Most of us don’t give a second thought to our tongues unless we happen to bite them (and we know how painful that can be!). The tongue is essential for so many things, however, and how your tongue looks can be very revealing — it may even indicate a sign of a health problem.
The tongue is made up of muscles that are well-supplied with blood vessels and nerves. The muscles of the tongue are covered with a layer of connective tissue, and above this layer is a mucous membrane that makes up the surface of the tongue. The tongue is also covered with little bumps called papillae and taste buds. The taste buds are tiny organs that allow you to experience tastes that are salty, sweet, sour, and bitter, as well as umami, or savory.
A strip of tissue called the lingual frenulum anchors the tongue to the floor of the mouth. Muscles keep the tongue in place, and when you close your mouth, your tongue pretty much fills up your entire mouth.
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According to the website informedhealth.org, the tongue’s jobs are to:
A healthy tongue should be pink and covered with small nodules (those are the papillae). If your tongue doesn’t look like this, it could indicate a problem.
Like every other muscle in the body, the tongue can develop its own set of problems. These can include:
These problems can have many different causes. Some common tongue issues include:
This is a type of yeast infection that leads to bumpy white patches or spots on the tongue. These white spots can also occur on the cheeks, gums, roof of the mouth, or tonsils. Thrush can affect people of all ages, including adults with a weakened immune system, and people who have diabetes. White spots might also indicate leukoplakia, in which cells in the mouth grow in excess, or oral lichen planus, a chronic inflammatory condition.
With burning tongue (also called burning mouth), the tongue and the roof of the mouth have a burning or scalding sensation. Dry mouth, taste changes or loss of taste, and a tingling sensation in the mouth may also occur. The cause often can’t be determined.
This may sound like something straight out of a horror movie, but it’s real. With this condition, the tongue looks dark and furry due to an accumulation of dead skin cells. Smoking, dry mouth, some medications, and poor oral hygiene can lead to this. Fortunately, black hairy tongue is temporary and harmless. Having diabetes, taking antibiotics, or getting chemotherapy may also cause a black hairy tongue, says the Cleveland Clinic.
This also happens when dead skin cells build up on the tongue, mostly due to poor oral hygiene, tobacco use, and certain medications. Yellow tongue is also harmless and will improve with better oral care.
A red tongue might indicate a deficiency of folic acid and/or vitamin B12, scarlet fever, or Kawasaki disease, which is seen in children. A “geographic tongue” is a harmless condition in which red patches appear on the tongue.
Glossitis is when the tongue becomes swollen and inflamed, causing it to appear smooth and shiny. There are different types of glossitis, and it may occur due to a number of conditions such as infection, allergic reactions, Sjogren’s syndrome, injury, vitamin deficiencies, skin conditions in the mouth, hormonal factors, or irritants, such as tobacco, alcohol, hot foods, or spices.
Canker sores are small, painful sores that appear on the tongue, as well as on the lips, cheeks, and gums. They can result from biting your tongue but may also appear for seemingly no reason. Stress, medication, toothpaste, allergies, and dehydration may trigger canker sores.
Tongue cancer happens when cells in the tongue grow out of control and form lesions on the tongue. Symptoms include red, white, or dark patches on the tongue, sore throat, a sore lump on the tongue, pain with swallowing, or bleeding of the tongue.
Treatment of any kind of tongue problem depends on the cause. Thrush is usually treated with an antifungal medication. Tongue cancer may be treated with radiation or chemotherapy. Vitamin deficiencies are treated with nutrient supplements. And oral hygiene can treat black hairy tongue and yellow tongue.
If you have any issues with your tongue or are concerned in any way, let your health care provider know. They may take a swab or culture an area to help determine the cause and the appropriate treatment.
Good oral health is important for everyone, and especially for people with diabetes. What does practicing good oral hygiene mean? The National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH) describes oral hygiene as:
Along with these steps, consider cleaning your tongue (no, that doesn’t mean washing your mouth out with soap and water!). Some people clean their tongue with their toothbrush, but many dentists recommend using a tongue scraper, which is designed to eliminate that white coat formation that forms on the tongue. A tongue scraper can help prevent bad breath, prevent thrush, and prevent gum disease and tooth decay, too. You can purchase a tongue scraper at your local drugstore or online. Choose one with the American Dental Association (ADA) seal of approval.
When you use a tongue scraper, put it in your mouth carefully and as far back as you can. Gently scrape your tongue from the back to the front and do this multiple times. Spit out any saliva and rinse your mouth. Repeat until your mouth feels clean. When you’re done, wash the scraper with soap and warm water, dry it, and store it in a clean, dry place.
Want to learn more about keeping your mouth healthy with diabetes? Read “Diabetes and Dental Health,” “Four Ways to Improve Your Oral Health,” and “Practice Good Oral Health for Diabetes.”
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