Tongue Problems

Medically Reviewed by Jabeen Begum, MD on May 13, 2024
Written by Hilary Parker
9 min read

The tongue is a muscular organ in the mouth. It's covered with moist, pink tissue called mucosa. Tiny bumps called papillae give the tongue its rough texture. Thousands of taste buds cover the surfaces of the papillae. Taste buds are collections of nerve-like cells that connect to nerves running into the brain.

The tongue is anchored to the mouth by webs of tough tissue and mucosa. The tether holding down the front of the tongue is called the frenum. In the back of the mouth, the tongue is anchored into the hyoid bone. The tongue is vital for chewing and swallowing food, as well as for speech.

The four common tastes are sweet, sour, bitter, and salty. A fifth taste, called umami, results from tasting glutamate (present in some foods and in MSG). The tongue has many nerves that help detect and transmit taste signals to the brain. Because of this, all parts of the tongue can detect these four common tastes. The commonly described “taste map” of the tongue doesn't really exist.

photo of Tongue anatomy

Tongue problems include a variety of symptoms, from pain to changes in color and texture, that can have many different causes.

Though often hailed as "the strongest muscle in the body," the tongue is made up of a group of muscles that allow us to taste food, swallow, and talk.

Because you use your tongue all the time, tongue problems can be frustrating and uncomfortable.

Different causes of tongue problems have different symptoms. You might have:

  • Pain
  • A burning sensation
  • Lumps
  • Sores
  • Color changes, ranging from white to black
  • Texture changes (Your tongue can become smooth, patchy, or form hair-like growths.)
  • Swelling
  • Problems with tongue movement
  • Loss of taste

There are a variety of causes for common tongue symptoms. The majority of tongue problems aren’t serious, and most can be resolved quickly.

In some instances, though, a discolored or painful tongue can indicate more serious conditions, including vitamin deficiencies, AIDS, or oral cancer. For this reason, it is important to seek medical advice if you have any ongoing problems with your tongue.

Sore tongue

Many things can cause tongue pain or painful bumps to form, including:

  • Trauma. Accidentally biting your tongue or scalding it on something hot can leave you with a sore tongue until the damage heals. Grinding or clenching your teeth can also irritate the sides of the tongue and cause it to become painful.
  • Smoking. Smoking too much can irritate your tongue and make it sore.
  • Burning tongue syndrome. Some postmenopausal women get this syndrome, which makes the tongue feel as if it has been burned.
  • Other medical problems. Medical conditions, including diabetes and anemia, can have a sore tongue as a symptom.
  • Infection. Certain bacterial, viral, or fungal infections can also cause tongue pain.
  • Dental problems. Not taking good care of your mouth can make your tongue hurt and change its color to white, yellow, or black. If your dentures don’t fit well, they can also cause mouth and tongue pain.
  • Glossopharyngeal neuralgia. This is a rare condition that impacts a nerve in part of your tongue and causes sharp, stabbing pain.

Tongue bumps

If you've noticed bumps on your tongue, they could be due to:

  • Canker sores. Many people will get these mouth ulcers on the tongue at some point. The cause is unknown, although they can be worse during periods of heightened stress.
  • Enlarged papillae. If one or more of your taste buds becomes inflamed or irritated, it can swell and form a painful bump on your tongue.
  • Oral cancer. Though most sore tongues aren’t anything to worry about, you should consult a doctor if you have a lump or sore on your tongue that doesn't go away within a week or two. Many oral cancers don't hurt in the early stages, so don't assume a lack of pain means nothing is wrong.
  • Syphilis. This sexually transmitted infection can cause sores called chancres that show up on the tip of your tongue and other parts of your mouth and throat. They start off as small red patches and develop into bigger, open sores that can be red, yellow, or gray.
  • Herpes stomatitis. The herpes virus can uncommonly cause cold sores on the tongue, but cold sores are usually on the lip.

Swollen tongue 

Also known as macroglossia (big tongue), a swollen tonguecan be divided into various categories based on its cause. These include congenital, inflammatory, traumatic, cancerous, and metabolic causes. Thyroid disease, lymphangiomas, and abnormalities at birth are among some of the causes of an enlarged tongue.

Tongue movement problems

Some tongue problems can cause trouble moving your tongue, including:

  • Dysarthria. This condition, which causes speaking problems, can happen due to brain damage and brain changes.
  • Glossoptosis. This means your tongue isn’t where it should be. In babies, this means the tongue is farther back in the mouth than it should be right after birth. It can block the airway and make it hard for them to breathe, eat, and swallow.
  • Tongue-tie. Also known as ankyloglossia, tongue-tie is a condition from birth that limits how far the tongue can move. It happens when a thick or tight piece of tissue (lingual frenulum) connects the bottom of the tongue to the mouth floor, making breastfeeding difficult. It can also affect eating, talking, and swallowing.

Loss of taste

Many things can cause a loss of your sense of taste, also called ageusia, including:

  • COVID-19
  • A sinus infection (sinusitis)
  • Common cold
  • Flu (influenza)
  • Sore throat (pharyngitis)
  • Strep throat
  • Salivary gland infections
  • Gum (periodontal) disease
  • Head or ear injuries

Atrophic glossitis

This condition causes the tongue to lose its bumpy texture and become smooth. Sometimes, this is due to anemia, a B vitamin deficiency, or an allergy, infection, trauma, or injury. Symptoms include:

  • Soreness, tenderness, or pain
  • Swelling
  • Redness
  • Trouble speaking, eating, or swallowing

White tongue

A number of things that can cause a whitish coating or white spots on the tongue, including:

  • Leukoplakia. This condition causes cells in the mouth to grow too much. That leads to the formation of white patches inside the mouth, including on the tongue. Although not dangerous on its own, leukoplakia can be a precursor to cancer. So it is important for your dentist to find the cause of white patches on your tongue. Leukoplakia can develop when the tongue has been irritated, and it is often found in people who use tobacco products.
  • Oral thrush. Also known as candidiasis, oral thrush is a yeast infection inside the mouth. The condition brings on white patches that are often cottage cheese-like in consistency on the surfaces of the mouth and tongue. Oral thrush is most commonly seen in infants and older people, especially denture wearers, or in people with weakened immune systems. People with diabetes and people taking inhaled steroids for asthma or lung disease can also get thrush. Oral thrush is more likely to happen after the use of antibiotics, which may kill the "good" bacteria in the mouth. Eating plain yogurt with live and active cultures may help restore the proper fauna in your mouth. Also, medications may be used to combat the infection.
  • Oral lichen planus. A network of raised white lines on your tongue with a lace-like appearance can be a sign of this condition. Doctors often can't pinpoint its cause, but it usually gets better on its own. You can do some things that might help: Practice proper dental hygiene, avoid tobacco, and cut back on foods that irritate your mouth.

Yellow tongue

If your tongue has turned yellow, it may be due to:

  • Lack of dental care
  • Smoking
  • Chewing tobacco
  • Bacteria overgrowth 
  • Certain foods
  • Mouthwash ingredients like chlorhexidine, alcohol, and menthol

Medical conditions such as an autoimmune disease, gastritis, psoriasis, and jaundice can also cause a yellow tongue.

Strawberry tongue

Many things can cause a normally pink tongue to turn red. In some instances, the tongue may even take on the appearance of a strawberry with enlarged red taste buds dotting the surface. Possible causes include:

  • Vitamin deficiencies. A lack of folic acid and vitamin B12 may cause your tongue to appear reddish.
  • Geographic tongue. This condition, also known as benign migratory glossitis, is named for the map-like pattern of reddish spots that develop on the surface of the tongue. At times, these patches have a white border around them and their location on the tongue may shift over time. Though usually harmless, you should check with your dentist to investigate red patches that last longer than 2 weeks. Once the dentist has determined that the redness is a result of geographic tongue, no further treatment is necessary. If the condition makes your tongue sore or uncomfortable, you may be prescribed topical medications to ease discomfort.
  • Scarlet fever. People who get this infection may develop a strawberry tongue. If you have a high fever and red tongue, be sure to contact a doctor right away. Antibiotic treatment is necessary for scarlet fever.
  • Kawasaki syndrome. This disease, usually seen in children under the age of 5, affects the blood vessels in the body and can cause strawberry tongue. During the severe phase of illness, children often run an extremely high fever and may also have redness and swelling in their hands and feet.
  • Pellagra. A serious lack of vitamin B3 (niacin) causes this disease, which can eventually lead to death. One of the symptoms is a red swollen tongue.
  • Pernicious anemia. This autoimmune condition prevents your body from absorbing vitamin B12 and can cause a swollen red tongue.

Black tongue

Though troubling in appearance, a black, hairy tongue is typically nothing serious. It comes from an overgrowth of bacteria, dead cells, and other debris that get trapped on your tongue. Several things can cause it:

  • Overgrown papillae. The small bumps on the surface of your tongue grow throughout your lifetime. In some people, the papillae become very long rather than being worn down by daily activities. That makes them more likely to harbor bacteria. When these bacteria grow, they may look dark or black, and the overgrown papillae may appear hair-like.
  • Medical treatments. People who are taking antibiotics or receiving chemotherapy may be more likely to have a black hairy tongue.
  • Poor oral care. This condition isn’t common but is most likely to happen in people who don’t have good dental hygiene.

Your doctor can usually tell what’s wrong with your tongue by looking at it. They may want to test you for medical conditions that can cause tongue symptoms, like diabetes or a vitamin deficiency.

It's possible you'll need other exams to diagnose your tongue problem. Your doctor may perform a laryngoscopy to look at the base of your tongue. It's a procedure where they use a small mirror and light to look at your throat area.

If you have a mouth tumor, you may have a biopsy to check for cancer.

Treatments for tongue problems vary depending on their cause. Some problems go away by themselves, but treating an underlying health condition can improve symptoms.

Your doctor may suggest a medicated rinse or gel. If you have oral thrush, you may need antifungal medication.

If a nerve condition is impacting your tongue, speech therapy could help with speech and swallowing

Cancer treatment can range from surgery to radiation and chemotherapy or drug therapy.

Because some tongue problems can be linked to poor oral health, it’s important to take care of your mouth and teeth. Brush and floss regularly and use a tongue scraper to remove bacteria and other particles. If you smoke, talk to your doctor about quitting.

Home remedies for tongue discomfort include:

  • Avoiding toothpaste with sodium lauryl sulfate
  • Avoiding spicy or acidic foods
  • A warm salt water rinse

Tongue problems can range from pain to changes in color and texture, often caused by various factors like trauma, smoking, canker sores, burning tongue syndrome, or medical conditions such as diabetes or oral cancer. Diagnosing tongue problems involves a visual examination and, in some cases, testing for underlying health conditions or biopsies for cancer. Treatments vary based on the cause and may include medicated rinses, antifungal medication, or cancer treatment like surgery or chemotherapy.