Tongue Problems

What are tongue problems?

Your tongue is a powerful muscle that helps you chew and swallow food. It also enables you to speak. Problems with your tongue — including pain, swelling or trouble moving your tongue — can make these routine activities difficult. Other tongue problems, like a tongue that changes color or texture, can feel strange and upsetting when you don’t know the cause.

Most tongue problems aren’t serious. But sometimes, changes in your tongue signal a more serious condition. See a healthcare provider to get your tongue checked out if you’re having severe symptoms that last longer than a few weeks.

Can your tongue indicate health problems?

It can. How your tongue looks, feels, moves and functions can provide clues about your health. Often, the clues are pretty straightforward. For example, a painful tongue may be a sign that you drank a hot cup of coffee too fast. Other times, you’ll need to see a healthcare provider to determine the issue. For example, a swollen or enlarged tongue may mean an allergic reaction, a nutritional deficiency or a tumor, among other things.

If you’re unsure, see a healthcare provider. They can advise you on whether you need treatment or if you can manage the issue at home with lifestyle changes.

What are the symptoms of tongue problems?

Common symptoms that may affect your tongue include:

• An enlarged or swollen tongue.
• Trouble moving your tongue.
• Complete or partial loss of taste.
• Change in your tongue color (white, yellow, dark red, purple, brown or black).
• Change in your tongue’s texture (smooth, covered in raised patches or hair-like growths).
• Pain, soreness or a burning sensation throughout your tongue or in certain parts.

What common problems affect the tongue?

Tongue problems or changes in your tongue may be a sign of short-term or long-term (chronic) conditions. They range in severity from simple first-degree burns from eating hot foods to more serious conditions like oral cancer.

Enlarged or swollen tongue

Macroglossia involves having an atypically large tongue. The cause is usually an underlying condition you’re born with (congenital) or acquired over time. Conditions that cause an enlarged tongue include:

• Acromegaly: A rare condition that causes your body to release too much growth hormone. As a result, you may have an oversized tongue.
• Amyloidosis: A protein disorder that prevents tissues and organs from working as they should. It can cause your tongue to enlarge and look rippled on the edges.
• Beckwith-Wiedemann syndrome: A growth disorder that affects your child’s physical development. It may cause your child’s tongue to appear too big in their mouth.
• Down syndrome: Down syndrome is a congenital condition that may affect your child’s mental and physical development. It may cause their tongue to appear larger than is typical.
• Hunter syndrome (mucopolysaccharidosis): A rare group of diseases that affects your child’s development. An enlarged tongue is a common symptom.
• Hypothyroidism: A common condition where your body doesn’t release enough thyroid hormone into your bloodstream. It’s a common cause of macroglossia in children.
• Tumors: Lymphangiomas and hemangiomas are benign (noncancerous) growths that can cause your tongue to get bigger. Lymphoma is a cancer that can cause an enlarged tongue.

Glossitis involves having a swollen tongue because of inflammation. Causes include:

• Infections.
• Mouth injury.
• Hormone changes.
• Nutritional deficiency.
• Dry mouth (xerostomia).
• Irritation from spicy food or tobacco.
• An allergic reaction to food or medicine.

Trouble moving your tongue

You may have trouble moving your tongue if you have nerve damage affecting the tissue or a structural issue that limits movement. Causes include:

• Dysarthria: Nerve damage that leads to weakened or paralyzed speaking muscles, including your tongue.
• Glossoptosis: A congenital condition that causes your baby’s tongue to be set too far back in their mouth, affecting how their tongue moves. Glossoptosis may result from cerebral palsy, Down syndrome or Pierre Robin syndrome.
• Tongue-tie (ankyloglossia): A congenital condition that causes your baby’s tongue to attach to the floor of their mouth, limiting movement.

Loss of taste or taste changes

Tongue problems include complete loss of taste (ageusia), partial loss of taste and a changing sense of taste.

Potential causes include:

• Injury to your taste buds (as with a severe tongue burn).
• Bacterial, viral or fungal infections.
• Medication side effects (like taste changes during chemotherapy).
• Nerve damage.

Tongue color and texture changes

Various conditions get their names from the key symptom: changes in your tongue’s appearance. A white, yellow or black tongue is usually a sign of poor hygiene. Not caring for your tongue can cause bacteria and fungi to grow. In rare cases, color and texture changes signal an underlying medical condition.

• White tongue: A white film covers your tongue, or white patches appear scattered on your tongue. A white tongue is usually a sign of bacteria build-up. A white tongue may be a sign of thrush or oral lichen planus. Rarely, it’s a sign of leukoplakia, a condition that sometimes progresses to cancer.
• Yellow tongue: Dead skin cells build up on your tongue, causing the surface to look yellow.
• Black hairy tongue: Dead skin cells or bacteria get trapped on your tongue, causing the surface to look black or brown. It may appear like it’s covered in fuzz or fur. Causes of black hairy tongue other than poor hygiene (most common) include radiation therapy to your head and neck, tobacco and alcohol use, and dry mouth.
• Geographic tongue: Smooth red patches of skin appear on your tongue, surrounded by white borders. The red patches outlined in white resemble the borders on a map, which is why it’s called geographic. Geographic tongue isn’t contagious and is a harmless condition, but it can feel painful.

A red tongue may be a symptom of a variety of conditions, including:

• Folic acid deficiency and vitamin B-12 deficiency: Your tongue may also feel swollen and sore.
• Kawasaki disease: Your tongue may also appear cracked. Or it may look red and bumpy, like a strawberry. This is called a strawberry tongue.
• Pellagra: Your tongue may also swell, and you may have mouth sores.
• Pernicious anemia: Anemia can cause your tongue to appear red and smooth instead of bumpy and swollen. It may also feel sore.
• Scarlet fever: Strawberry tongue is a common symptom of scarlet fever.

Red or white patches on your tongue or thickened areas that don’t go away may be a sign of tongue cancer.

Tongue Pain

Tongue pain, including soreness and burning, is one of the most common tongue problems. Usually, tongue pain results from infection and inflammation.

Common causes of tongue pain include:

• Injury: Consuming foods or drinks that are too hot can cause a painful, burned tongue.
• Sores and mouth ulcers: Canker sores, cold sores (fever blisters) and mouth ulcers can form on or around your tongue. They can feel painful and make eating difficult.
• Dental issues: Poor oral hygiene can cause tongue pain and lead to unsightly color changes (white, yellow or black hairy tongue). Poorly fitted dentures can cause mouth and tongue pain.
• Glossopharyngeal neuralgia: A rare condition that affects the nerve that runs through a portion of your tongue. It can cause stabbing pain in the back of your tongue.
• Burning mouth syndrome (burning tongue): A painful condition that causes your tongue and the roof of your mouth to feel as if they’re burning. You’re more likely to have burning mouth syndrome if you’re postmenopausal and over 60.

You may experience tongue pain alongside other symptoms affecting your tongue, like a swollen tongue or color changes — as with anemia, geographic tongue and glossitis.

How are tongue problems diagnosed?

A healthcare provider will consider the changes in your tongue alongside other symptoms and information to diagnose the underlying issue. They may:

• Ask about your symptoms. They’ll ask how long you’ve noticed changes in your tongue and if the condition has worsened. They may ask if you’ve tried any remedies that have improved your symptoms.
• Ask about your lifestyle and habits. They may ask about your oral habits if they suspect your tongue problems relate to dental care.
• Perform a physical exam. They’ll examine your tongue. Often an exam is enough to make a diagnosis.
• Order a blood test. You may need a blood test if your provider suspects your tongue problems relate to anemia or a nutritional deficiency.
• Perform a biopsy: Your provider may remove a tissue sample and test it in a lab if they suspect you have abnormal cells, as with cancer and precancerous conditions.

Your experience and the tests you receive depend on what’s most likely causing your tongue problems.

How are tongue problems treated?

The approach you’ll need to treat or manage your condition depends on what’s causing your symptoms. Treatments may include:

• First-aid: You may need basic first-aid to care for a burned tongue.
• Speech therapy: You may need help with your speech and swallowing if you have a nerve condition affecting your tongue.
• Medicine: You may need anti-fungal medicines or antibiotics if you have an infection.
• Dentist visits: You may need to visit your dentist if your tongue hurts because of issues with oral hygiene.

How can I reduce my risk of developing tongue problems?

Not all conditions that cause tongue problems are preventable. Still, you can reduce your risk of infection and inflammation by practicing good oral hygiene. Brush twice daily and floss once each day. Scrape your tongue to remove bacteria. Get regular dental cleanings.

Avoid smoking and using tobacco products, which can cause painful ulcers and increase your risk of oral cancer.

When should I worry about my tongue?

Schedule a visit with a healthcare provider if you have severe pain or symptoms that don’t resolve within a few weeks. Most tongue problems improve over time. Symptoms that don’t improve may signal an underlying condition that requires treatment.

What does a diseased tongue look like?

Healthy tongues are uniformly pink and covered in tiny bumps. Diseased tongues may be dark red, white, yellow or even black. They may be covered in fuzzy growths instead of bumpy. They may appear smooth instead of bumpy.

A note from Cleveland Clinic

Most of the time, you shouldn’t stress over changes in your tongue. Symptoms usually improve on their own in time. If symptoms persist or get worse, schedule a visit with your healthcare provider. Often, a physical exam is all it takes for a diagnosis. Your healthcare provider can recommend treatments based on what’s causing the issues with your tongue.