A lifestyle resource for today's active adult: Live Smart, Live Well, Live Large

The tongue is the principal organ of taste, an aid in chewing, swallowing, and in humans, an important organ of speech. It is made up of many groups of muscles that run in different directions to carry out all the tongue's jobs.

The front part of the tongue is very flexible and can move around a great deal, working with the teeth to create different types of sounds for word formation. The top of your tongue is covered with a layer of bumps called papillae. Papillae help grip food and move it around while you chew and contain your tastebuds. People are born with about 10,000 tastebuds however as a person ages some of his or her tastebuds die. (An old person may only have 5,000 tastebuds!) That's why some foods may taste stronger to you as a child than they do as an adult. Tastebuds can detect sweet, sour, bitter, and salty flavors.

So how do you know how something tastes? Each tastebud is made up of taste cells, which have sensitive, microscopic hairs called microvilli. Those tiny hairs send messages to the brain, which interpret the signals and identify the taste for you. Identifying tastes is your brain's way of telling you about what's going into your mouth, and in some cases, keeping you safe.

Functions of the Tongue
Tasting and Processing the Food: Your tongue works along with our teeth, lips and mouth to taste, chew, and swallow food. Your teeth help your tongue grind food as the tongue mixes the food around your mouth. Without your teeth, lips, and the roof of your mouth, your tongue wouldn't be able to form sounds to make words. Saliva is needed for the proper functioning of the tongue. A dry tongue can't taste a thing so saliva helps the tongue and our sense of taste by keeping it wet. Saliva moistens food and helps to break it down, which in turn makes it easier for the tongue to push the food to the back of the mouth for swallowing.

Fighting Germs: The back section of your tongue contains something called the lingual tonsil. Tonsils are small masses of tissue that contain cells that help filter out harmful germs that could cause an infection in the body.

The Tongue is One Tough Worker: with all that talking, mixing food, swallowing, tasting, and germ fighting, does your tongue ever get a rest? No. Even when you are sleeping, your tongue is busy pushing saliva into the throat to be swallowed.

Tongue Conditions
Tongue movement problems are most often caused by nerve damage. However, problems moving the tongue may also be caused by ankyloglossia, a disorder where the band of tissue that attaches the tongue to the floor of the mouth is too short. Tongue movement disorders may result in speech difficulties or difficulty moving food during chewing and swallowing.

Taste Abnormalities: Taste problems can be caused by damage to the tastebuds, nerve problems, side effects of medications, an infection, or other conditions. As stated previously, the tongue normally senses sweet, salty, sour, and bitter tastes. Other "tastes" are actually a function of the sense of smell.

Enlargement of the Tongue: Tongue swelling occurs with Down syndrome, acromegaly, myxedema, amyloidosis, rhabdomyoma, and other disorders. The tongue may get wider in persons who have no teeth and do not wear dentures.

Color Changes: Color changes may occur with inflammation of the tongue (glossitis). Papillae are lost, causing the tongue to appear smooth. Geographic tongue is a patchy form of glossitis where the location of inflammation and appearance change from day to day.

Hairy Tongue: Hairy tongue is a harmless condition in which the tongue looks hairy or furry. Although its appearance can be worrisome the disorder usually goes away with antibiotics.

Black Tongue: Sometimes the upper surface of the tongue turns black or brown in color. This is an unsightly condition but not harmful.

Pain in the Tongue: This may occur with glossitis and geographic tongue. Tongue pain may also occur in with diabetic neuropathy, oral cancer, mouth ulcers, and leukoplakia (thickened white patches).

After menopause, some women have a sudden feeling that their tongue has been burned. This is called burning tongue syndrome or idiopathic glossopyrosis. There is no specific treatment for burning tongue syndrome.

Possible Causes of Tongue Conditions
• Anemia
• Cancer
• Dentures that irritate the tongue
• Oral herpes (ulcers)
• Neuralgia
• Referred pain from teeth and gums
• Referred pain from the heart

Possible causes of tongue tremor:
• Neurological disorder
• Overactive thyroid

Possible causes of white tongue:
• Local irritation
• Smoking and alcohol use

Possible causes of smooth tongue:
• Anemia
• Vitamin B-12 deficiency

Possible causes of red (ranging from pink to magenta) tongue:
• Folic acid and vitamin B-12 and Niacin deficiency
• Injurious anemia
• Plummer-Vinson syndrome
• Sprue

Possible causes of tongue swelling:
• Acromegaly (tumor of the pituitary gland)
• Allergic reaction to food or medicine
• Amyloidosis (infiltrative disease of the tongue)
• Cancer of the tongue
• Congenital micrognathia (small jaw)
• Down syndrome
• Hypothyroidism
• Infection
• Leukemia
• Lymphangioma (tumor of the lymphatic area)
• Neurofibromatosis
• Injurious anemia
• Strep infection

Possible causes of a hairy tongue:
• AIDS
• Antibiotic therapy
• Drinking coffee
• Dyes in drugs and food
• Chronic medical conditions
• Overuse of mouthwashes containing oxidizing or astringent agents.
• Radiation of the head and neck
• Tobacco use

Possible cause of grooves in the tongue:
• Birth defect -- normally occurs in 10% of population

Source – Tongue Conditions and Causes - National Medical Library/National Institute of Health’s MedlinePlus encyclopedia

Care of your Tongue
Practice good oral hygiene and be sure to eat a well-balanced diet. Some conditions such as Canker sores are caused by viruses and cannot be cured by treatment. They must heal on their own. See your dentist if you have a tongue problem caused by dentures. Antihistamines can help relieve a swollen tongue caused by allergies. You should avoid any food or drug that causes the tongue to swell.

When to Contact a Medical Professional: Make an appointment with your doctor if your tongue problem persists.

Dr. Polavaram specializes in internal medicine and is the owner of Capital Primary Care with offices in Cary and Raleigh.