The mouth is a natural communicator, in more ways than you may realize. It’s home to over 500 strains of good and bad bacteria (thankfully, mostly the former). The trouble-causing germs can spread like gossip to other parts of your body through the bloodstream, and possibly contribute to serious health issues, from cardiovascular disease to diabetes, pneumonia, and Alzheimer’s. But information flows the other way, too, and a stinging pain on your tongue can indicate a vitamin deficiency, a food allergy, or even hormonal changes. Read on to learn about the broader health messages your mouth can send, from subtle cues to cries for help.
The Sign: A Painful Sore
Translation: Chances are you’re run down, and your ulcer (aka canker sore) is telling you to get some rest already. “They often appear when your immune system is weakened by a cold, fatigue, or emotional stress,” says dentist Mark Wolff, Ph.D., chair of the department of cariology and comprehensive care at New York University College of Dentistry. However, food sensitivities, period-related hormonal shifts, gastro‑intestinal issues, a potential irritant in toothpaste (some studies have found a link between canker sores and sodium lauryl sulfate, a foaming agent), and even accidentally biting your cheek can trigger sores too.
Treatment: Expect 7 to 10 days of shock and ow. An over-the-counter topical gel, cream, or liquid (look for one that contains an anesthetic, like benzocaine; an antiseptic, like hydrogen peroxide; or both) can dull the pain and help it heal, says Wolff. “Rinsing your mouth with warm salt water each night may work as well,” he adds, since salt helps reduce inflammation. If your canker sores crop up more often than the common cold, consider tracking them in a diary. That way you can cut out any spicy or acidic foods that may be causing them or, if they coincide with recurring deadlines, try to fit in some yoga or meditation to offset the stress.
The Sign: A Dry Mouth
Translation: Oversipping at happy hour or feeling nervous can bring on a temporary cottony sensation. (So can a sinus issue or nasal congestion.) But if that stale, tacky feeling stays in your mouth no matter how much water you sip, it may be linked to a medication, says Wolff; antidepressants, blood-pressure drugs, and antihistamines are common culprits. If you don’t address it, more than your comfort may be at risk: In addition to providing moisture, saliva helps keep the mouth and teeth clean by clearing away food debris and bacteria, so its absence can foster the germs that cause tooth decay and gum disease, says Stanley Heifetz, a New York City‒based cosmetic and restorative dentist.
Treatment: Hydrate. “Drink lots of water, and try green tea, which has antimicrobial properties,” says Heifetz. Sugar-free gum can offer some relief, since chewing stimulates the salivary glands, says Wolff: “This is especially beneficial after a meal.” If you drink alcohol, cut back, particularly on red wine, whose tannins can interfere with saliva production. And ask your doctor if dry mouth is a known side effect of any medications you take -- there may be an alternative.
The Sign: A Gray-White Tongue
Translation: That film is likely just accumulated gunk. “The top of your tongue is like a carpet,” says dentist Graham Forbes of Capital Dental Design, in Richmond, Virginia. “The tiny bumps, or papillae, on it create a texture that can trap plaque.” This can worsen if a cold or an infection throws off your mouth’s bacterial ecosystem. And eating spicy foods, smoking, or drinking can cause the papillae to become inflamed, locking in bacteria and debris that then build up into the coating (or plaque) you see.
Treatment: A few gentle passes with a tongue scraper should do the trick. Wolff also recommends brushing the top of your tongue with baking soda, which works as an antiseptic and a cleanser. Any swelling should go down over time, but drinking warm water with lemon (an anti-inflammatory) or swishing with salt water may help speed things along.
The Sign: A Too-Red Tongue
Translation: Are you vegan or vegetarian? A smooth, bright-red tongue may mean you have a vitamin B12 or iron deficiency, since low levels of each can lead to a loss of papillae. People who eat only plant-centric meals are especially prone to a B12 deficiency, since the vitamin is found only in meat, poultry, and dairy products; iron loss can occur in women who have heavy periods.
Treatment: Ask your doctor if you need a supplement, which should help rebalance your diet and return your tongue to its normal color and texture.
The Sign: Bad Breath
Translation: If your usual routine -- brush, floss, rinse, repeat -- can overpower your morning breath, you might just have a case of dry mouth in disguise, since a lack of moisture lets stinky bacteria thrive. “Our mouths dry out naturally overnight, because we may produce less saliva and often breathe through our mouth while we sleep,” says Forbes. But gum-disease bacteria can release an odor too, as can the mucus from a sinus infection. And if you still have your tonsils, you may have developed a tonsil stone. “The deep grooves on your tonsils can trap food and bacteria, and if they’re not rinsed away, they can calcify into tiny white, pebble-like deposits that can release a pretty big smell,” says Forbes.
Treatment: If your breath’s still funky after you give your teeth and tongue an a.m. once-over, Heifetz recommends sipping warm lemon water. You can also chew gum or parsley and gargle with alcohol-free mouthwash. For sinus issues, try rinsing with a neti pot or using a saline nasal spray; if symptoms don’t improve, talk to your doctor about other treatments, such as an allergy medication that may help ease your breathing. Tonsil stones may sound unusual, but one study showed that up to 40 percent of patients may have them. Luckily, they’re simple to take care of. You can remove one yourself with a toothbrush, a cotton swab, or even a clean finger, says Forbes -- but if that makes you (literally) gag, have your dentist or doctor do it.
The Sign: Stinging Tongue Spots
Translation: Feel like you’ve got the world’s worst pimple on your tongue? It’s probably time to examine your diet. These white or red bumps, called transient lingual papillitis, are inflamed taste buds, and they can be a reaction to spicy foods or a food allergy, says Wolff. Stress, hormone fluctuations, or gastrointestinal issues could also be to blame.
Treatment: To ease the pain, try a warm salt-water rinse or an OTC topical antiseptic gel, cream, or mouthwash. Stick to cool beverages, and talk to your doctor if the sensitive spots occur so often that you suspect a food allergy.
The Sign: A Cracked Tongue
Translation: The cracks could be genetic or a sign of dehydration, but they’re more likely a natural by-product of aging. (Yes, just like the wrinkles on your face.) They also appear to be more common in people who have psoriasis -- an inflammatory disease that is thought to provoke the fissures.
Treatment: There’s nothing you need to do, other than keep the grooves clean to prevent bacteria and food particles from lodging there and causing inflammation or pain. Drink lots of water to ward off dehydration, and make a habit of using a tongue scraper or a soft-bristle brush.
The Sign: Extra-Tender Gums
Translation: You’re probably not cleaning your teeth regularly or thoroughly enough. Skipping sink sessions can lead to gingivitis, a mild form of gum disease that results when particles of food caught between teeth or along the gumline attract inflammation-causing bacteria. If your gums look red and swollen instead of firm and pink, or bleed when you brush or floss, that’s the likely cause. But gingivitis can strike strict brushers, too: Even if you tend to your teeth like clockwork, “most people aren’t capable of cleaning every surface of every tooth,” says Heifetz.
Treatment: “Gingivitis is almost always reversible with proper daily brushing, flossing, and a cleaning at your dentist’s office,” says Forbes. Two times a day, brush around each tooth and gum thoroughly -- “spend two minutes brushing, not 20 seconds,” says Heifetz -- and then floss. If the puffiness or bleeding doesn’t subside after about two weeks, it’s time to get a professional cleaning.
The Sign: Tongue Ripples
Translation: Your tongue is enlarged, and the ripples or scallops around its sides are actually indentations from your teeth. Sleep apnea is one explanation: Experts have found that patients with the condition often have large tongues, either due to genetics or because their tongue has gained volume along with their body weight (the back of the human tongue is about 30 percent fat), according to a 2014 study of obese sleep-apnea patients. Hypothyroidism can also cause swelling throughout the body, including the tongue. Rule out those two possibilities and the ruffles might point to stress-related tooth clenching or grinding, an allergy, or possibly even a B12 or iron deficiency.
Treatment: If you have other possible symptoms of sleep apnea -- acid reflux, snoring, sleepiness, or memory problems -- talk to your dentist (the profession is now becoming trained to tackle it) or doctor to schedule a visit to a sleep specialist for an official diagnosis. If you’re sleeping just fine, ask about getting tested for hypothyroidism, which can be easily treated with a prescription medication.
A clean mouth is part of your body’s first line of defense. These three tools can help you keep it sparkling between checkups.
A 2014 review of 56 studies comparing electric brushes with manual ones found that after three months, people using the former had a 21 percent greater reduction of plaque and an 11 percent lower occurrence of gingivitis. “You don’t have to be as perfect navigating the ins and outs of your teeth,” says Forbes. “It does a lot of the work for you.” We like colorful Goby brushes (from $50 each, goby.co).
Research suggests that these at-home versions of the dentist’s sprayer can help reduce gum bleeding caused by gingivitis. “It’s a great option for those who don’t like to floss with string,” says Heifetz, who recommends the Waterpik Aquarius Professional ($80, waterpik.com).
Dental Disclosing Tablets
Here’s another way to brush more carefully: Turn your teeth (temporarily) red. Chews such as Butler G-U-M Red-cote ($30 for 248, amazon.com) release a dye that briefly stains plaque, highlighting problem spots. “Using them twice a week will help you become a more proficient brusher,” says dentist Ana Gutiérrez Gossweiler, director of the Oral Health Research Institute Clinic at Indiana University School of Dentistry.