Is tongue pain becoming a problem? This is what your tongue is trying to tell you

Are you experiencing tongue pain? If so, your tongue might be trying to tell you something surprising about your health. 

You might not have realized it, but your tongue can be a very important indicator of what's going on in the rest of your body. From stress and vitamin deficiencies to a risk of oral cancer, tongue pain or a cracked tongue can be frustrating but shouldn't be ignored. 

Find out what your tongue pain could mean with our handy guide to tongue health, which covers everything from canker sores to thrush.

1. A cracked tongue

It could mean: you need to step up your brushing

A fissured tongue, or a cracked tongue, is rarely a cause for concern and is considered very normal.

The condition is thought to be genetic (over 80% of Down's Syndrome children have fissured tongues) and just as wrinkles deepen with age, so can the cracks on the tongue.

Problems only tend to arise with a fissured tongue if poor dental hygiene causes debris to collect in the cracks, which can lead to infection. Symptoms can include a sore or burning tongue.

How to treat it: If you have any concerns about your fissured tongue, it's a good idea to get your tongue checked out by a dentist, who can clean out the fissures and recommend the best oral hygiene practices.

2. Canker sores on tongue

It could mean: You're feeling stressed. 

Canker sores on tongues are punched-out, painful areas that occur on the tongue or cheeks. They are most uncomfortable for the first four to five days, then subside and eventually disappear within two weeks.

Canker sores on tongues are thought to be caused by a virus and typically occur when people are run down or stressed. Other causes can include excessive consumption of acidic or spicy foods, vitamin deficiencies, hormones, stress or autoimmune disorders.

How to treat it: If you experience canker sores on your tongue accompanied by a fever, you have difficulty swallowing or the sores last for more than three weeks, visit your doctor for medical advice. 

3. White lumps on tongue

It could mean: You have thrush.

Tongue pain caused by white lumps on tongues that are not your toothpaste could mean you're suffering from oral thrush.

Oral thrush is a yeast infection caused by an overproduction of candida which manifests as white lumps on tongues. The condition is often linked to antibiotics as these can kill off good bacteria and allow the yeast to take over.

Thrush, which can be painful and cause food to taste a bit strange, typically occurs in young children but can also affect people with autoimmune diseases, diabetes that isn't well-controlled, chemotherapy patients and the elderly.

How to treat it: If you suspect you might have thrush, see your doctor. Unlike other yeast infections, thrush can't be treated with over-the-counter products

4. Burning tongue

It could mean: You're drinking too much, overusing mouthwash, or are menopausal.

A burning tongue sensation can also be caused by irritation or a vitamin deficiency.

Drinking too many irritating fizzy or alcoholic beverages, overbrushing your tongue or overusing your mouthwash can irritate the mouth tissues and cause a burning tongue. If you experience a burning sensation in your mouth, try to drink fewer or less acidic drinks.

Deficiencies in B vitamins and minerals including iron and zinc can also contribute to burning tongue syndrome by affecting the health of your oral tissues. Make sure you are eating a well-balanced diet with fresh fruits and vegetables, whole grains, dairy, nuts, seeds and healthy proteins.

If your burning tongue symptom is also accompanied by white patches on your tongue, red and purple patches on your body and thinning nails speak to your doctor as this could be a sign of Lichen planus.

A burning tongue is also one of the lesser-known symptoms of the perimenopause too. This effects around four in ten women who are menopausal.

How to treat it: Make sure you're drinking plenty of water, cut down on acidic drinks and visit your doctor for a blood test to find out if you should be taking additional vitamin supplements.

5. White patches on tongue

It could mean: You are at risk of oral cancer.

Small, white patches on tongues can be caused by a condition called Leukoplakia. Leukoplakia is not a form of cancer but it does increase your risk of developing oral cancer.

Smoking is the most common cause of Leukoplakia, but other irritants can trigger it too, such as rough, uneven teeth, injury to the side of the cheek from biting, chewing tobacco and inflammatory conditions of the body.

Leukoplakia often goes away on it's own, but in 5-17% of cases it can develop into oral cancer, so it's always best to get it checked out by your dentist or doctor if you have concerns.

How to treat it: Small white patches on tongues can be removed by your doctor or dentist using a scalpel or laser. Larger leukoplakia patches will require oral surgery.

6. Red tongue

It could mean: You have a B12 deficiency.

A glossy, bright red tongue may be a sign your body is lacking iron or vitamin B12. Both of these nutrients are needed to mature papillae on the tongue and if your body is deficient in them, you can lose the papillae, which can make your tongue appear very smooth.

In severe cases, this "balding" red tongue can cause pain when eating hot liquids or spicy foods. Vegetarians are especially prone to low levels of B12, which is found in certain meats.

How to treat it: If your tongue is a strawberry red color, ask your doctor for advice on supplements.

7. Red patches on tongue (or 'Geographic tongue')

It could mean: Nothing at all—you've simply inherited it from your family.

Geographic tongue is an inflammatory disorder that usually affects the top and sides of the tongue. Typically, affected tongues have a bald, red patches in varying sizes that is surrounded, at least in part, by an irregular white border.

How to treat it: In most cases, there is no need for treatment of this condition. Occasionally, geographic tongue may cause a burning or smarting sensation. In this case, topical anaesthetics can be used for surface numbing. Anti-inflammatory drugs (cortisone-like drugs) can also be prescribed to help control discomfort.

There have not been any reports of geographic tongue causing cancer. In most cases, biopsies are not necessary to establish a diagnosis.

8. Tongue ulcers that cause tongue pain

It could mean: Nothing at all—most mouth ulcers are caused by things you can avoid doing, like biting your tongue.

Mouth ulcers are very common and rarely a sign of anything serious, though they can cause tongue pain

How to treat it: In most cases, there is no need for treatment of this condition unless they last longer than 3 weeks and keep coming back— in which case see your doctor for advice. If you have several mouth ulcers at once this can be a symptom of hand, foot and mouth (which also causes a rash on hands and feet) or oral lichen planus, a rash that affects inside your mouth, as well as other parts of your body.

Tongue cancer symptoms—how to tell if your tongue pain could be something serious

Sometimes it's hard not to wonder if your symptoms can be symptomatic of something much worse, in this cause tongue cancer or oral cancer.

We've already covered above that white patches on the tongue can be a sign of Leukoplakia, which increases your risk of tongue cancer. But the symptoms of tongue cancer might include:

• A red or white patch on the tongue that won't go away and isn't geographic tongue
• A sore throat that doesn't go away
• A sore spot (ulcer) or lump on the tongue that doesn't go away
• Pain when swallowing
• Numbness in the mouth that won't go away
• Unexplained bleeding from the tongue (that's not caused by biting your tongue or another injury)
• Pain in the ear (this is a very rare symptom)

These symptoms can be signs of other conditions and might be due to something less serious. But if you have any concerns, always ask your doctor for advice.