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4 common tongue problems: Treatment and when to worry

19 September 2019

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The tongue is composed of a series of muscles and enables your body to carry out vital processes, like breathing and swallowing. It’s covered in small bumps, known as papillae. They contain your taste buds and give your tongue its rough texture.

Any problems that we develop on our tongues can be hard to ignore. Some common tongue problems include:

  • discolouration
  • pain or discomfort
  • changes in texture

Why is my tongue white?

Sometimes, the papillae on your tongue can become enlarged and swollen. Swelling of the papillae makes it easier for bacteria, dead cells and debris to get lodged between them, forming a white coating on the tongue’s surface.

Causes of swollen papillae include:

  • excessive alcohol consumption
  • a dry mouth or frequent breathing through the mouth
  • irritation (from dental equipment or contact with sharp teeth edges)
  • a diet low on fibre
  • a fever
  • dehydration
  • a lack of oral hygiene

Tongue discolouration or white patches on the tongue can be caused by a health condition. Conditions that can cause a white tongue include:

  • lichen planus - a rash that can affect the inside your mouth or other parts of your body
  • leukoplakia - white patches which commonly appear on the tongue, although they can also appear on the cheeks and in patches on the gums (this does not recover on its own and should be seen by a doctor or dentist)
  • geographic tongue - a condition where smooth, oddly-shaped red patches and white lines appear on the tongue
  • mouth ulcer - painful, white sores that can develop on the tongue or elsewhere in the mouth
  • oral thrush - an infection that occurs when there is an overproduction of Candida fungus

What to do

To treat a white tongue at home, try to:

  • practise good oral hygiene (brushing your teeth twice a day, flossing at least once a day, using a fluoride mouthwash daily)
  • avoid tobacco
  • reduce your alcohol intake
  • eat a balanced diet (making sure you get your 5 A Day)
  • regularly visit your dentist for a check-up and cleaning every six months

When to worry

See your doctor or dentist if you:

  • have persistent pain or itchiness that is not improving or is getting worse
  • notice white patches on your tongue

Why is my tongue black?

A black tongue is not a cause for concern most of the time. It is usually caused by a build-up of dead skin cells. These accumulate on the tips of the tongue’s papillae, creating the appearance of a hairy texture.

The papillae can at the same time become stained a blackish colour by bacteria or certain substances.

Image of a black hairy tongue

There are some possible factors that may affect how well a tongue is able to shed dead skin cells, including:

  • an underproduction of saliva
  • poor oral hygiene
  • eating mushy or liquid foods (solid foods help remove dead skin from your tongue)
  • dry mouth, which can be caused by some medications

Some things which may result in the black discolouration of the tongue are:

  • tea or coffee
  • antibiotics
  • tobacco
  • certain mouthwashes (oxidising agents like peroxide can alter the balance of bacteria in your mouth)
  • bismuth subsalicylate (found in certain non-prescription gastrointestinal medications such as pepto-bismol, which can temporarily stain the tongue)

What to do

You should be able to treat a black, hairy tongue at home by making a few simple changes to your dental hygiene practices, such as:

  • brushing your teeth twice a day
  • eating a healthy diet
  • brushing after eating
  • brushing after drinking liquids that can stain teeth like tea, coffee or alcohol
  • chewing a sugar-free gum
  • avoiding tobacco (either in the form of smoking or chewing tobacco)
  • brushing your tongue
  • flossing at least once a day
  • using a tongue scraper
  • seeing your dentist for a check-up and a clean (this should be done regularly, every six months)

When to worry

Visit your doctor if your black tongue persists for more than one or two weeks.

Info

Always speak to your doctor before discontinuing a medication, even if you think it may be the cause of a black tongue.

Why is my tongue sore?

A sore tongue is most commonly caused by injury or trauma. For example, you may have burned or bitten your tongue.

Though you may experience discomfort ranging from mild irritation to pain, a sore tongue is rarely a cause for concern, recovers fairly quickly, and can be managed at home.

In some cases, a sore tongue may be a sign of an underlying health condition, particularly if white patches are also appearing on its surface. In this circumstance, you should see a doctor so they can help you treat any underlying illnesses.

What to do

To help treat a sore tongue at home, you can:

  • brush your tongue with a soft toothbrush
  • use a sodium lauryl sulphate free toothpaste
  • drink cool drinks through a straw
  • try taking painkillers
  • avoid alcohol
  • quit smoking if you smoke
  • avoid foods that can irritate your tongue, including hot food and drink, hard, spicy, salty or acidic foods

When to worry

Visit your doctor if you are ever worried about tongue pain, or if:

  • you are experiencing pain or itching that is persistent or getting worse
  • there are white patches on your tongue

Why are there sores and/or bumps on my tongue?

Tongue bumps are usually not a cause for concern and are usually the result of an injury like a bite or a burn. Other potential causes of tongue injury include:

If you have a gap between your teeth, a bump may form where your tongue fills the space.

Small bumps that appear on both sides of the tongue are usually nothing to worry about. However, if a bump appears on only one side of your tongue, you should make an appointment with a doctor to have it examined.

What to do

Some causes of tongue bumps, such as irritation or injury will clear up on their own. Bumps caused by an underlying condition, however, will likely need treatment from a doctor. Bacterial infections, for example, will need to be treated with antibiotics.

See your doctor if you are ever worried about a tongue bump or if you have developed a tongue bump and have not damaged your mouth recently.

While your tongue is healing, there are steps you can take to manage your symptoms (regardless of the cause). You can try to:

  • avoid foods that can irritate your mouth, like acidic or spicy foods
  • drink plenty of water
  • gargle with warm salt water and baking soda mouth rinses on a regular basis
  • reduce pain by using non-prescription topical treatments (check what is available in your area)
  • avoid mouthwashes containing alcohol
  • brush your teeth twice a day
  • floss your teeth once a day
  • quit smoking and avoid any tobacco-based products
  • drink less alcohol
  • eat fewer foods that can cause tooth decay, like sugary foods

When to worry

Seek emergency medical attention if you experience the symptoms of anaphylaxis alongside tongue bumps, like a very swollen tongue or breathing difficulties.

Also see a doctor immediately if you are feverish or in severe pain.

Make an appointment with your doctor if your symptoms do not improve after a week, if they get worse, or if your bumps keep recurring.

You should also make an appointment with your doctor or dentist if you experience patches in your mouth that are red or white in colour, or sores or lumps, especially if they feel hard.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.

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