We roll it, wiggle it, and wag it – without it, we can’t speak, chew, swallow, taste, whistle, lick, slurp, and laugh. Your tongue is a mobile, dexterous group of muscles that affects every movement in and out of your mouth. Its surface is covered with small, fleshy protuberances called papilla, which contain most of your taste buds. And like any other muscle in the body, it can experience pain, swelling, discolorations, and difficulty moving. If you notice any of the following changes in color, texture, or pain level on your tongue, contact your dentist to schedule a thorough examination. While some conditions are not serious, others will require medical attention to resolve.

Changes in Color

• A red or bright pink color can indicate a vitamin or mineral deficiency in iron, folic acid, or Vitamin B-12.

• A tongue whitens when a layer of bacteria and debris builds on it – the build-up can be caused by smoking, alcohol consumption, poor oral hygiene, illness, infection, dehydration, dry mouth, medications, or antibiotic use. These factors alter the natural balance of bacteria in the mouth and promote more bad bacteria to linger.

• One of the most common infections that causes whitening is oral thrush. Thrush is a fungal infection that appears as creamy white patches of yeast across the tongue.

• A white tongue can also be a sign of oral lichen planus. Lichen planus is a chronic inflammatory disorder that attacks the mucous membranes inside the mouth. Alongside swollen mouth tissues and open sores, a common sign of lichen planus is a white, lacy patchwork pattern on the tongue.

Changes in Texture

• Benign migratory glossitis: Also referred to as a geographic tongue, this condition occurs when smooth red patches appear on the surface and sides of the tongue. The affected areas are “bald” and smooth due to the absence of papilla. These patches may shift in size and location over time.

• Black hairy tongue: Like hair, the protruding papilla on the tongue grow. Those with black hairy tongue don’t shed the dead cells like most humans do and this creates a buildup that traps bacteria and causes the tongue to look black and hairy. Eating foods with rougher textures helps scrub its surface free of dead cells.

Pain and Swelling of the Tongue

• Sometimes, pain is the result of an injury – accidentally biting the tongue can cause a cut or sore to develop.

• Trauma can also occur by biting into an extremely hot substance – this can inflame and irritate the surface papilla.

• If you have pain on the sides of your tongue, it may be caused by grinding or clenching teeth.

• Sudden swelling can occur in the setting of an allergic reaction. If you experience rapid swelling seek medical help as soon as possible – a swollen tongue can obstruct the airway and make breathing difficult.

Sores and Lesions on the Tongue

• Canker sores commonly develop on or under the tongue. The exact cause of these small white or yellow sores is unknown. While canker sores can be mildly painful or irritating, they are benign and will resolve on their own within a few weeks.

• If you develop a lump or sore that persists for longer than two weeks, it’s time to see a dentist or dermatologist. Lumps or sores that do not heal on their own could be an early sign of tongue cancer. In fact, an unusual or long-lasting sore may be the only sign of cancer in the beginning phases – there is usually no pain in the first stages of the disease.

• Leukoplakia is characterized by white patches that develop as a result of irritation, such as ill-fitting dental hardware or sharp edges of teeth. These patches are especially common in smokers because tobacco is a major irritant. Leukoplakia patches can slowly grow to become thick, raised, and roughened. Most lesions will resolve on their own once the irritant is removed, but leukoplakia should still be examined and diagnosed by a dentist or dermatologist – the lesions have the potential to progress into cancer.

Any change in size, shape, color, texture or appearance of the tongue should be reported to your dentist to determine the severity and best course of treatment. At home, work proper tongue care into your oral hygiene routine – brush your tongue every day along with your teeth, to prevent the buildup of bacteria. Make sure your dental hardware fits correctly, to avoid rubbing or irritating the sides and surface of the tongue. And if you have an unusual lump, bump, sore, or lesion that’s been present on the tongue for more than two weeks, contact Boyett Family Dentistry to schedule an appointment for a mouth exam and oral cancer screening.