If you have been to a physician’s office, you probably have been asked to stick out the tongue, the reason doctors do this is to check its color and how it appears because it can provide crucial clues to your health. The color of a person’s tongue can be an indicator of nutritional deficiency, dehydration, a dental problem, or another health issue.

The normal color of a healthy tongue is usually pink, there are tiny nodules referred to as papillae that cover the tongue’s surface.  If an individual’s tongue color changes to something different, or it develops lesions and patches that don’t disappear or it becomes painful and swollen, you need to visit a physician.

Black Hairy Tongue

 Having black hairy tongue could indicate bacteria overgrowth in the mouth. This is a harmless and temporary condition. Certain strains of bacteria can accumulate on the small projections covering the tongue known as papillae making the tongue to appear black. If the outer layer of an individual’s tongue doesn’t shed as required, the papillae can become large and make the tongue to feel hairy.

Causes of black hairy tongue

  Doctors don’t exactly know what causes the tongue to become black and hairy, however, some research indicate that it could be due to changes in the normal bacteria within the mouth as a result of taking antibiotics or using products containing bismuth. Black hairy tongue could also be caused by smoking and use of other tobacco products. Drinking too much tea or coffee or not following properly oral hygiene can bring about this condition.

Although chronic bad breath may not be linked to having black hairy tongue, use of some mouthwashes could increase the risk. Using mouthwash products that contain astringents like witch hazel or menthol or oxidizing agents like peroxide could increase a person’s likelihood of having black hairy tongue.

Treatment of black hairy tongue

In most cases, a black hairy tongue tends to resolve if you brush gently using a toothbrush. Maintaining proper oral hygiene will help prevent the problem from coming back. You can use diluted hydrogen peroxide to rinse the mouth. Double rinsing will usually help.

Green Tongue

When your tongue is green, it can be due to a number of things. Often, having a green tongue begins with a whitish appearance and then changes to take the greenish look after drinking or eating something or taking certain medications.

Causes of green tongue

There are different conditions that can cause a green tongue. Geographic tongue is a condition that presents with harmless lesions that may change color. Initially, the lesions appear red and have raised white borders, however, with time, the borders can change the color to appear green. A person with geographic tongue has irregular lesions forming on the tongue and they are smooth often varying in size and shape. The patches appear to migrate  from one part of the tongue to another.

A geographic tongue has a map-like appearance of the lesions that tend to disappear and appear frequently. A person has extra sensitivity on their tongue after they use certain substances like toothpaste, cigarettes, mouthwashes, acidic and spicy foods, or sweet food.

Hairy tongue syndrome may make the tongue appear greenish. This happens after the tongue cells don’t shed as they should causing the papillae to become hairy or rough, which creates locations for bacteria or yeast to thrive. The presence of these microbes can cause the tongue to have a green hue. Hairy tongue syndrome may cause other symptoms like having a burning sensation, bad breath, and abnormal taste or lack of taste since the taste buds are covered. Other causes of a green tongue are:

• Lichen planus
• Oral cancer
• Oral thrush

 Treatment of green tongue

Treating green tongue largely depends on what the cause it. If fungus, bacteria, and yeast are causing the tongue to be green, medications like nystatin, clotrimazole, fluconazole, and itraconazole may be used. Brushing the teeth gently can help with a green tongue. You may want to avoid using mouthwashes and sprays because they can irritate the lesions.

Eating plain yogurt can help rebalance bad and good bacteria in the mouth. Keeping blood sugar at healthy levels can also help, especially in people with diabetes. If inflammation is causing green tongue, treatment may involve use of corticosteroids, OTC pain relievers, and antihistamines to reduce pain and inflammation; or stop allergy reactions.

 White Tongue

When the tongue is whitish, it is usually due to overgrowth and swelling of papillae. The white coating is due to debris, dead cells, and bacteria that are lodged within the enlarged papillae. Inflammation of the papillae may arise from dry mouth, poor oral hygiene, dehydration, mouth breathing, alcohol use, smoking, taking low roughage diet, or due to fever and mechanical irritation from dental appliances or sharp tooth edges.

There are diseases and health conditions that make the tongue to have a white hue and they include:

• Syphilis
• Oral lichen planus
• Leukoplakia
• Tongue cancer
• Geographic tongue
• Oral thrush
• Mouth cancer
• Immunosuppression due to diseases like HIV/AIDS

Brown Tongue

A brown tongue can be caused by presence of bacteria in a person’s mouth. Smoking, poor oral hygiene, and taking excessive coffee and tea can cause this problem. Treatment involves proper oral hygiene and stopping smoking. Eating a healthy diet can help get rid of the discoloration.

Yellow Tongue

Having a yellowish tongue may be due to presence of bacteria, dead skin cells, and discoloring particles. A yellow tongue will clear up by taking basic home oral care.  However, at times, it can be something more serious like jaundice. Using oxidizing agents found in toothpastes, rinses, and mouthwashes can cause the mouth and tongue to irritate and become dry. This in turn causes the tongue to change its color. A yellow tongue is associated with compounds like mental, thymol, eucalyptus, alcohol, witch hazel, and peroxides.

Certain medications or drugs can cause the tongue to turn yellow. If you are taking antibiotics, blood thinning medications, cancer medication, iron salts, medication for diabetes, and antipsychotic medications, they can lead to a yellowish tongue. Gastric conditions or infections like gastritis and Helicobacter pylori bacteria can make the tongue to be yellow.

Treating a yellow tongue means addressing the causal factor. You can brush the teeth and rinse with antibacterial mouth rinses. You can also increase fiber intake and reduce consumption of sugary items. Quitting smoking also helps prevent yellowing of the tongue. You also need to avoid alcohol and colored or dyed drinks. Staying hydrated and using humidifiers can help prevent dryness of the mouth.

Other tongue discolorations are:

• Strawberry red tongue– This is caused by something like scarlet fever. In young children, it could indicate Kawasaki disease.
• Pale, smooth tongue– This can be due to iron deficiency anemia, it can also be as a result of pernicious anemia that occurs from deficiency in vitamin B12.
• A smooth red tongue– This can be due to glossitis or inflammation of the tongue. It could also be due to pellagra that is caused by deficiency of vitamin B3 or niacin.

In a nutshell, many things can cause a person’ tongue to change its hue. You need to watch out for any symptoms that accompany the changes in tongue’s color; and see a doctor if you suspect that there is a serious condition causing the problem.