It’s easy to assume that if your tongue is sore, discolored or causing some other symptom, it signals an oral health problem. While that is sometimes true, it’s often just the tip of the iceberg.
What most people don’t realize: Your tongue gives important clues to your overall health and can actually help predict health problems elsewhere in your body.
Beware: New research shows that certain tongue problems, including those associated with cancerous tumors, are on the rise.
What you need to know…
It’s a good idea to examine your tongue at least once a week. What to do: When you first wake up, stand in front of a mirror close to a window with natural light shining into your mouth. Do not brush your teeth or tongue first, since doing so may remove signs of problems.
Important: If you notice that your tongue has a new or unusual coating, color or texture or you have an unexplained taste in your mouth, see an otolaryngologist—an ear, nose and throat (ENT) doctor—for an evaluation.
Common tongue problems that can signal health issues elsewhere in the body…
• Slimy or patchy white tongue. Surprisingly, this condition, commonly known as thrush, could be a red flag for a sinus infection or gastroesophageal reflux disease (GERD). Thrush, which is typically caused by a fungal infection, can be a tip-off that a patient’s sinuses are inflamed or infected or that stomach acid is flowing back into the mouth and/or sinuses—this causes irritation and increases risk for infection.
While most sinus infections are caused by viruses or bacteria, fungi (especially mold) can also lead to inflammation/infection in the nose and sinuses.
Recent finding: The number of cases of fungal sinusitis has significantly increased over the past three decades, due in part to inappropriate use of antibiotics and the use of new immunosuppressive drugs, such as those prescribed to treat rheumatoid arthritis and given after organ transplant.
Treatment for thrush needs to be aggressive, including prescription topical antifungal medications (swishes and lozenges). Treating fungal sinusitis or GERD will also help thrush. Reducing alcohol and sugar intake may help starve the fungi, which feed on sugar and yeast.
• White or red sores. If you have a stubborn white or red sore or patch (or a lump, bump or an ulcer) on or under your tongue that doesn’t go away within a week or two, be sure to see your dentist or doctor.
There could be several possible causes for such sores or patches—the most serious being tongue cancer. Other symptoms of this type of malignancy may include chronic tongue pain, a sore throat and trouble swallowing, chewing or moving your tongue. If your dentist or doctor is concerned, he/she should refer you to an otolaryngologist who will perform a biopsy. You may need surgery to remove a tumor (minimally invasive techniques are used whenever possible, especially if diagnosed early), along with radiation and/or chemotherapy for larger and more advanced tumors.
Recent research: Oropharyngeal cancers (affecting the back of the tongue, throat, soft palate and/or tonsils) are on the rise in both men and women in the US—largely due to the increasing prevalence of human papillomavirus (HPV), which can be spread through oral sex. Researchers think that an increase in people having oral sex, especially with many partners, could be behind the rise in oropharyngeal cancers. Smoking and alcohol consumption are also risk factors.
• Burning mouth. A fiery sensation in the tongue (and sometimes lips, gums and throat), known as burning mouth syndrome, typically occurs out of the blue, but upper respiratory tract infections, sinus infections, dental work and stress have been known to trigger it. For unknown reasons, postmenopausal women are also at increased risk.
Other culprits: Too little vitamin B-12, riboflavin, folate, zinc or iron.
What helps: The first step is a complete physical examination that includes blood tests and a comprehensive medical history. You’ll likely also need a consult with a nutritionist or integrative health practitioner who can help assess you for nutritional deficiencies and work with you to improve your diet and recommend supplements.
