Tongue problems may include pain, hairy appearance, unusual color, unusual smoothness, swelling, mouth ulcers, white lining, a split or groove in the tongue (fissure), cobblestone appearance, or positioning off to one side.
The tongue is mainly composed of muscles. It is covered with a mucous membrane. Small bumps (papillae) cover the upper surface of the tongue. Between the papillae are the taste buds, which provide the sense of taste. In addition to taste, the tongue functions in moving food to aid chewing and swallowing, and it is important in speech. Changes in appearance of the tongue may indicate a primary tongue disorder or may be a symptom of other disorders.
DIFFICULTY MOVING THE TONGUE This is most often caused by damage to the hypoglossal nerve (cranial nerve XII). It may also be caused by ankyloglossia (tongue-tie), a disorder where the band of tissue that attaches the tongue to the floor of the mouth (frenulum) is too short. These disorders rarely cause difficulty but may result in speech difficulties or difficulty moving food during chewing and swallowing.
TASTE ABNORMALITIES This can be caused by damage to the taste buds, neurologic abnormalities, side effects of medications, infections, and many other conditions. 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 This occurs with Down's syndrome, acromegaly, myxedema, amyloidosis, rhabdomyoma, and other disorders. The tongue may broaden in persons with no teeth who do not have dentures.
TEMPORARY SWELLING AND COLOR CHANGES These occur with inflammation of the tongue (glossitis). Papillae are lost, causing the tongue to appear smooth. Geographic Tongue (benign migratory glossitis) is a patchy form of glossitis where the location of inflammation and appearance changes from day to day.
HAIRY TONGUE This is a harmless condition that involves enlargement and profusion of tongue papillae, causing the tongue to appear hairy or furry. Hairy tongue is not a harmful disorder, although its appearance can be worrisome. The disorder usually clears with antibiotics.
BLACK TONGUE This occurs occasionally. The upper surface of the tongue turns black or brown in color, and in some cases the papillae elongate. This is an unsightly condition but not harmful.
PAIN IN THE TONGUE This may occur with glossitis and geographic tongue. It may also occur in some post-menopausal women (for unknown reason) and with diabetic neuropathy. The tongue may be a site of oral cancer, mouth ulcers, and leukoplakia.
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