Tongue Diseases Vary: Where Do Your Symptoms Lead?

There are a number of tongue diseases, and it can be overwhelming to figure out the specifics. There are different signs and symptoms for each disease, while some symptoms are shared. Typical signs include pain, sores, burning, noticeable changes in texture or taste of food, discoloration, and swelling.

Since some diseases have similar symptoms, it is important to contact a healthcare professional so they can properly diagnose and treat the disease.

woman sticking tongue out

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Tongue Diseases and Characteristics 

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.

Oral thrush tends to cause white lesions on the tongue and cheek that resemble 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 injures 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.

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.

The population most affected includes men 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 a swollen, burning, or itchy tongue; discoloration of the tongue; and 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:

  • Allergies
  • Hormonal disturbances
  • Diabetes
  • Psychological factors

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

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.

Leukoplakia typically occurs in men between the ages of 50 to 70.

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

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.

A Word From Verywell

If you have symptoms of any disease, it is essential that you contact a healthcare professional. With tongue disease, it is just as important to seek the opinion of a dental or medical professional. Some of these conditions are very serious and need the proper medical attention.

A dental checkup or physical exam can help to determine what is going on, and you can be referred to the right medical professional to get the proper treatment and plan that will help the condition presented.

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Article Sources
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  1. Cleveland Clinic. Thrush. Updated October 19, 2019.

  2. MedlinePlus. Kawasaki disease. Updated August 31, 2016.

  3. The American Academy of Oral Medicine. Fissured tongue. Updated May 13, 2015.

  4. 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

  5. The American Academy of Oral Medicine. Geographic tongue. Updated May 13, 2015.

  6. The American Academy of Oral Medicine. Hairy tongue. Updated May 13, 2015.

  7. Cleveland Clinic. Leukoplakia.  Updated August 5, 2020.

  8. Cleveland Clinic. Burning mouth. Updated July 29, 2019.

  9. National Center for Advancing Traditional Sciences. Macroglossia. Updated February 1, 2021.