10 Tongue Diseases and Conditions

What They Are and How to Recognize Them

Discoloration, pain and swelling, sores, burning, and noticeable changes in the texture or taste of food are a few signs and symptoms of tongue diseases and other tongue problems. These range from oral thrush seen in newborns to leukoplakia, which may be a sign of developing cancer in adults.

Some are relatively common, while others are rare. Some are typically easy to treat, while others are not.

This article presents these 10 different tongue diseases and other problems, along with their symptoms:

  • Oral thrush
  • Kawasaki disease
  • Median rhomboid glossitis
  • Fissured tongue
  • Atrophic glossitis
  • Geographic tongue
  • Hairy tongue
  • Leukoplakia
  • Burning tongue
  • Macroglossia
woman sticking tongue out

Jonathan Knowles / Getty Images

Oral Thrush

Oral thrush is an oral yeast infection that commonly affects newborns and younger children, but it may also affect adults with weakened immune systems, such as those living with human immunodeficiency virus (HIV).

Oral thrush tends to cause white lesions on the tongue and cheek that may appear to look like cottage cheese. This condition can also be seen on the gums, tonsils, or roof of the mouth.

Symptoms include:

  • Loss of ability to taste
  • Redness and soreness inside and on the corners of the mouth
  • A cottony feeling inside of the mouth

Antifungal medications are known to help thrush. It is important to speak with a healthcare provider to get the proper diagnosis and treatment.

Kawasaki Disease

Kawasaki disease (also called Kawasaki syndrome) is a rare and serious systemic inflammatory condition that affects children, usually in association with an infection.

When this condition occurs, the immune system causes damage to the blood vessels. The blood vessels then become inflamed and narrow, or close off completely.

At times, Kawasaki disease will affect the coronary artery wall, the arteries that bring the oxygen and blood supply to the heart. This can lead to:

  • Heart inflammation
  • Heart valve problems
  • Aneurysm

This disease is usually treated in the hospital and can include aspirin and/or an IV of immunoglobulin.

It is important to speak with a healthcare professional before giving a child aspirin and other treatments to try to help this condition.

Some children diagnosed with COVID-19 have developed symptoms similar to Kawasaki disease. It's referred to as multisystem inflammatory syndrome in children (MIS-C). Your healthcare provider can help you to learn more about MIS-C if your child tests positive for COVID-19.

Median Rhomboid Glossitis

When an individual has median rhomboid glossitis (MRG), the normal coating of the tongue is missing. The top, middle, or back of the tongue has a smooth, red, flat or raised nodular area that ranges between 2 to 3 centimeters long. This condition is considered a chronic fungal infection.

About 1% of the general population is affected, usually males between the ages of 30 and 50. There are minimal to no symptoms, so it is important to check with a doctor for proper diagnosis and treatment. Dentists are most often the healthcare professional to diagnose this condition.

Fissured Tongue

Fissured tongue causes grooves or a number of small furrows on the top surface of the tongue. The fissures can be deep or shallow, multiple or single. This condition is more common as people age, and men are affected more than women.

Fissured tongue is not contagious and is harmless. A dentist is most likely to discover the condition, and it is important to follow up with a healthcare professional for proper treatment.

Atrophic Glossitis

Atrophic glossitis can occur from:

  • An injury
  • An allergic reaction
  • Diseases
  • Anemia
  • Malnutrition

Atrophic glossitis can also occur from vitamin and mineral deficiencies such as iron, folic acid, zinc, and vitamin B12.

Some of the symptoms of this condition are:

  • Swelling, burning, or itching in the tongue
  • Discoloration of the tongue
  • Difficulty swallowing

Again, check with a healthcare professional to get a proper diagnosis and treatment for this condition.

Geographic Tongue

Geographic tongue appears on the top and sides of the tongue. When a person has this condition, the appearance of the tongue has a red bald area of varying size. Sometimes, lesions called geographic stomatitis appear on the cheeks, under the tongue, on the gums, or on the palate.

While the cause is unknown, doctors speculate factors that could cause this condition include:

Some experts consider this condition a form of oral psoriasis.

Hairy Tongue

When an individual has hairy tongue, it is typically an abnormal coating on the surface of the tongue. There is a defective shedding on the covering tissue of the tongue. This condition occurs because there is a lack of stimulation to the top of the tongue.

The appearance of hairy tongue varies depending on the cause of the condition. The tongue can appear green, white, brown, or pink. If yeast or bacteria are present, the tongue will have a black appearance. This is known as black hairy tongue.

Although there are no direct symptoms, general feelings associated with the condition are:

  • Abnormal taste
  • Burning
  • Feeling of gagging


Leukoplakia is typically caused by heavy smoking, chewing tobacco, and alcohol use.

When an individual has this condition, white spots or patches appear on:

  • The inside of the cheeks
  • The surface of the tongue
  • The underside of the tongue

The two types of leukoplakia are:

  • Homogenous: A thin, evenly colored white patch that is consistently wrinkled, smooth, or ridged throughout the area of the patch
  • Non-homogenous: An irregularly shaped patch that is elevated, speckled, flat, or has protrusions

Leukoplakia can be an indicator that tongue cancer is developing. The determination of cancer depends on abnormal cells and the appearance, size, and shape of the patches. The only way to reliably differentiate a non-cancerous leukoplakia from one harboring cancer is through biopsy.

Burning Tongue

Burning tongue, also known as burning mouth, is a condition where the roof of the mouth and tongue have a burning sensation.

When individuals have burning tongue, it is usually out of the blue and the pain is known to come and go. The main symptom of burning tongue is the feeling of a dry mouth.

The condition is typically diagnosed by clinical symptoms. If there is no occurrence of diabetes, vitamin deficiency, or an oral yeast infection, the condition is generally considered burning tongue.

Vitamin and mineral deficiencies—such as vitamin B12, iron, or folate deficiency—cause symptoms similar to burning tongue.


Macroglossia is an abnormal enlargement of the tongue.

Symptoms of this condition include:

  • Speech impairment
  • Difficulty eating
  • Snoring
  • Ulceration
  • Abnormal growth of the teeth and jaw

If a person has primary amyloidosis, Beckwith-Wiedemann syndrome, congenital hypothyroidism, or Down syndrome, these conditions could be associated with macroglossia.

Treatment depends on the cause and can range from surgery to speech therapy. Surgery is known to help with speech, chewing, and physical appearance.

When to See a Healthcare Provider

If you have symptoms of any disease, it is essential that you contact a healthcare professional. With tongue disease, it is important to consult a dental professional or otolaryngologist, a specialist in ear, nose, and throat disorders.

Your throat problems may be relatively benign, but some causes are very serious and need immediate medical attention. Tell your provider about your symptoms if they continue for more than a few days, or interfere with speaking, swallowing, and other daily functions.

Be sure to see a dentist for routine check-ups, too. Many tongue diseases are first spotted by oral health professionals, even if your symptoms don't seem concerning or you have none at all.

A Word From Verywell

Tongue problems are not uncommon, and may occur because of infection, injury, or a more serious disease like tongue cancer. An early diagnosis that leads to early intervention can improve outcomes, but many oral cancers are only diagnosed at an advanced stage. See your healthcare provider as soon as possible if you have concerning symptoms.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Kawasaki disease.

  2. Centers for Disease Control and Prevention. For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19.

  3. The American Academy of Oral Medicine. Median Rhomboid Glossitis.

  4. The American Academy of Oral Medicine. Fissured tongue.

  5. Chun-Pin Chiang, Julia Yu-Fong Chang, Yi-Ping Wang, Yu-Hsueh Wu, Yang-Che Wu, Andy Sun. Atrophic glossitis: etiology, serum autoantibodies, anemia, hematinic deficiencies,hyperhomocysteinemia, and management. J Formosan Medical Association. 2020;119(4):774-780. doi:10.1016/j.jfma.2019.04.015

  6. The American Academy of Oral Medicine. Geographic tongue.

  7. The American Academy of Oral Medicine. Hairy tongue.

  8. Chaturvedi AK, Udaltsova N, Engels EA, Katzel JA, Yanik EL, Katki HA, et al. Oral Leukoplakia and Risk of Progression to Oral Cancer: A Population-Based Cohort Study. J Natl Cancer Inst. 2020 Oct 1;112(10):1047-1054. doi:10.1093/jnci/djz238. 

  9. Reyad AA, Mishriky R, Girgis E. Pharmacological and non-pharmacological management of burning mouth syndrome: A systematic review. Dent Med Probl. 2020 Jul-Sep;57(3):295-304. doi:10.17219/dmp/120991.

  10. National Center for Advancing Traditional Sciences. Macroglossia.

By Yvelette Stines
Yvelette Stines, MS, MEd, is an author, writer, and communications specialist specializing in health and wellness.