You wake up, brush your teeth, give yourself a smile, and notice there’s some weird colouring or texture on your tongue that definitely doesn’t seem normal. WTF?
Yes, it’s unexpected — but don’t freak out. “I have had patients that noticed a colour change on the tongue and Googled what it means and scared themselves silly by finding really dangerous conditions when the real cause was that they took a medication for an upset stomach that changed the tongue colour for a few hours,” says Dr. Lee Gause, DDS, founder and dentist at Smile Design Manhattan.
It turns out, lots of things (and typically harmless things!) can change the colour and coating of your tongue. The thickness of the coating is correlated with the severity of the condition, according to Gause. For instance, “a grey coating can be related to Gastritis or Peptic Ulcer, while a brown coating is often correlated with lung issues,” he says.
A healthy tongue is light pink in colour. If you notice yours looks different, you’ll want to figure out what’s going on so you can get back to normal as soon as possible. Here’s a guide to what the colour of your tongue means for your health, and what you should be doing about it.
White Tounge
A thick or heavy white coating on the surface of the tongue, also known as Leukoplakia, can come from cigarette smoke or irritation to the tongue. “This is more of a coated appearance,” he says. Don’t mistake it for thrush, which “looks like a layer of cottage cheese on the tongue, and is often associated with diabetes or weakened immune systems.”
Leukoplakia is most common in people who smoke a lot. “Smoking is never healthy, but we don’t see this in social smokers,” Gause says. “The problem is [when] social smokers become heavy smokers.”
It may take time to notice you have the condition. “Leukoplakia builds gradually until it gets out of hand, so it may not be noticed by the patient,” he adds. “That is why something seemingly obvious, like a thick white coating on the tongue may be missed until it is seen by a dentist or doctor.” Your best bet? Get routine check-ups with your doc.
Red Tongue With a “Mapped” Appearance
Does your tongue look like it’s dotted with smooth little islands?
“This is called geographic tongue,” Gause explains. “This is quite common and not dangerous. The tongue has red and white patterns that look like a map, hence the name.” No need to worry here — while it’s unknown why it happens, it’s NBD.
Red Tip of the Tongue
Oddly enough, a red tip of the tongue can signify mental or emotional stress, Gause says. It can flare up during high-stress situations, and it’ll resolve itself once things have settled down. “Also, psychological medication can change both salivary flow and hydration of the mouth, which can impact the mouth overall and the colour of the tongue,” he explains.
Black and Hairy Tongue
Yuck — that’s the first word that comes to mind, here. This can happen when there’s a build up of bacteria, or if you’re a regular smoker. “Treatment: good oral hygiene, including brushing three times a day, flossing, and not smoking,” he says. In fact, smokers often get one or two extra cleanings per year.
“An electric toothbrush is a great add-on to help patients achieve a cleaner mouth,” he adds. “Brushing of the tongue should occur every time you brush your teeth, and smokers and nonsmokers alike should use a tongue scraper, which can be bought over the counter to keep buildup off the tongue.”
There’s another possible reason for a black tongue: Pepto-Bismol. “Pepto-Bismol, which contains bisthmus, can also turn the surface of the tongue black,” says Dr. Jon Marashi, DDS.
Yellow Tongue
This can signify liver or stomach problems, says Dr. Jon Marashi, DDS. “A yellow tongue can be the gradual start of disease, leading to a brown or black-coloured tongue down the line,” he says.
On the less dangerous end, “The most common causes of a yellow tongue can be poor dental hygiene, smoking, or certain medications,” he says. Improving your dental hygiene is an easy fix; however, if you do not see any improvement, you should get it checked out by a medical professional.
Brown Tongue
Usually a brown tongue comes from what you’re eating or drinking: “A brown discolouration of the tongue can be due to heavy coffee drinking and/or smoking,” Marashi says. If your tongue is permanently brown, it could mean you’re experiencing lung problems due to chronic smoking.
Blue or Purple Tongue
A blue or purple tongue can be an indicator of heart trouble, Marashi says. “If the heart is not pumping blood properly, or if there is a lack of oxygen in the blood, your tongue can turn a bluish purple,” he explains. If you see blue or purple, definitely make an appointment with your doctor.
Pale Tongue
A pale-coloured tongue can indicate a vitamin or nutrition deficiency — specifically vitamin B12 and vitamin A. “This can easily be corrected by seeing your physician [or an RD] where they might suggest a diet change or supplements,” he says.
Try eating more foods rich in vitamin A, like carrots, sweet potatoes, squash, cantaloupe, spinach, and kale, as well as foods rich in vitamin B12, like liver, fish, beef, and fortified cereal.
If you notice something strange on your tongue, stay calm and don’t try to self-diagnose. Go to a medical or dental professional for advice.
This article originally appeared on Men’s Health US.
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