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Health: Appearance of a healthy tongue

A healthy tongue has a uniform pink colour and a smooth texture.

It should not present sores, swelling, spots or significant colour changes.

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The tongue as an indicator of health problems

Changes in the appearance of the tongue can be signs of local problems, such as infections or irritations, or systemic conditions, such as nutritional deficiencies, autoimmune diseases, and digestive problems.

Regular check-ups with your dentist help identify potential problems early.

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Most common changes

1. Colour change (red, white, yellow, black, or purple).

2. Spots or patches (white, dark, or reddish).

3. Fissures

4. Swelling

5. Pain or burning sensation

6. Persistent canker sores or wounds.

Causes of spots or changes in tongue colour

– White spots: Oral candidiasis, leukoplakia, lichen planus

– Dark spots: Pigmentation from tobacco or excessive use of chlorhexidine mouthwash

– Yellow colour: Poor hygiene, bacterial infection, or jaundice

– Black colour: Hairy tongue caused by bacterial accumulation, tobacco, or poor hygiene

– Red colour: Vitamin deficiency (such as B12), scarlet fever

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White patches on the tongue: causes and treatment

  • Common causes:
    • Oral candidiasis: Fungal infection, usually associated with low immunity or antibiotic use
    • Leukoplakia: Lesion caused by chronic irritation (smoking, alcohol, or dentures)
    • Lichen planus: Autoimmune disorder
  • Treatment:
    • Good oral hygiene (brushing the tongue)
    • Use of antifungals (in the case of candidiasis)
    • Do not smoke
    • Consult your dentist for an accurate diagnosis

Reasons for recurrent canker sores

  • Causes:
    • Emotional stress
    • Local trauma (biting the tongue, ill-fitting dentures)
    • Nutritional deficiencies (iron, vitamin B12, or folic acid)
    • Food allergies
    • Autoimmune diseases or conditions such as Crohn's Disease
  • What to do:
    • Use oral rinses or specific gels
    • Seek medical evaluation if canker sores are frequent or severe

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When is a wound concerning?

A wound on the tongue should be taken seriously if it:

  • Persists for more than 2 weeks
  • Increases in size or causes intense pain
  • Is accompanied by other symptoms, such as difficulty swallowing, bleeding, or weight loss
  • Is hardened or has irregular edges (this could be a sign of oral cancer).

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Tips for maintaining tongue health

  1. Daily oral hygiene:
    • Brush the tongue with a soft toothbrush or scraper
  2. Hydration:
    • Drink plenty of water
  3. Avoid harmful habits:
    • Reduce tobacco and alcohol consumption
  4. Balanced diet:
    • Consume foods rich in vitamins and vegetables
  5. Regular examinations:
    • Visit the dentist periodically
  6. Observe changes:
    • Check for changes in colour, texture, or the appearance of wounds


Dr. Ricardo Maia

Dentist

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