Your tongue can change color, swell, feel sore or look furry for many reasons, most of them minor. MedlinePlus, from the National Library of Medicine, explains that minor infections or irritations are the most common cause of tongue soreness. Some changes point to a nutrition problem or another condition, so persistent changes are worth checking.
Glossitis: an inflamed tongue
MedlinePlus defines glossitis as a swollen, inflamed tongue. It often makes the surface look smooth because the tiny bumps (papillae) are lost. Geographic tongue is one type.
Symptoms
- smooth tongue surface
- sore, tender or swollen tongue
- pale or bright red color
- problems chewing, swallowing or speaking
- rarely, a blocked airway
Causes
MedlinePlus lists allergic reactions to oral care products, foods or medicines, dry mouth from Sjögren syndrome, infection from bacteria, yeast or viruses (including oral herpes), injury from burns, rough teeth or bad-fitting dentures, skin conditions, irritants such as tobacco, alcohol, hot foods and spices, hormonal factors and certain vitamin deficiencies. It sometimes runs in families.
Other tongue changes
Hairy and black tongue
MedlinePlus says hairy tongue looks hairy or furry and can sometimes be treated with antifungal medicine. Possible causes include antibiotic therapy, drinking coffee, dyes in medicines and food, overuse of mouthwashes with oxidizing or astringent ingredients, tobacco, head and neck radiation, and chronic conditions. A black or brown upper surface is unsightly but not harmful. Good oral care can help both. See our mouthwash guide.
White, smooth or red tongue
- White: local irritation, smoking and alcohol use. For white patches, see also leukoplakia and oral thrush.
- Smooth: anemia or vitamin B12 deficiency.
- Red: folic acid and vitamin B12 deficiency, pernicious anemia and other conditions.
Swelling
MedlinePlus says sudden swelling can come from an allergic reaction or a medicine side effect. Other causes include infection, hypothyroidism and certain genetic or medical conditions. The tongue may get wider in people who have no teeth and don’t wear dentures.
Pain and burning
Tongue pain can occur with glossitis, geographic tongue, mouth ulcers, leukoplakia, oral cancer, vitamin B12 deficiency and diabetic neuropathy. Biting the tongue and heavy smoking can also cause pain. After menopause, some women have a sudden burned feeling (burning tongue syndrome). See burning mouth syndrome.
Home care
- Brush thoroughly at least twice a day and floss at least once a day (MedlinePlus glossitis guidance).
- Eat a well-balanced diet.
- Avoid irritants such as hot or spicy foods, alcohol and tobacco.
- Canker sores heal on their own.
- Antihistamines can relieve allergy-related swelling. Avoid the trigger food or medicine.
- See your dentist if dentures are causing the problem.
When to get help
MedlinePlus says to contact your provider if a tongue problem makes eating or breathing difficult or persists, or if glossitis lasts more than 10 days. Get emergency care right away if tongue swelling blocks the airway or makes breathing difficult.
What to expect at the visit
The provider will look closely at your tongue and may ask when it started, what makes it worse, whether you wear dentures, about taste changes, medicines, allergies, and tobacco or alcohol use. Blood tests or a biopsy may be needed. MedlinePlus says treatment depends on the cause and may include antibiotics, diet changes or supplements, or anti-inflammatory medicines. Glossitis goes away once its cause is treated.
Frequently asked questions
Is black hairy tongue dangerous?
MedlinePlus says a black tongue is unsightly but not harmful.
Can vitamins affect my tongue?
Yes. MedlinePlus links smooth or red tongue to vitamin B12 and folic acid deficiency. Ask your provider before taking supplements.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “ElevatedTongueLA” by Doc James, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.