There is more to a healthy tongue than meets the eye. In fact, the look of the tongue is rarely as important as how it feels.
Marshfield Clinic otolaryngologist Dr. Kenneth Condon said while tongues may come in various shades of pink and red, most of that variation is no cause for concern.
“The thing that would get my attention would be somebody complaining of pain,” Dr. Condon said. “A healthy tongue is one that’s not painful. There are many variations in how the tongue can look that are completely normal.”
Why does my tongue hurt?
Multiple conditions cause pain in the tongue and mouth. Oral thrush is a fungal infection of the mouth, which can be painful, Condon said. The infection also can cause difficulty swallowing.
Ulcers also may cause pain in the mouth, and Condon said it is possible an ulcer could be caused by an oral cancer.
“Common canker sores are not cancerous.” Condon said. “The common canker sore will come and go within several days. Ulcers lasting more than a month may be cancer, and they need to be biopsied.”
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Another painful possibility is called burning mouth syndrome, in which the mouth feels like it is burning or tingling. With burning mouth syndrome an underlying medical condition may be causing the burning or tingling sensations.
When looks do matter
While slight variations in the appearance usually aren’t cause for concern, a few instances raise red flags.
“Leukoplakia is a condition where white patches appear on the inside of the mouth. Those white patches are thought to be precancerous,” Condon said.
Those most at risk for mouth cancers are heavy drinkers, smokers and those having been exposed to human papillomavirus.
A less serious condition is known as black hairy tongue. Bacteria stimulate the tongue’s papillae, which then get longer and begin to look like black hairs. This condition could indicate that mouth hygiene needs to be improved.
Condon says the bottom line is, in general, not to be overly concerned.
“Relax about it. If it’s not hurting, it’s alright,” he said.
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