Tongue is a very interesting muscle present in the mouth. The upper surface of the tongue (dorsum) comprises of tiny bumps called papillae which are covered by taste buds. The tongue plays an important role in mastication and swallowing food, as well as in speech.
What does the doctor infer just by looking at my tongue when I am ill?
Tongue acts as a reflection of how your body is functioning. A healthy human tongue is generally light pink in color and is covered with taste buds. However, any deviation from the normal appearance is indicative of some form of health issues, though not always severe. The tip of the tongue provides information about the functioning of small intestine and heart, whereas, the area behind the tip of your tongue tells the doctor about your immune system and respiratory system. The sides of the tongue provide a great deal of information on the condition of your liver.
Can I ensure my good health by regularly checking my tongue?
In order to ensure good health and to avoid exacerbation of medical conditions, it is always advisable to check for appearance of any discoloration or spots on your tongue. Any irregularity in the appearance of your tongue should be addressed immediately.
For instance, a swollen or inflamed tongue that is strawberry red in color is indicative of vitamin B12 or folic acid deficiency, which can be corrected by simply incorporating food rich in these vitamins in your daily diet. Appearance of ulcers along with red spots and fever may be indicative of a medical condition called Scarlet fever and medical help should be sought immediately if such symptoms are observed.
Causes of Brown Spots on Tongue
Sometimes, you may observe black or brown colored spots and patches on your tongue. These spots may persist on your tongue for a long time and may increase in number as your age increases. Most of the times, apart from the obnoxious appearance, these spots are harmless and are not indicative of any serious medical conditions.
Albeit, tiny brown spots on your tongue may become a matter of concern when they begin to increase in length and start to appear like hair. Hairy tongue (Lingua villosa nigra), as the medical condition is called, is characterized by desquamation of the papillae present on the dorsum. Unlike the normal process, the papillae do not shed and this results in a build-up of a protein called keratin. In severe cases, the papillae start forming a hair-like network on the dorsum of the tongue which attracts a lot of bacteria, fungus and yeast.
These patches may vary in color depending on factors such as the color of the mouthwash you use or the candy you had. Hairy tongue is a common condition in elderly people, mostly men. One of the major causes for occurrence of hairy tongue is poor oral hygiene.
Apart from hairy tongue, there may be other reasons for appearance of little black or brown spots on your tongue. Smoking or chewing tobacco acts as a trigger to attract bacteria and fungus to grow on the tongue. Excessive growth of bacteria on the tongue may lead to appearance of dark spots on the tongue.
2. Tongue piercing
This is another cause of formation of brown patches on the tongue. After the wound caused due to tongue piercing is healed, a dark spot remains on the tongue which promotes growth of fungus. Moreover, tongue-piercing leads to loss of normal tongue pigmentation, which is later seen as brown or black discoloration at the pierce-point.
3. Oral fibroma
A form of benign tumor called as oral fibroma may very rarely lead to formation of brown patches or spots on the tongue. It is a condition in which formation of scar-like tissue occurs in the mouth due to severe irritation for a long duration of time. Initially, small spots appear on the tongue which gives rise to formation of brown or dark patches. In case of oral fibroma, the brown patches are accompanied with other symptoms like formation of dome shaped lump attached at its base or by a stalk to a part of the oral cavity tissue.
Hyperpigmentation also leads to formation of dark brown or black spots on the tongue. Hyperpigmentation is a type of hereditary disorder that is caused due to excessive production of a pigment called melanin. At times brown spots on tongue may appear due to a type of cancer called melanoma, which is mostly caused due to excessive exposure to ultraviolet radiations of the sun. This condition is more common in people above 40 years of age, especially women.
5. Certain Medications
Brown patches on the tongue may also occur as a side-effect to certain medications like cyclophosphamide, doxorubicin or bismuth. People undergoing head and neck radiation therapy may notice a few brown patches on their tongue as a side- effect of the therapy. Sometimes, filling teeth with silver or amalgam may act as a source for formation of brown spots on the tongue.
6. Usage of Contraceptives
It is fairly common to have black spots on the tongue during pregnancy or during use of contraceptives. Contraceptives and pregnancy cause hormonal changes that lead to hyperpigmentation and thereby discoloration of tongue.
7. Oral cancer
Other less probable causes of appearance of brown patches on the tongue include oral cancer. Appearance of dark spots on the tongue along with tissue growth in the oral cavity and sore throat may be an indication of cancer.
Appearance of brown spots or patches on the tongue along with inflammation and soreness in the mouth could be indicative of anaemia. Brown or red discoloration of tongue is sometimes observed in a condition called Kawasaki syndrome which majorly affects children under the age of 5 years. The discoloration occurs due to impairment of blood supply and blood vessels in the body. Other symptoms like fever and swelling of hands and feet are also observed in Kawasaki syndrome. Dark spots may also occur as a result of HIV infection.
9. Fungal infection
In infants, brown patches may be caused due to a type of fungal infection called candidiasis. The patches formed due to candidiasis are generally white in color, but, may be brown in very rare instances.
How to get rid of Brown spots on tongue?
Most of the times, brown spots or patches appear on the skin as a result of poor oral hygiene. These spots can be taken care of by practicing good oral hygiene habits. Brushing teeth at least twice a day followed by gargling using a medicated mouthwash helps in keeping a check on the bacterial load in the mouth.
- The brown spots that are already present on the tongue can be scraped off using a toothbrush or a tongue scraper.
- Pain associated with these spots or blisters can be relieved by application of milk of magnesia or glycerol using a soft clean cotton ball.
- Avoiding smoking and consumption of tobacco can also help in reducing the occurrence of brown spots or discolorations in the mouth.
- Drinking sufficient water and keeping intake of spicy food to the minimum possible limit helps in reducing the occurrence of spots, blisters and discoloration by washing out toxins and reduction of bacterial load.
- Home remedies such as potato juice, lemon juice, aloe-vera, pineapple and cucumber juice may help in lightening the spots on the tongue. OTC products containing hydroquinone, calcium, soy milk or kojic acid may also be applied to reduce the intensity of these spots.
- If the brown spots or patches are persistent for a long period of time and cause bleeding, immediate medical help should be sought; it may be a form of oral cancer. Surgical intervention may be required in case of oral fibroma or melanoma.
- Apart from the reasons mentioned above, other serious conditions such as Peutz-Jeghers syndrome or Laugier-Hunziker syndrome may also lead to appearance of dark spots on the tongue.