The overall appearance of your tongue can tell you a lot of what is going on in your body in terms of your general health. That is why doctors in the nineteenth century always told their patients to stick their tongue out so that they (the doctors) can have a visual examination of it as part of the diagnostic process. We dentists are trained to examine the tongue and to evaluate our findings in relation to numerous diseases both local and systemic.If the tongue is red, it could mean that you have a vitamin deficiency. A glossy, bright red tongue may be a sign your body is lacking iron or vitamin B12. Vitamin B12 and iron are needed to mature papillae (the carpet-like surface) on the tongue. If you are deficient in those vitamins, you lose those papillae on the tongue, which can make it appear very smooth. In severe cases, this “balding” can cause pain when eating hot liquids or spicy food. Vegetarians are especially prone to low levels of vitamin B12, which is found in certain meats.

If you notice that your whole tongue is red, and you are a vegetarian, ask your doctor about taking supplements. Notable vitamin deficiencies can also be associated with an autoimmune disease in the gut, in which the stomach does not absorb vitamins.
On the other hand, if your tongue appears brown or with a furry darkness, it could mean you do not have the best oral hygiene. A tongue covered in dark hairs (actually called “black hairy tongue”) may look nasty, but dentists agree that it is not cause for major concern. We have papillae on the surface of our tongue, which grow throughout our lifetime. These are normally worn down by eating, but sometimes they can become overgrown, which makes them more likely to harbor bacteria and become dis-colored by bacteria or from food. This can cause bad breath or taste abnormalities.

Typically, this condition is brought on by smoking, drinking coffee and dark teas or poor oral hygiene. Removing the offending cause, like smoking, and brushing the tongue or using a tongue scraper, may be all you need to cure it.
If the surface of your tongue appears like white cheese, you may very well have a yeast infection. A lumpy, white-coated tongue could be thrush, an oral yeast infection caused by over production of Candida albicans (a fungus). This condition is often linked to antibiotics. Remember that your tongue is home to naturally occurring bacteria and yeast. When you take an antibiotic, which selectively kills off bacteria, it can allow yeast, which is not killed off be antibiotic, to take over.

Thrush, which might cause taste disturbances or a bit of pain, can also occur in those with weakened immune systems. Typical in young children, thrush also affects people with autoimmune diseases, people with diabetes the is not well controlled, chemotherapy patients and the elderly.

Wrinkles on the tongue could indicate that you are getting old (yes, even our tongues show signs of aging). Fissures and cracks in the tongue are typically harmless, but problems can arise if poor hygiene leads to infection within the crevices. Once in a while a fungal infection can develop inside the clefts. You will suddenly have a pain, foul smell, and sometimes burning. Often the infection is treated with a topical antifungal medication. Some dental appliances, like dentures, can also cause indentations on the tongue.

Small patches of white, especially under the tongue, if you are a smoker, is not good news. These lesions have five to seventeen percent chances of developing into cancer. They are called leucoplakia and considered to be pre-cancerous. However, the process may be reversed if you stop smoking in time.