The tongue can give the doctor a clue to diagnosis. Coating or furring of the tongue is not really diagnostic of any one condition.
It is often furred in smokers, in mouth breathers and in those with poor oral hygiene. And it becomes coated during the course of any feverish illness or even with a simple digestive upset.
The tongue becomes dry and coated in dehydration and this can be a good indicator of the fluid balance of the body.
Where the tongue is coated in some parts but smooth in others is called the “geographic” tongue as it looks like a map. There are usually no other symptoms.
It is believed that this is due to emotional factors and seen only in anxious individuals. It requires no treatment.
In the past mothers used to worry whether their children were tongue-tied.
The frenulum is a band of tissue under the tongue which anchors it to the floor of the mouth. True tongue-tie is rare. The frenulum is short and this prevents the child from extruding the tongue.
If the child can put the tongue beyond the bottom teeth there is no problem.
Some tongues have deep fissures or cracks and an older generation of doctors looked for this sign as one indication of syphilis. But some people have inherited this condition and with them fissures in the tongue are normal.
An ulcer at the side of the tongue can come from an ill-fitting denture or a broken tooth. It can also be due to cancer.
In some anaemias the tongue loses it papillae (the taste buds) and becomes smooth, shiny and sore.
Leukoplakia is a pre-cancerous condition. The tongue becomes dry with a thick, white deposit like dry, cracked, old paint. This is mostly seen in elderly heavy smokers with poor mouth hygiene.
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