Mirror, 24 Sep 2023: Too often the focus of a healthy mouth centres on the teeth – but what about the tongue?
One of the few parts of the digestive system you can actually see, this highly efficient and powerful muscle is often overlooked when it can actually provide invaluable insights into our wellbeing. A healthy tongue should be smooth, supple, slightly moist and pale red in colour.
A tongue is covered in taste buds scattered all over the top and sides, allowing us to taste anything we consume. According to traditional Chinese medicine there are five taste buds – bitter, sweet, salty, sour and spicy. This still stands true, but modern science has identified another taste – umami – which is a sort of meaty savoury sensation.
Contrary to popular belief there is no such thing as a tongue map or distinct zones for discerning between the various tastes. But even though science debunked this in 1974, wine glasses are still often misleadingly sold with the promise that they will direct wine to a specific part of the tongue.
The number of taste buds can vary from person to person, but some have been blessed with a huge amount. They are often referred to as ‘super tasters’ and while they’re not necessarily connoisseurs they are very sensitive to certain tastes.
You may not have thought about it, but many things can go wrong with this most versatile of organs. Here, award-winning dental hygienist Alison Lowe talks us through nine ways your tongue can tell how healthy you are.
Geographic tongue
This is actually a very common condition, which causes a characteristic appearance instantly recognised by experts. The top and sides of the tongue develop smooth red patches that are irregular in appearance. They can resemble the outline of a map and these are usually edged with wavy white lines.
Often, after a few weeks (or sometimes months) the position of these lines and red patches change. It is a harmless, benign condition that isn’t linked to any infection or cancer, but about one in 10 people with geographic tongue may have mild discomfort, or a burning or painful sensation.
Black hairy tongue
Everyone’s tongue is covered with very small little bumps called papillae. In some people these become overgrown so it gives the appearance the tongue is wearing a fur coat. Why it’s black is a mystery but it’s thought smoking, antibiotic use, steroid therapy and iron treatment all play a part. Sufferers should be reassured that although the condition is unsightly it is perfectly harmless.
Anaemia
It isn’t uncommon for people suffering with anaemia to have red lines and patches on the tongue. Glossitis (inflammation of the tongue) is a symptom of this; the tongue appears very smooth and shiny and this is often accompanied by a burning sensation. Sufferers of pernicious anaemia may also find their tongue swells.
Iron deficiency
This is sometimes caused by a lack of minerals and vitamins such as B12, folic acid and copper. So, if your tongue is feeling less than in the pink it might be a good idea to get your iron levels checked. A sore tongue is also often a sign of a nutritional deficiency, usually vitamin B6.
Coated tongue
Another aspect you should be aware of is the coating on the top of your tongue. All healthy tongues have a natural coating due to sloughing of the surface layer. If for some reason this doesn’t shed, then a furry coating will form, giving a white or discoloured appearance to the tongue. This is particularly common in people who have a very soft diet or are suffering from a febrile illness.
The colour and thickness of the coating can vary from day to day, from white to orange or brown depending on how much tea or coffee you drink and whether or not you smoke. A dry mouth may also make you more prone to a coated tongue. The general consensus is that although it doesn’t look nice there’s rarely anything sinister about it.
Thrush
Due to its humidity, temperature and hiding niches between the papillae, the tongue is the perfect location for colonisation of Candida albicans, otherwise known as thrush. This can easily be treated with Nystatin lozenges available from your pharmacy.
Hairy leukoplakia
This is a common oral condition and appears as white lesions on the tongue (though sometimes it can be the first sign of HIV).
Menopausal changes
Some women find fluctuating hormone levels during menopause can bring about a condition known as burning tongue. This condition is incredibly common and although it can be distressing it is rarely indicative of a serious underlying condition.
Gonorrhoea
Many infections are found on or under the tongue. One rare but very possible infection is gonorrhoea, characterised by small white bumps under the tongue.
In order to clean the mouth thoroughly, tongue brushing should be incorporated with your brushing routine. Lots of bacteria live on top of the tongue but brushing will not only help to remove these, but also improve the taste in your mouth and contribute to overall cleanliness.
The easiest way to clean the tongue is to use a tongue scraper, simply poke your tongue out, place the scraper at the back and pull it forwards removing any coating in the process. If you find this a bit unusual at first, try practising with a spoon.
How to check your tongue
The best way to study your tongue is to get a small piece of cloth, stick your tongue out, fold the cloth over the tip and pull it gently towards you. If you find something on your tongue that you haven’t noticed before it’s as well to get it checked out.
Never ignore bumps, open sores, swellings, discolourations or persistent pain and tenderness. It may be that you’ve dipped it in something too hot, but it’s best to establish if that’s the case or not.
