When your kid colors a tongue on an animal or a person in a coloring book, what color do they use? We tend to think of tongues as being red or pink. Although, sometimes our tongues (our, meaning humans in general) can appear as other colors to be sure. The color possibilities of our tongue are visual signs or indicators that perhaps something is not quite right with our health. Let’s review the potential colors and what they might mean.

A Colorful Review of the Tongue

A healthy tongue is customarily pink, with a slight white coating. The pink can vary from a dark pink to a light pink and still be considered healthy or “normal”.

A red tongue (not to be confused with dark pink) can signify a few different possibilities: a deficiency of vitamin B, scarlet fever, allergic reaction, Kawasaki disease, and/or even eczema. Smooth red patches or red islands on the top of the tongue or the sides is indicative of a condition called geographic tongue or glossitis. The red patches may appear and then disappear only to reappear in a different spot on the tongue later.

An orange-colored tongue can be the result of certain antibiotics or foods. Also, dry mouth and poor oral hygiene can manifest this color as well.

A yellow tongue is most likely to be the result of bacteria buildup. Smoking or chewing tobacco are common miscreants for this in addition to copious amounts of black tea, coffee, and/or alcohol. More serious conditions can present a yellow tongue as well such as jaundice and possibly diabetes. Lastly, the tongue can turn yellow right before it turns black and hairy. (More on black in a bit.)

A green tongue most likely indicates oral thrush. Oral thrush is an easily treated condition that occurs when the natural balance of bacteria and yeast in your mouth tips and the yeast takes over. Initially, thrush may look white, but if untreated can turn green. Oral thrush is quite common in breastfeeding infants and can cause them pain during swallowing.

A bluish tongue is likely an indication of issues with blood circulation. This should be taken seriously for the reason that it can mean a blood disorder, kidney disease, or respiratory issues.

A purple tongue may similarly, be indicative of poor blood circulation, but could also point to heart problems or Kawasaki disease.

A white tongue is most commonly indicative of oral thrush. It can be thick and patchy, and if not addressed could turn greenish (as previously stated). Another possible cause of a white tongue could be a rash called lichen planus, but this would appear more as streaks or stripes instead of coloring the entire tongue.

A gray tongue may indicate digestive concerns or eczema.

A brown tongue is usually the result of smoking or excessive consumption of dark liquids, notably coffee or black tea.

A black tongue has a few different possible explanations. It can be due to excessive consumption of dark liquids such as black tea or coffee. However, it can also be a result of bacteria due to poor oral hygiene. It is also worth noting that the common over-the-counter medicine of Pepto Bismol can temporarily turn a tongue black. This occurs because the main ingredient in that special pink medicine is bismuth, and our mouths have sulfur (the presence of sulfur in your mouth is completely natural). The combination of sulfur with bismuth can cause your tongue to turn black but the discoloration should subside a few days following the last time you or your kid ingested the medicine.

A keratin buildup is another likely cause of black tongue, this often is accompanied by a hairy texture (more on tongue textures in the next section). In rare cases, diabetes or HIV can be a cause.

Tongue Textures

Your tongue in its natural, healthy state, is pink, but not is not smooth. Our tongues all have little bumps on the top and sides; these are called papillae. Contrary to common misperception, these papillae are not in and of themselves the taste buds, but some of them are homes to the taste buds. In addition to some of them containing taste buds, they also trap bacteria and serve the important function of helping to grip our food to make chewing and swallowing easier.

If your child’s tongue (or yours) appears hairy, this is not normal. Also, it’s not actually hair, it’s the papillae. Normal, healthy papillae are no more than 1mm long. The “hairiness” comes because the dead cells or the papillae aren’t shedding properly. A component of papillae is keratin, which is also the main protein of the hair on your head. The length of the normal short papillae continues to grow as they build up which explains the hairy appearance. Moreover, food, bacteria, and yeast will accumulate in the mass of lengthened papillae and will cause the discoloration. The hairy tongue can present because of poor oral hygiene, as a side effect of certain antibiotics or radiation, or tobacco use.

In most circumstances, hairy tongue can be eliminated by tongue brushing and/or a tongue scraper. It is important to note that once a person has had hairy tongue, they are more susceptible to a recurrence. The best way to avoid hairy tongue is to be sure you are brushing/scraping the tongue with the toothbrush as part of your daily dental hygiene routine.

Time for a Checkup at a Nearby Pediatric Dentist?

You now know more about the tongue than you ever thought (probably), and we hope it’s helpful! If your child’s tongue is discolored, make an appointment for us to check it out. As you likely noted, many of the possible discolorations of the tongue are related to oral hygiene. Keep up good brushing routines, and come to see us at least once every six months.