What can your tongue tell you about your health?

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Your tongue has between 2,000 and 4,000 taste buds, allowing you to appreciate the taste of food. Your tongue is also home to the majority of bacteria that live in your mouth – some promote health, while others can cause issues.

Your tongue can change colour depending on a variety of factors, including what you’ve eaten and whether you’re hydrated.

What does a healthy tongue look like?

‘A healthy tongue is pink, moist and doesn’t feel painful. The surface of your tongue is covered with little nodules and bumps called papillae, which contain our taste buds,’ explains Dr Nikki Ramskill, a Livi GP.

Tongue chart UK

1. If your tongue has a yellow coating…

‘A yellow or brown coating on your tongue might be caused by a build-up of bacteria from poor oral hygiene, smoking, alcohol or drinking lots of coffee or black tea,’ says Dr Ramskill.

A dry mouth and using products with thymol, menthol, witch hazel, peroxides, eucalyptus or alcohol can also cause a yellow coating.

If your face, eyes and tongue look yellow, speak to a doctor as this might be caused by problems with your liver or gallbladder.

2. If your tongue is white…

The most common reasons for this include:

Oral thrush

‘If your tongue has a thick white coating, it could be oral thrush – a yeast infection of your mouth’s mucous membranes,’ says Dr Ramskill. Oral thrush is common in babies. If you’re breastfeeding, your baby can pass the infection from their mouth to your nipples. It can be easily treated with over-the-counter antifungal medicines.

Lichen planus

This is a disease that causes inflammation inside your mouth or other parts of your body. ‘It looks like you have a white lacy pattern on your tongue and inside the mouth,’ explains Dr Ramskill.


Leukoplakia appears as a white patch on your tongue, gums or the inside of your cheeks and is most commonly caused by smoking. Speak to a doctor if you have this, as there’s a slight risk it can develop into mouth cancer over time.

3. If your tongue is sore and bumpy…

‘Bumps on the back of the tongue are normal. These are just papillae, which are essential to the normal function of your tongue,’ says Dr Ramskill.

‘If you have a sore, bumpy tongue, it could be a sign of infection or inflammation caused by trauma – you might have accidentally bitten your tongue or burnt it on a hot drink or food. Use over-the-counter medications, like paracetamol and ibuprofen, to help with pain, or apply a gel directly to the sore area.’

4. If you have tongue ulcers…

Mouth ulcers – sometimes referred to as canker sores – can appear on your tongue. They might be caused by biting your tongue or damage caused by a toothbrush. Pregnancy and certain medicines can cause ulcers, too.

Feeling stressed, run down and anxious are also common causes of ulcers. A recent study found a significant link between depressive symptoms and experiencing mouth ulcers.

They usually clear up on their own within a few weeks, but if you have a particularly painful ulcer, try avoiding spicy, salty and acidic foods and toothpaste containing sodium lauryl sulphate.

‘A pharmacist can recommend a gel, spray or mouthwash to speed up the healing time. If you have a mouth ulcer that isn’t healing, get it checked by a doctor because in rare cases it can be a sign of mouth cancer,’ says Dr Ramskill.

5. If your tongue is swollen…

If your tongue is swollen, you may be experiencing glossitis – an inflammation of the tongue. It can have several causes, including an allergic reaction, a dry mouth, injury or a nutritional deficiency.

‘If your tongue swells after eating a certain food, seek medical advice straight away. The swelling can spread to the back of the throat and lead to breathing difficulties,’ explains Dr Ramskill.

6. If your tongue is black and looks hairy…

A black, hairy-looking tongue is usually caused by a build-up of dead skin cells on the tips of the tongue’s papillae, which trap bacteria and food remnants. This may be due to poor oral hygiene, smoking, a dry mouth or eating a diet of mainly soft foods.

Try tongue cleaning or scraping and flossing, and eat a healthy diet.

7. If your tongue is red…

Kawasaki disease is a rare but serious illness, most often seen in children, which causes a red, inflamed tongue.

Bacterial infections like scarlet fever can also cause a bright red tongue, alongside a rash across the whole body, a sore throat and a fever. Vitamin B12, folic acid or iron deficiency can also cause a redder tongue.

How can I look after my tongue health?

Looking after your tongue is as important as taking good care of your teeth if you want to maintain good oral health. Here’s how to do it:

Drink plenty of water – staying hydrated helps wash away bacteria and food from your tongue and also helps to prevent a dry mouth, which increases your risk of fungal infections and tooth decay.

Clean your tongue – use a toothbrush, tongue scraper or cleaner. This helps remove bacteria and dead cells from the surface of the tongue, which may cause bad breath.

Give up smoking – it can irritate your tongue and contribute to conditions like leukoplakia.

Chew sugar-free gum – this stimulates saliva production, which helps rinse away bacteria, clears food, reduces acid in your mouth and alleviates a dry mouth.

When should I see a doctor?

If you have concerns about any of these symptoms and there isn’t an obvious temporary cause, speak to a doctor. Dr Ramskill advises you to seek health advice if:

  • You’re worried about the colour of your tongue or any changes in sensation
  • You notice any lumps, bumps or sores on your tongue
  • You have unexplained or severe tongue pain that continues for several days
  • You experience itchiness that gets worse and doesn’t go away
  • You have a white patch in your mouth that hasn’t gone away for 2 weeks

Arrange an appointment with a dentist if you have any problems with your teeth or gums, like bleeding, painful or swollen gums or toothache.

This article has been medically reviewed by Dr Nikki Ramskill, a Livi GP

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