Tongue diagnosis: This means spots, coatings & Co.

Tongue diagnosis: This means spots, coatings & Co.

Heavy white coating on the tongue

If a thick, white coating covers the tongue, this is often a sign of an infection, such as a cold or flu. Long-term treatment with antibiotics can also cause a white tongue.

If the coating is only on both sides of the central gutter, this can indicate a pancreas disease.

White coating with redness

If the tongue is thick and coated with white, this can indicate oral candidiasis in combination with a reddened tongue or oral mucosa. This is an infection in the mouth caused by the yeast fungus Candida. The disease, also known as oral thrush, is divided into three forms, two of which have the typical plaque.

Affected people who suffer from oral thrush unfortunately also suffer from a furry or burning sensation in the mouth, bad breath or difficulty swallowing. Oral thrush is highly contagious.

Cracks in the tongue

Cracks or furrows in the tongue can have very different causes. As the most obvious explanation, biting the tongue can cause a tear. A common pathological trigger is inflammation of the tongue (glossitis). This can be caused by tooth diseases, diabetes, liver diseases or stomach diseases such as Crohn’s disease.

Heavy smoking or food intolerances can also cause cracks in the tongue.

Black coating (hairy tongue)

A black or blackish-green tongue coating can result from antibiotic treatment, for example. External stimuli, such as smoking or specific substances, such as mouthwash, can also cause a black tongue.

In addition to a fungal or bacterial infection, pathological causes can also include a severe weakening of the immune system, which the disease can cause. A black tongue is also known as a “hairy tongue” because the tongue’s papillae change in a way that gives the appearance of hair on the tongue.


Large, demarcated spots (map tongue)

White or yellowish discolourations on the tongue, which can migrate and are separated from the rest of the tongue, can indicate a so-called “map tongue” (lingua geographic). The causes have not been precisely clarified, but a predisposition is likely.

A tongue of the map can remain in place for several years or even decades. However, it usually does not cause symptoms in those affected and is not contagious.

If the tongue feels furry, there is often a fungal disease behind it. However, this is usually accompanied by a clear coating, inflammation and pain in the mouth.

But certain foods, such as red wine, pineapplekiwi or unripe fruit, can also trigger a furry feeling on the tongue.

Yellow coating

A yellow tongue can be a symptom of a fungal infection in the mouth. Usually, there is also a furry or burning sensation or an inflamed tongue.

A yellow coating on the tongue can also indicate liver and gallbladder damage, such as can result from poisoning. This poisoning can, for example, have been caused by chemicals, plants or medications . If you suspect poisoning, you should seek medical advice as quickly as possible.


If blisters appear on the tongue, there can be various illnesses behind them. As a rule, the blisters are aphthous ulcers, which can occur, for example, due to deficiency symptoms, small skin injuries or as a reaction to certain foods or medications. They are also a common accompanying symptom of viral infections or other illnesses, such as Crohn’s disease. Blisters on the tongue can also be caused by mouth rot.

Red tongue (raspberry tongue)

A red, swollen tongue with the papillae prominently prominent is also known as raspberry tongue. Raspberry tongue (also known as strawberry tongue) is a common symptom of scarlet fever. But it can also occur as part of Kawasaki syndrome.

Burning tongue

Burning and stabbing pain in the tongue can occur as part of burning mouth syndrome. The pain usually affects the front two thirds of the tongue. A feeling of dry mouth often occurs at the same time.

Various illnesses can also cause a burning tongue . These include a dysfunction of the salivary glands, fungal diseases or diabetes mellitus.

Numb tongue

numb feeling in the tongue that lasts for a long time can be attributed to various causes. In addition to damage to the affected nerves, a vitamin B12 deficiency or a dysfunction in the periodontium (craniomandibular dysfunction, or CMD for short) can cause a numb tongue.

Inflamed tongue

An inflamed tongue (medical: glossitis) can be attributed to very different causes. For example, mechanical irritation, such as sharp tooth edges or braces, can cause inflammation. Other possible triggers for the inflammation include increased alcohol and/or cigarette consumption as well as poor oral hygiene.

In addition to viral or bacterial infections, some more serious illnesses, such as diabetes mellitus or liver disorders, can also be associated with an inflamed tongue. The symptoms can also indicate a vitamin or iron deficiency.

Swollen tongue

If the tongue is swollen, the cause is usually an allergic reaction (oral allergy syndrome). This can be triggered by food, insect bites or certain medications, especially ACE inhibitors. Lips and oral mucous membranes are often also affected by the swelling. If the tongue swells very badly, medical help should be sought as quickly as possible, as severe allergic reactions can also result in anaphylactic shock.

In addition to an allergic reaction, for example, hypothyroidism, inflammation in the mouth or a lack of C1 esterase inhibitors (angioedema) can also cause a swollen Tongue cause.

Fold tongue

With a folded tongue (lingua plicata), transverse and longitudinal furrows appear on the tongue’s surface. Except for a possible hypersensitivity to spicy or acidic foods, there are usually no symptoms with the tongue. If leftover food is deposited in the folds, bad breath can develop.

The wrinkled tongue itself does not require any therapy. However, furrows in the tongue can be a symptom of various diseases such as diabetes or Crohn’s disease. Possible causes of a wrinkled tongue should, therefore, be checked by a doctor.

grey tongue

A gray-coated tongue can indicate various diseases. For example, a lack of stomach acid (acidity) can cause a grey tongue. A gastric ulcer can also be noticed, among other things, by a grey coating.

In rare cases, painful ulcers on the tongue with grey-yellow nodules can occur due to organ tuberculosis.

Bluetongue with cyanosis

If the tongue, lips or mucous membranes turn bluish, this can indicate cyanosis. This occurs when the blood is not saturated with sufficient oxygen, for example, in the case of restricted lung function. Cyanosis can occur, among other things, as a result of bronchial asthma, pulmonary oedema or heart failure.


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