal adjustment, repositioning splints.
FISSURED TONGUE:
About five people out of 100 will develop fissures in the tongue – typically starting around age 50 and getting deeper over the years. Fissures are harmless. Gently brush the tongue to clear food and bacteria.
- Typical of old age
- Associated with Down syndrome, Sjögren’s syndrome and psoriasis.
GLOSSITIS:
Commonly called “bald tongue” or “smooth tongue”. Can be painful and cause loss of taste. Papillae deteriorate.
- Symptom of vitamin deficiency, lack of Vitamin B12, Vitamin D, zinc, and/or iron.
MACROGLOSSIA:
The tongue is too big compared to the rest of the mouth.
- Rare condition, typically genetic and related to other genetic conditions. These are endocrine, and metabolic disorders (hypothyroidism, amyloidosis, acromegaly, Down syndrome, cretinism).
- Can also develop as a reaction to allergy, chronic infection, inflammation or malignancies.