12 Common Tongue Problems and Treatments Explained

The human tongue is not only an important part of swallowing and tasting — it can also serve as an indicator of disease and disorder in the body. There are a wide variety of tongue disorders that can cause symptoms in how the tongue looks and feels, including irritation, inflammation and discoloration, to name a few.¹

Some tongue disorders can be congenital, meaning you are born with it, while others may be acquired.² Regardless of how you acquire a tongue disorder, it can be uncomfortable and may even be a warning sign of a more serious disease.¹

Here is a closer look at common tongue disorders and their recommended treatments.

1. White Tongue

A white tongue can be a symptom of several possibilities. One common cause is oral candidiasis, a yeast infection also known as oral thrush. This may show up as a white, patchy or sore-like presentation inside the mouth or on the tongue. It can occur in any age group, though it’s more common in babies and children.³

White tongue can also be a side effect of gastroesophageal reflux disease (GERD), which causes gastric secretions to rise back up the esophagus and onto the tongue.⁴

Other factors that can contribute to a white tongue include:⁵

• Poor oral hygiene
• Dehydration
• Tobacco and alcohol
• Certain foods and diet
• Medications
• COVID-19

How to treat white tongue

Treatment will depend upon the diagnosis. If white tongue is caused by oral thrush, it will typically be treated with an antifungal rinse, pill or lozenge.³ If it is due to GERD, healthcare providers may treat it with one or more medications, ranging from antacids, which are a temporary solution, to proton pump inhibitors, which reduce the amount of acid the stomach makes.⁶

If white tongue is linked to another condition, different treatments will be considered. Additionally, basic recommendations — such as improving oral hygiene, quitting smoking and alcohol, making dietary changes or using a mild fluoride toothpaste — may be encouraged.⁵

2. Red Spots

Little red spots or bumps on the tongue are most likely what dentists call transient lingual papillitis. Essentially, they are an inflammation of the naturally occurring taste buds, officially known as papillae. The redness can result from injury — such as biting the tongue or drinking a too-hot beverage — or from a virus, poor diet or stress.⁷

Red spots might also indicate capillary hemangiomas, which are benign vascular lesions that don’t require treatment.⁸

A more serious possibility, which we’ll discuss below, is strawberry tongue. This can result from a bacterial infection or disease.⁷

How to treat red spots on the tongue

The good news is that these spots tend to heal on their own without much need for intervention.⁷

3. Tongue Bumps

Bumps on the tongue could be from tumors.⁸ They could also be from canker sores, which are white or red sores that can be caused by bacteria, viruses, trauma or immune system problems.⁹

Some tongue bumps are benign tumors and include:⁸

• A fibroma, which occurs after an injury and is usually left alone
• A giant cell granuloma, which may require surgical removal
• A lipoma, which is a painless swelling in the submucosal tissues that may require surgical removal
• Lymphangiomas, which are translucent nodules or blister-like bumps that can be treated with surgery, cryotherapy, embolization, steroids or other options

Tongue bumps that are malignant tumors — often treated with chemotherapy, radiation, surgery, stem cell therapy or immunotherapy — include:⁸

• Squamous cell carcinoma
• Verrucous carcinoma
• Lesions resulting from non-Hodgkin's lymphoma

How to treat tongue bumps

Tongue bumps that are not tumors, such as canker sores, tend to go away on their own but can be treated with topical anesthetics and antimicrobial mouthwashes. Avoiding spicy or acidic foods may also be advised.⁹

4. Burning Tongue

Most people who experience burning mouth syndrome — pain or a hot burning sensation in the mouth — feel it on their tongue. The condition doesn’t have an identified cause. Medical experts often treat it as neuropathy, an unspecified nerve pain, after ruling out other possible causes for the pain. Burning tongue may have a hormonal connection, as most people who report it are postmenopausal women.¹⁰

Other causes of mouth pain include oral lichen planus (see below), Sjögren’s disease, oral thrush and viral lesions, among others. Some medications, poorly fitting dentures, teeth grinding and allergies can also cause burning of the mouth and tongue.¹⁰

How to treat burning tongue

To treat appropriately, a healthcare provider must first determine the root cause, such as underlying diabetes, thyroid issues or food allergies. Lifestyle changes, such as reducing tobacco or alcohol consumption, may also help.¹⁰

If the pain is caused by oral thrush, as mentioned above, it will likely be treated with an antifungal medication. A vitamin deficiency will typically receive vitamin supplementation. Diabetes and thyroid conditions will need to be addressed and treated by specialists in those disease areas. If no underlying cause can be determined, medications that calm the nervous system may be prescribed.¹⁰

5. Blistered Tongue

A blistered tongue can occur from food trauma, such as eating food that is hot, sharp or hard.¹¹ It can also be caused by chemical trauma, dental procedures, steroid inhalers and some diseases.¹¹ Additionally, the autoimmune disease pemphigus vulgaris can cause blisters on the mouth and tongue.¹²

Other kinds of lesions that can appear or feel like blisters include herpes simplex virus lesions (cold sores)¹³ and those created by conditions and diseases such as canker sores, oral thrush and cancer, as mentioned above.

How to treat a blistered tongue

Pemphigus vulgaris is treated with systemic corticosteroids and, if necessary, immunosuppressive medications.¹² Canker sores, as mentioned above, tend to go away on their own, but topical anesthetics and antimicrobial mouthwashes can help.⁹ Herpes simplex viral lesions also tend to go away on their own, but some health care providers may prescribe an antiviral medication if the virus is in its early stages.¹³

6. Inflamed Taste Buds

Taste buds, or papillae, can become inflamed for a variety of reasons. Causes of these raised sore bumps include:¹⁴

• Poor oral hygiene
• Dry mouth
• Acid reflux
• Eating spicy or acidic foods
• Temperature sensitivity
• Oral infections
• Oral cancer (most common in heavy drinkers and smokers)
• Vitamin deficiencies (caused by a lack of nutrients such as iron or vitamin B)
• Stress
• Smoking
• Injuries and irritation

A dentist or doctor should be consulted for an inflamed taste bud — or other lesion or bump — that persists for more than two weeks. A healthcare provider can help determine the root cause and appropriate treatment.¹⁴

How to treat inflamed taste buds

If inflamed taste buds are a result of poor oral hygiene, brushing the surface of the tongue with a toothbrush may help. If the inflammation is caused by chronic dry mouth, drinking more water or juices may help. (If dry mouth is due to nasal congestion, the doctor may treat that first.) If acid reflux is the cause, antacids or similar medications, as well as dietary changes, may help. Other disease-related cases, such as cancer, would be treated by a specialist in that disease.¹⁴

7. Oral Lichen Planus

Oral lichen planus is a condition thought to be an autoimmune disorder that causes white blood cells to attack the skin cells of the inner mouth. This condition affects only about 2% of the population and, most often, women. It is so named for its lichen-like appearance.¹³

How to treat oral lichen planus

This condition is typically treated with corticosteroids.¹³

8. Leukoplakia

Leukoplakia can be confused for white tongue or oral thrush because it shows up as white patches in the mouth and on the tongue.⁸ But because the patches don’t rub off in any way, those other conditions typically can be ruled out.¹⁵ Leukoplakia is often associated with smoking or high alcohol consumption and may also be linked to the human papillomavirus (HPV).⁸

Though the patches don’t usually cause pain, they can be sensitive to extreme temperatures and spicy foods.⁸ In some cases, leukoplakia is a precursor to or found with oral cancer.¹⁵

How to treat leukoplakia

Making lifestyle changes, such as quitting smoking or reducing alcohol consumption, may help. This condition is also often treated with techniques such as surgery, laser ablation, electrocauterization or cryosurgery.⁸

9. Geographic Tongue

Geographic tongue, which affects up to 2.5% of the population, occurs with raised lesions that move around the tongue and can disappear and reappear. The cause is unknown, but the condition may be linked to stress, psychological factors, allergies, diabetes and hormones, though no direct cause has been found.¹⁶

Researchers have theorized that geographic tongue might be the oral form of psoriasis, as the condition is more frequent in people with psoriasis. Vitamin deficiencies may also play a role.¹⁶

How to treat geographic tongue

Treatment typically involves maintaining proper oral hygiene and avoiding alcohol, as well as hot, spicy, sour and acidic foods and beverages.¹⁶

10. Kawasaki Disease or Scarlet Fever

Kawasaki disease, a condition that primarily affects children, is characterized by a high fever and inflamed blood vessels. It poses a significant threat to the heart if not treated within 10 days.¹⁷

One of the symptoms is known as strawberry tongue — rough, red spots that make the tongue look like the skin of a strawberry. The inner mouth and lips can also get very red or become dry and cracked.¹⁷

Strawberry tongue can also occur in scarlet fever, which results from a streptococcal bacterial infection.¹⁸

How to treat Kawasaki disease or scarlet fever

When children are hospitalized with Kawasaki disease, the treatment typically consists of intravenous immunoglobulin (IVIG), which reduces high fevers and helps keep the blood vessels from becoming damaged. Additionally, baby aspirin is given to avoid blood clots.¹⁷

When strawberry tongue is a side effect of scarlet fever, it is treated with antibiotics.¹⁸

11. Glossitis

Glossitis is inflammation of the tongue that can cause soreness as well as changes in the tongue's texture and color. The exact cause of glossitis is not clear, but contributing factors may include:⁸

• Anemia
• Vitamin B deficiencies
• Infections
• Adverse reactions to medications
• Poor hydration
• Autoimmune conditions
• Psoriasis

How to treat glossitis

When symptoms are present, glossitis is often treated with anti-inflammatory and analgesic mouth rinses.⁸

12. Black Hairy Tongue

Hairy tongue results from a defective shedding of the surface tissue of the tongue and is more common in older individuals. A lack of stimulation to the top of the tongue causes a keratin buildup. Certain types of oral yeast infections can also gather a hairlike mesh on the tongue and can even change the color of the tongue to brown or cream. Some bacteria and yeast can make the tongue appear black, which is then referred to as black hairy tongue.¹⁹

How to treat black hairy tongue

Black hairy tongue is typically treated by debridement — brushing away the accumulations on the tongue. Additionally, a healthcare provider will attempt to figure out what caused the condition, such as medication or food, and recommend stopping or changing the aggravating factor.¹⁹

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Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more. Her work has appeared in The Atlantic, The Billfold, Good Magazine, GOBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, PayPal, The Washington Post and more.