What Are Tongue Disorders?

Tongue disorders are characterized by changes in the texture and appearance of the tongue’s surface.

  • Glossitis is inflammation of the tongue, whereby the tongue becomes extremely smooth, swollen, red and painful.
  • Geographic tongue also involves inflammation, but in focal, sensitive, migrating patches.
  • Macroglossia is an abnormally enlarged tongue.
  • Hairy tongue and discolored tongue are more unsightly than painful, and both can usually be remedied by good oral hygiene.

Tongue cancer, the most serious disorder, primarily affects people over 40. A small ulcer or a raised white patch (leukoplakia) may be the earliest sign of cancer. Most leukoplakias do not become malignant, however a leukoplakia must be evaluated and biopsied—and it must also be monitored if not removed entirely. Tongue cancer may spread rapidly to surrounding tissues in the gums, lower jaw or lymph nodes in the neck; detection before cancer spreads is essential for a favorable prognosis.

What Causes Tongue Disorders?

  • Hairy tongue and discolored tongue (in which papillae, the small projections on the tongue, become elongated or darkened) may be caused by tobacco, foods or medications such as antibiotics. Poor oral hygiene is a contributing factor.
  • Tongue disorders may be a sign of an underlying ailment, such as systemic lupus erythematosus, candidiasis, psoriasis or syphilis. Disorders associated with glossitis include a deficiency of vitamin B12 (pernicious anemia) or other B vitamins, scarlet fever, toxic shock syndrome and infection (particularly herpes simplex, which may also cause cold sores on the tongue). Down syndrome, intrauterine hypothyroidism (cretinism), amyloidosis and overproduction of growth hormone by a pituitary tumor (Acromegaly) can cause macroglossia.
  • Chronic irritation due to smoking, alcohol, jagged teeth or dentures can cause leukoplakia or glossitis.
  • Tongue cancer is often associated with smoking and alcohol use (especially in combination).
  • Hairy leukoplakia may be a complication of HIV.

Symptoms of Tongue Disorders

  • A painful, red, swollen tongue that glistens and is extremely smooth (glossitis)
  • Painless red patches that heal then reappear on other parts of the tongue (geographic tongue)
  • Elongated papillae that make the tongue look hairy or discolored (hairy tongue)
  • A painless, raised white patch that may become firm or rough (leukoplakia)
  • Discoloration of the tongue ranging from yellowish white to brown-black (hairy tongue)
  • Bad breath
  • Excessive salivation
  • Difficulty swallowing
  • Swelling
  • Stiffness of the tongue
  • Taste problems

Preventing Tongue Disorders

  • Brush or scrape the tongue when you brush your teeth to promote good oral hygiene.
  • See a dentist at least once a year.
  • Avoid tobacco and excessive use of alcohol.

Tongue Disorder Diagnosis

  • Examination and patient history are often sufficient.
  • Salivary gland test can be performed.
  • Tongue biopsy may be performed when cancer or mucous membrane disease is suspected.
  • To evaluate for conditions, such as systemic causes of tongue disorders, a blood test can be performed.

How to Treat Tongue Disorders

  • Treatment is directed at the underlying cause. For example, if a tongue disorder is caused by a vitamin deficiency, dietary guidelines or vitamin supplements may be recommended. Ill-fitting dentures or jagged teeth should be remedied by a dentist.
  • A mild salt solution, antiseptic mouthwash or topical ointment may soothe discomfort.
  • Antibiotics or antifungual medication may be used when the disorder includes minor bacterial or fungal infections (as in glossitis).
  • Tongue cancer may require surgical excision of all affected tissue, followed by radiation therapy. Tumors that have spread may also require chemotherapy.

When to Call

  • Call a doctor if your tongue is sore, swollen or stiff, or if symptoms persist for more than a few days.


Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference

Simeon Margolis, M.D., Ph.D., Medical Editor

Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at Healthcommunities.com

Published: 31 Jan 2012

Last Modified: 01 Dec 2014