The Tongue as a Mirror of Health and Disease

The physical body gives subtle clues as to the status of overall health and wellness. With conscious attention, it is possible to detect physiological imbalance and early disease before chronic health challenges set in. The tongue often times shows early signs of physiological imbalance and therefore can be a road map leading us to the root cause of disease and the restoration of health.

The tongue contains taste receptor cells and is supplied by both the nervous and circulatory systems. The tongue is a sensitive organ which serves many functions and its appearance may change in relation to physiological changes within the body. A healthy tongue should be pink and covered with small nodules (papillae). Any deviation from normal tongue appearance, or pain in the tongue, could be a sign of imbalance in the physiology.

Some of the most common deviations from normal tongue appearance and the associated pathology are listed below.

White Coated Tongue

The most common cause of a white coated tongue is an overgrowth of the yeast, Candida Albicans. The white coating may develop on the tongue, inner cheeks, and sometimes the roof of the mouth, gums, and tonsils. This coating can be scraped off oral tissues.

Common causes of oral yeast overgrowth are:

• Low or suppressed immune function
• Medication side effects (prednisone, inhaled corticosteroids, antibiotics)
• Diabetes
• Chemotherapy/Radiation
• Dentures
• High sugar diet

Nutrition suggestions which may assist in the reduction of oral yeast overgrowth include:

• Elimination of all forms of sugar from diet, even natural ones
• Limit or avoid vinegar, alcohol, mushrooms, hard/aged cheeses (mold)
• Avoid preservatives, colors and artificial sweeteners
• Eat a whole food diet
• Add a daily gut probiotic and oral probiotic

Brown/Black/Yellow/Hairy Tongue

A Brown/Black/Yellow/Hairy tongue may be caused by an overgrowth of bacteria in the mouth and gut which builds up on the tongue papillae. The chronic presence of bacteria on the tongue causes the papillae to grow and lengthen, creating hair-like projections. Normally, the papillae are pinkish-white in color, but as they grow, pigments from food, drinks, and the bacteria themselves get caught in the papillae, dyeing the tongue a color.

Suggestions which may assist in the reduction of Brown/Black/Yellow/Hairy Tongue:

• Good oral hygiene
• Whole food healthy diet
• Daily probiotic and daily oral probiotic

Fissured Tongue

Fissured tongue has been associated with genetics, environmental factors, as well as systemic diseases.

Conditions associated with Fissured Tongue:

• Psoriasis
• Orofacial granulomatosis
• Pernicious anemia
• Nutritional deficiency (low Vitamin A, B complex)
• Down’s Syndrome
• Diabetes Mellitus
• Melkersson-Rosenthal Syndrome
• Acromegaly
• Sjogren’s Syndrome

Suggestions which may assist in the reduction of burning or painful fissured tongue:

• Brush tongue with soft toothbrush daily
• Drinking filtered water
• Reduce wintergreen, peppermint, cinnamon
• Keep a food journal to track and avoid offending foods/products

Scalloped Tongue:

A scalloped tongue gets its name from the wavy or rippled indentations that appear along the sides of the tongue.

Conditions associated with Scalloped Tongue

• Parafunctional Habit (clenching/grinding)
• Hypothyroidism
• Amyloidosis
• Dehydration
• Anxiety
• Sleep Apnea

Proper diagnosis of underlying systemic cause in relation to Scalloped Tongue is paramount. Diagnosing the underlying cause of a scalloped tongue will assist in developing a plan for proper treatment.

Geographic Tongue

eographic tongue (also known as benign migratory glossitis) is an inflammatory disorder appearing on the top and sides of the tongue. Affected tongues have a bald, red areas of varying size surrounded, at least in part, by an irregular white border. Geographic tongue may be seen in conjunction with fissured tongue.

Systemic conditions associated with Geographic Tongue

• Genetics
• Emotional stress
• Allergies
• Hormonal disturbances
• Diabetes
• Psoriasis

Geographic Tongue is typically asymptomatic. If mild discomfort or burning sensation is present, avoiding hot, spicy, acid foods as well as toothpaste with additives/whitening agents may be helpful.

Oral Lichen Planus

Lichen planus can appear in the mouth in several different patterns. The reticular pattern, which is asymptomatic, is commonly found on the cheeks as web-like, slightly raised white threads. Erosive Lichen Planus appears bright red due to the loss of the top layer of the mucosa in the affected area. In most instances, individuals with erosive lichen planus are uncomfortable when eating and drinking. To help reduce symptoms, avoid extreme temperature, acidic and spicy foods and beverages

The cause of lichen planus is not completely understood, but genetics and immunity may be involved. Findings suggest that the body is reacting to an antigen within the surface of the skin or mucosa.


The causes of leukoplakia are varied but most commonly can be seen in relation to:

• Chronic irritation
• Cancer
• Suppressed immunity
• Lymphocytic leukemia
• Multiple myeloma
• Autoimmune disease

Any discoloration, sore or pain in the mouth which does not resolve within two weeks should be evaluated by your dentist and/or medical professional.

Aphthous Ulcer

n aphthous ulcer (canker sore) is a small red ulcer with a white or yellow center located on the inside of the cheeks, lips and tongue. The cause of aphthous ulcers is unknown at this time. The sores are not contagious and resolve on their own within 1-2 weeks. Any sore in the mouth which does not resolve within two weeks should be evaluated by a dentist and/or medical professional.

Common systemic imbalances associated with aphthous ulcers include:

• Autoinflammatory syndromes
• GI Disease
• Suppressed immunity
• Nutritional deficiencies (Vitamin B12)
• Allergies
• Genetic predisposition

Symptoms can include:

• Burning sensation
• Pain
• Inflammation
• Fever
• Swollen lymph nodes

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Bumps on the tongue

There are many possible causes for a bump on the tongue, some of the most common are:

• Trauma
• Irritation
• Oral Cancer

Any discoloration, lump, sore or pain on the tongue which does not resolve within two weeks should be evaluated by your dentist and/or medical professional.

*The information provided above is for educational purposes only. It is intended to supplement, not substitute for, the expertise and judgment of a qualified integrative physician. A qualified integrative physician or other medical professional should be consulted to determine appropriate diagnosis and treatment plan before taking any natural product, changing your diet or commencing or discontinuing any course of treatment.