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Most tongue disorders respond to better dental hygiene and diet, but a few require antibiotics or vitamin supplements to treat. Tongue disorders involving tongues that appear discolored are typically considered harmless and can be treated at home by brushing or scraping the tongue. Glossitis, an inflammation producing a swollen tongue marked by pain, might need antifungal or antibiotic medication. Leukoplakia refers to a lump or sore that may indicate a precancerous condition that can be removed via surgery.
Black, hairy tongue, also called furry tongue, might appear after a fever, especially if antibiotics were taken that disrupted the natural bacteria in the mouth. This condition usually appears on the top of the tongue and may cause bad breath and a metallic taste in the mouth. Black tongue disorders can also appear after taking upset stomach medication containing bismuth. Dentists commonly recommend brushing or scraping the tongue to remove the discoloration.
Yellow tongue disorders usually appear before the tongue turns black. These might indicate temporary conditions that disappear on their own. Small projections on the tongue called papillae might swell and change color if bacteria build up. This condition can be treated with a hydrogen peroxide solution, brushing, or adding fiber to the diet to reduce the amount of bacteria in the mouth. In rare cases, yellow tongue might indicate gall bladder or liver problems, which tests can confirm.
Glossitis represents a more serious disorder needing drugs to treat. The tongue might appear smooth, beefy red, and cause pain when eating, talking, or swallowing. If anemia causes the tongue to appear pale, it might indicate a vitamin deficiency. Dentists commonly prescribe an antibiotic or antifungal drug if infection is present. Dietary supplements generally treat anemia. In severe cases of glossitis, swelling might become so pronounced it impedes breathing.
Leukoplakia indicates a precancerous sore usually caused by irritation from rough teeth or ill-fitting dentures. Pipe smokers and tobacco users face a higher risk of developing this disorder, which is more common in older people. Treatment involves removing the lesion and conducting a biopsy to test for oral cancer.
When leukoplakia appears with hairy tongue, it might indicate an immune system disorder. This tongue condition might include white or gray spots that appear fuzzy and raised and which are caused by uneven teeth or fillings. Although usually not harmful, this disorder might show up as a symptom of immune disease.
Geographic tongue disorders are generally harmless and require no treatment. Random patches of bumps, sores, or lumps might pop up on the sides of the tongue or floor of the mouth. They rarely appear on the top of the tongue. These sores may look bright red and cause a burning sensation aggravated by hot foods, beverages, or alcohol. For an unknown reason, geographic tongue is less common in people who smoke.
Painful papillae might appear after consuming foods high in acid, such as orange juice and tomato-based products. Taste buds near the papillae might become irritated by certain foods or from biting the tongue. A mouth rinse often relieves pain from this condition.