Your tongue health

Melanie Wright explores tongue health and what it reveals about your well-being, as well as signs of tongue cancer. 

You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies

Your tongue plays a crucial role in daily life; helping with speaking, tasting, chewing, and swallowing. But have you ever considered how your tongue’s health reflects your overall well-being? Changes in colour, texture, or appearance can be early signs of health conditions, including cancer. 

Understanding the normal anatomy of the tongue

The tongue is a muscular organ covered with a mucous membrane and is divided into different regions that serve a unique function:

Dorsum (top surface): This area is covered with tiny structures called papillae, which house taste buds and assist in manipulating food.

Ventral surface (underside): The underside of the tongue is smooth, rich in blood vessels, and more sensitive, making it prone to injury or infection.

Lingual frenulum: A small tissue fold beneath the tongue that helps with its movement and plays a role in speech.

Intrinsic and extrinsic muscles: The intrinsic muscles allow the tongue to change shape for functions like speaking and swallowing, while the extrinsic muscles attach it to nearby structures, facilitating movement in various directions.

Healthy tongue appearance 

A healthy tongue typically presents itself in a pink or light reddish shade, with a thin, white layer that can be removed through regular cleaning. 

The tongue’s surface should feel slightly textured due to small papillae, which are responsible for the sense of taste. Any sudden changes in the tongue’s colour, texture, or the presence of long-lasting sores could point to a potential health issue that needs medical attention.

Warning signs to monitor

Regular self-examinations of your tongue can be an early warning system for health issues. Key signs to look out for include:

Persistent red or white patches: These could be signs of irritation or infection, and in some cases, may indicate early stages of precancerous or cancerous changes.

Sores or ulcers that persist: If a sore or ulcer remains for more than two weeks without healing, it should be evaluated by a healthcare provider.

Lumps or areas of thickened tissue: Any unexplained lump or unusual thickening in the tongue can potentially be an early indicator of oral cancer.

Pain or a burning sensation: Chronic discomfort or a burning feeling on the tongue might suggest an underlying infection or another medical condition.

Changes in texture or coating: An unusually thick coating, a hairy appearance, or noticeable cracks on the tongue could be linked to infections, inadequate oral hygiene, or nutritional deficiencies.

Other unusual symptoms: These may include persistent sore throat, feeling as though something is stuck in your throat, numbness of the tongue, difficulty or pain while chewing or swallowing, or a change in your voice.

Tongue cancer: risk factors and early detection

Tongue cancer is a serious condition that can initially appear as a sore, lump, or colour change on the tongue. Early stages may go unnoticed, and it can sometimes be discovered only during a routine check-up. The tongue extends from the mouth into the throat, and early detection of abnormalities is vital. If you notice any suspicious changes, it’s essential to consult a dentist, oral health specialist, or an ear, nose and throat surgeon right away.

Two main types of tongue cancer:

• Oral tongue cancer: Found at the front part of the tongue; this type is often visible and can be diagnosed earlier.

• Oropharyngeal tongue cancer: This occurs toward the back of the tongue and is more difficult to detect. Often diagnosed later when it has spread to nearby lymph nodes.

Key risk factors

Tobacco and alcohol use: Smoking and excessive alcohol consumption are significant contributors to the development of tongue cancer.

Human papillomavirus (HPV): Certain strains of HPV are linked to the development of oral cancers.

Age: Individuals over the age of 45 have a higher risk, usually due to long-term exposure to known risk factors.

Poor oral hygiene: Inadequate dental care, especially in those who smoke or drink alcohol, may increase the risk of developing tongue cancer.

Weakened immune system: A compromised immune system, whether from an existing illness or as a result of medications, can heighten the risk of cancer.

Maintaining tongue health during cancer treatment

Cancer treatments, such as chemotherapy and radiation, can impact the mouth and tongue, causing dryness, ulcers, infections, and taste changes. Here are tips to help maintain tongue health during treatment.

Practice good oral hygiene: Brush at least twice a day, floss daily, and use a tongue scraper to remove bacteria and debris. During treatment, you may experience oral mucositis (painful sores in the mouth) or xerostomia (dry mouth). Rinsing with a saltwater solution can help soothe irritation and prevent infections. Fungal infections, such as thrush, can also occur, so it’s important to speak with your healthcare team about appropriate treatments.

Stay hydrated: Sipping water regularly can help alleviate the discomfort of dry mouth and make swallowing easier, especially if you’re also dealing with changes in taste.

Avoid irritants: Spicy, acidic, or rough-textured foods can worsen mouth sores or increase sensitivity in the mouth and tongue. Opt for soft, mild foods to reduce irritation.

Visit your dental professional regularly: Regular dental check-ups during cancer treatment are essential. Your dentist can help you manage symptoms like mouth sores, dry mouth, or taste changes, and provide guidance on how to care for your mouth throughout the treatment process.

Consult your healthcare team: If you experience persistent pain, swelling, or signs of infection in your mouth, don’t hesitate to contact your oncologist or dentist. They can help guide you in managing symptoms and preventing complications, such as infections or mucositis.

Taking proactive steps can help protect your oral health and improve comfort during cancer treatment.

Take care of your tongue

Your tongue is a window into your overall health and paying attention to changes can help with early detection of serious conditions, including cancer. Regular dental check-ups, good oral hygiene, and knowing when to seek medical advice can make a significant difference. Your oral health is too important to ignore, if you notice any persistent changes, schedule a check-up with your healthcare professional today.