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Four reasons to watch your tongue

Got something on the tip of your tongue? What about on top? Maybe even on the side? Most people could go a whole day without thinking about their tongue—it’s something we take for granted. But believe it or not, your tongue is a great indicator of your overall health.

Ancient forms of medicine in China and India focused on the tongue as a microcosm of the body for thousands of years. Now, we’re learning that the tongue says a lot about someone’s health.

“The size, shape and color of your tongue can indicate medical conditions like hyperthyroidism, thrush infections and vitamin deficiencies,” explained Geisinger otolaryngologist Dr. Seth Linker. “If you notice anything abnormal about your tongue, it’s important to talk to your doctor.”

Here are some signs your tongue may be giving you and what they mean.

White, lumpy coating
If you have a thick, white coating on your tongue, it could be a sign of a thrush infection.

“Your tongue is home to many different types of organisms, including bacteria and yeasts,” said Dr. Linker. “If the balance of bacteria and yeast is disrupted by something like antibiotics, the yeast can take over the tongue, causing what is known as a thrush or oral yeast infection.”

Yeast infections like thrush aren’t immediately dangerous, but they should be treated as soon as possible.

If you notice painful white patches in your mouth, they could be lesions caused by irritation from your teeth, smoking, braces or dentures. If these lesions don’t go away within two weeks, see your doctor.

Black or brown fuzz
The cells on your tongue are constantly growing. For some people, these cells grow faster than your tongue can shed them. As these cells grow, they can resemble fuzz or hairs, and as bacteria grows on them, they can turn a brownish or blackish color. This condition, known as “hairy tongue” is not harmful, but it may be unsightly and cause bad breath. Normally, hairy tongue is more common in people who smoke, drink black coffee or tea, and have poor dental hygiene. Talk to your dentist if you have hairy tongue—they may recommend using a tongue scraper or brushing your teeth differently. 

“One other possibility for a black tongue is the ingredient bismuth,” said Dr. Linker. “Many people take medications like bismuth subsalicylate as an antidiarrheal or anti-nausea medication, and one common side effect is that your tongue may turn black after using it. This is not harmful and will go away—especially after brushing your teeth.”

Wrinkles, ridges and valleys
“As you get older, your tongue gets older too,” notes Dr. Linker. “And as your tongue ages, it may show cracks and ridges. While it may look serious, it’s often harmless.”

A small percentage of the population also has what is known as ‘geographic tongue,’ which causes raised, whitish spots on the tongue. Geographic tongue is harmless.

Some people may notice indents on the side of the tongue from their teeth. This is known as “scalloped tongue” and can be caused by conditions like stress or hyperthyroidism.

Strawberry red
If you have a glossy, bright red tongue, it could mean that you have a vitamin deficiency. The cells on your tongue require nutrients like vitamin B12 and iron to mature. If these cells don’t mature, they can die off, causing your tongue to appear smooth.

If your tongue is bright red, ask your doctor about whether you should take supplements or change your diet to get more nutrients.

If you notice red lesions or growths on your tongue that last longer than two weeks, talk to your doctor—those marks could be a sign of oral cancer. These lesions are not always painful and occur most often in older people.

Geisinger otolaryngologist Dr. Seth Linker, MD, sees patients at Geisinger Mt. Pleasant in Scranton and Geisinger Tunkhannock. To schedule an appointment with Dr. Linker, please call 800-275-6401 or visit