Spots on the tongue are common, usually due to a harmless or quickly disappearing condition. However, sometimes tongue spots are the result of an underlying medical problem that requires prompt treatment, such as an infection. The tongue spots may or may not be painful. The color and location of the spots on the tongue is also variable depending on the cause. The best prevention of tongue stains is good oral hygiene and adherence to a healthy lifestyle.

• Strawberry tongue
• Allergic reaction
• Blood blister
• Burning tongue syndrome
• Eruptive lingual papillitis and spotted tongue
• Hand, foot and mouth disease
• Hyperpigmentation
• Map tongue and tongue spots
• Medicines and spots on tongue area
• Oral thrush and tongue spots
• Oral lichen planus and mottled tongue area
• Smoking
• Scarlet fever and spots on tongue
• Tongue cancer and all kinds of lesions on the tongue
• Tongue piercing and tongue spots
• Transient lingual papillitis (lie bumps) and tongue spots
• Dehydration and tongue spots
• Fillings
• Kawasaki disease and spots on tongue
• Summer freckles
• Black hair tongue and spots on tongue area
• Alarm signals
• Prevention

• Oral hygiene
• Lifestyle

Strawberry tongue

A common cause of red spots and dots on the tongue is strawberry tongue. The tongue then changes from pink to a red strawberry color with large red papillae visible on the tongue surface. Possible causes of strawberry tongue indicate a vitamin B12 deficiency and the vitamin B complex, a benign migratory inflammation or scarlet fever.Some patients have an allergic reaction to food and then experience spots on the tongue / Source: Jill111, Pixabay

Allergic reaction

Some patients have allergic reactions to pet dander (e.g., dog), food, medications, and so on. This manifests itself in numerous possible complaints, such as a swollen tongue, red dots on the tongue, a swollen lip, a swollen face, swelling of the throat, wheezing, breathing problems, a stuffy nose, dizziness, etc. hives,

Blood blister

A black spot on the tongue may be the result of an injury that has caused a blood blister on the tongue. Tongue biting leads to a red or black spot on the side of the tongue or the tip of the tongue. Blood blisters are usually harmless and will disappear on their own as the wound heals. Stress is a cause of chronic tongue biting and cheek biting. Tooth damage or ill-fitting dentures sometimes also result in accidental biting of the tongue leading to the formation of a blood blister.Burning tongue syndrome may be the result of poorly fitting dentures / Source: Jim Sneddon, Flickr (CC BY-2.0)

Burning tongue syndrome

Burning tongue syndrome (glossophyrosis) is caused by a vitamin B12 deficiency, a fungal infection in the mouth, irritation from dentures or menopause. This results in a swollen tongue, a spotted tongue, a burning tongue, a dry mouth and/or a metallic taste in the mouth.

Eruptive lingual papillitis and spotted tongue

In eruptive lingual papillitis, in addition to spots, pustules also develop on the tongue. The tongue disease, which mainly affects children, involves an infection of the fungiform papillae on the tongue. Sometimes the tongue abnormality is accompanied by other problems in the oral cavity, such as angular cheilitis (irritation at the corners of the lips) and swollen lymph nodes in the neck and under the upper jaw. The condition often disappears spontaneously within two weeks.

Hand, foot and mouth disease

The hand, foot and mouth disease occurs in children under five years old. The patient develops spots on the tongue, gums or cheeks. These spots cause painful sores or blisters. Other symptoms include a red rash on the sole of the foot, buttock, palm of the hand and fever.

Hyperpigmentation

Black spots on the tongue indicate too much pigment on the tongue (hyperpigmentation). This harmless abnormality may or may not disappear spontaneously. The pigment spots on the tongue are the result of old age, because the adrenal glands do not produce enough hormones or because patients take certain medications. Some people who have more melanocytes are also prone to hyperpigmentation on the tongue.

Map tongue and tongue spots

Geographic tongue (benign migratory glossitis) is a condition in which red islands (spots) sometimes develop anywhere on the tongue that often move. The tongue appearance is due to missing papillae. Due to this tongue condition, the patient is more sensitive to salt, spices and other foods. The benign inflammatory disease of unknown cause is more common in patients with a family history. Medical treatment is usually not necessary as the complaints disappear within a few days, weeks, months or years.The use of certain medications may lead to stains on the tongue area / Source: Stevepb, Pixabay

Medicines and spots on tongue area

The use of some medications is associated with a spotted tongue in a number of patients, especially when using amiodarone, antimalarials (chloroquine, quinidine), cyclophosphmide, estrogen, antifungal agents (ketoconazo) and zidovudine.

Oral thrush and tongue spots

Oral candidiasis (oral thrush) is caused by the fungus Candida albicans that accumulates and grows on the lining of the tongue and mouth. When the fungus affects the tongue, several creamy white spots develop on it, which spread to other areas of the mouth such as the gums, tonsils, back of the throat, lips and palate. The tongue lesions sometimes resemble cottage cheese. Occasionally, tongue bleeding also occurs due to oral thrush. A number of patients with oral candidiasis develop red spots or spots on the tongue or throat lining. In most cases, patients with weak immune systems are affected (HIV/AIDS, cancer, infants, elderly, etc.). Mothers sometimes pass the fungal infection on to their children through breastfeeding. Oral thrush also often presents in patients taking certain medications.

Oral lichen planus and mottled tongue area

Oral lichen planus is a rare autoimmune disease that causes chronic inflammation of the tongue. This causes white lesions, red spots or ulcers to appear on the tongue or other oral tissues. This is usually accompanied by pain, which is made worse by eating certain foods or using toothpaste. The condition requires a thorough medical examination as oral lichen planus is sometimes a precursor to tongue cancer.Smoking is a risk factor for a spotted tongue / Source: Geralt, Pixabay

Smoking

Heavy smoking is often the cause of black spots on the side, top and bottom of the tongue. This unhealthy habit may cause a black hair tongue. Smoking also causes hyperpigmentation (dark spots on the tongue). Most smokers have some form of pigmentation in the oral cavity.

Scarlet fever and spots on tongue

Scarlet fever (scarlatina) is an infectious disease caused by group A streptococci, bacteria that also cause laryngitis. The main symptoms of scarlet fever are a red rash on the face and neck, which eventually spreads to other parts of the body (trunk, arms and legs). The affected skin feels like sandpaper and sometimes resembles a sunburn (red, painful skin due to exposure to sunlight). This also produces a strawberry tongue, causing a red, spotted and rough tongue to appear that is often covered with a white coating. Other symptoms of scarlet fever include headache, enlarged lymph nodes, difficulty swallowing, sore throat, and nausea or vomiting. Antibiotics are needed to treat scarlet fever.

Tongue cancer and all kinds of lesions on the tongue

Tongue cancer is the most serious cause of spots and other lesions on the tongue. The condition is associated with smoking, HPV (human papillomavirus) infection and excessive alcohol consumption.

Tongue piercing and tongue spots

People with a tongue piercing are more likely to experience tongue bleeding or inflammation of the tongue area, resulting in the formation of spots, tongue bumps and other lesions on the tongue. A professional must perform a tongue piercing and any complications or signs of infection require medical attention.

Transient lingual papillitis (lie bumps) and tongue spots

Sometimes white spots appear on the upper surface of the tongue. The exact cause of this condition is unknown as of October 2020, but some possible risk factors are stress, smoking, irritation of the tongue by spicy and acidic foods, stomach and intestinal problems (pyrosis, constipation, nausea) and menstruation. Transient lingual papillitis is sometimes reminiscent of tongue spots caused by an HPV (human papillomavirus) infection. Therefore, the doctor sometimes performs a biopsy to make the final diagnosis. Transient lingual papillitis does not require medical treatment and the problem usually goes away within a few days.Drinking enough fluids is necessary to prevent dehydration / Source: Clker Free Vector Images, Pixabay

Dehydration and tongue spots

Insufficient fluid intake may lead to stains on the tongue area. The tissues become dry and a white to yellow substance is formed on the tongue, made of dead cell debris and oral bacteria. People should drink at least between two and three liters of fluid per day to prevent dehydration symptoms such as patches on the tongue.

Fillings

Small dark spots on the side of the tongue may result from amalgam dental fillings. Sometimes doctors refer to this phenomenon as an amalgam tattoo.

Kawasaki disease and spots on tongue

Kawasaki syndrome is a vascular disease that mainly affects children under the age of five. This manifests itself in many symptoms, such as a red strawberry tongue with tongue spots, fever, red eyes or red and swollen feet and hands. Kawasaki syndrome occasionally results in inflammation of blood vessels (vasculitis), which is potentially fatal.

Summer freckles

Some people have dark brown spots on the skin. These freckles (spots) are also possible on the tongue. These harmless spots (melanocytic nevi) may affect various areas of the mouth with uneven discoloration.

Black hair tongue and spots on tongue area

Hairy spots on the tongue indicate a black hairy tongue (lingua villosa nigra). This temporary benign condition results from impaired removal of dead cells from the tongue surface. This results in the build-up of dead cells on the taste buds. When oral bacteria digest these dead cells and the ingested food, brown, black, or gray hairy spots appear on the surface of the tongue.

Alarm signals

It is wise to consult a doctor in the following circumstances:

• persistent discolored spots on the tongue, on the roof of the mouth or on the cheeks that do not disappear within two weeks
• other symptoms such as fever, swollen lymph nodes, difficulty swallowing or breathing problems
• a metallic taste or other taste change in the mouth
• a change in tongue appearance
• chewing problems
• swallowing problems
• tongue pain
• tongue tingling

Prevention

Oral hygiene

Good oral hygiene is necessary. In addition to brushing and flossing the teeth twice a day, it is important to clean the tongue every morning to remove dead cells and oral bacteria. In this way it is sometimes possible to prevent spots and other tongue bumps or lesions on the tongue. Using mouthwash after using a tongue cleaner is also recommended. In addition, a six-monthly visit to the dentist is recommended.Avoiding excessive alcohol consumption is important / Source: Jarmoluk, Pixabay

Lifestyle

Tobacco smoke damages the teeth and tongue and also increases the risk of halitosis (bad breath) and tongue cancer. It is therefore necessary to stop smoking. In addition, the patient avoids excessive use of alcohol, as this may also lead to tongue spots. In addition, alcohol abuse is associated with an increased risk of liver cancer and psychological problems. Eating spicy foods is also not recommended as they aggravate tongue lesions causing tongue pain. Patients do drink enough water (two to three liters per day for adults) because tongue spots sometimes occur due to dehydration.

read more

• Flaky tongue: Causes of flaky tongue area
• Tongue: Abnormalities in color, shape and texture
• Tongue Bumps: Causes of bumps on the tongue
• Geographic tongue: Spots on tongue due to missing papillae
• Tongue pain: Causes of sore tongue (tongue pain)