Tongue Colour Meaning

  • Kiran Kaur Chima Bachelor's degree, Biology/Biological Sciences, General, University of Lincoln, United Kingdom
  • Muna Hassan Bachelor of science in molecular biology and Genetics (2023)

The colour of the tongue is often overlooked in our daily lives, but it can be a valuable indicator of our overall health. In its healthy state, the tongue typically appears pink with a thin, white coating. However, this can vary due to a range of underlying health conditions and lifestyle factors. The tongue is not just an organ for taste and speech; it is closely linked to vital organs and can provide essential clues to our well-being through its colour, texture, coatings, and even its shape.1

Understanding tongue colors

Black tongue 

A black tongue may result from a buildup of keratin, poor oral hygiene, certain medications, tobacco use, or even radiation therapy. In some cases, it can be associated with underlying health issues such as diabetes.2

Pale Pink Tongue: A pale pink tongue might indicate a deficiency in essential vitamins, a weakened immune system, or a general lack of energy. It is essential to address these issues to maintain good health.3

White tongue

A white tongue, often accompanied by a thick coating, can signify a fungal infection, such as oral thrush, or leukoplakia. These conditions can be indicative of various health concerns.4

Purple tongue

A purple tongue is a clear sign of poor blood circulation or issues with the heart's circulation. Inflammation or infection can also contribute to this discolouration.

Red tongue

A red tongue might be linked to a vitamin D deficiency, scarlet fever, or hormonal imbalances. Monitoring this can help detect these issues early.5

Grey tongue

Grey discolouration can be attributed to conditions like eczema, which may have systemic effects on the body.6

Yellow tongue

A yellow tongue may be a result of poor oral hygiene and dry mouth, but it can also indicate liver issues, such as jaundice. Additionally, certain antibiotics and foods rich in beta carotene can contribute to this hue.7

Orange tongue

Similar to yellow, an orange tongue can be associated with poor oral hygiene, certain medications, and a diet rich in beta carotene.

Green tongue

Green discolouration typically results from bacterial overgrowth, which can be influenced by diet, hygiene, and other factors.8

Blue Tongue: A blue tongue signifies a lack of oxygen in the blood, often linked to blood disorders, respiratory problems, or kidney disease.

Tongue coatings

The presence and nature of tongue coatings can provide additional insights into one's health. For instance:

  • A thick coating might indicate poor intestinal health or digestive issues.
  • Yellow coatings may suggest infections elsewhere in the body.
  • Grey or black coatings can be linked to long-term digestive disorders, warranting attention.
  • A thick white coating can signal poor circulation or a yeast infection.

Tongue shapes

The shape of the tongue can also be significant. A puffy tongue might suggest an underlying health issue that needs addressing.

It's crucial to inspect your tongue before brushing your teeth and 30 minutes before eating. While some changes in tongue appearance may be harmless, persistent alterations should prompt a visit to a healthcare professional.1

Maintaining good tongue health

To ensure optimal tongue health and overall well-being, consider the following practices:

  • Brush your teeth at least twice a day with fluoride-based toothpaste.
  • Consume a healthful diet low in sugar, as this can positively impact oral and systemic health.
  • floss daily to prevent plaque buildup.
  • Have regular dental check-ups to stay on top of your oral health.
  • Avoid tongue or lip piercings, as they can increase the risk of oral health problems.
  • Stay away from tobacco products, which are known to have detrimental effects on oral health.9

Addressing discolored tongue

Discolouration of the tongue does not necessarily indicate a dirty tongue. Instead, it can suggest a bacterial buildup. If your tongue appears yellow, green, or black, improving your oral hygiene practices can be a simple yet effective solution. Daily brushing and flossing, along with cleaning the tongue's surface, can help combat this issue.

Dehydration and the tongue

Dehydration can manifest as dryness in the tongue and may be accompanied by a yellowish or whitish coating. If your tongue constantly adheres to the roof of your mouth, this is often a sign of dehydration. To prevent this issue, it's essential to maintain proper hydration by drinking an adequate amount of water daily.10

Medical evaluation and tongue health

If you notice any persistent or concerning changes in your tongue's colour, texture, or coatings, it is wise to seek medical evaluation. A healthcare provider can perform a thorough examination and, if necessary, order tests to identify underlying issues.

Tongue tests

In cases where a visual examination is inconclusive, healthcare providers may order specific tests to reach a diagnosis. These tests can help rule out various disorders and provide valuable insights into your overall health.

  • A Complete Blood Count (CBC) test is often the first step, checking for abnormalities in your blood.
  • In cases where tongue cancer is suspected, a biopsy of the tongue may be performed to confirm the diagnosis.
  • An indirect pharyngoscopy and laryngoscopy may be necessary, involving the use of mirrors or endoscopes to examine the base of the tongue.
  • In instances where venolymphatic malformations are suspected, imaging tests may be recommended. Diagnosing underlying syndromes may require genetic testing.

Blood circulation and tongue color

A purple or blue tongue can be a sign that the blood is not adequately delivering oxygen to the body's tissues. In some cases, oxygen-depleted, dark red blood circulates through the arteries, leading to a blueish discolouration known as cyanosis. Underlying causes of cyanosis can range from heart issues like coronary artery disease to respiratory conditions such as chronic obstructive pulmonary disease (COPD).11

A blue or purple tongue can also result from an airway obstruction that limits oxygen intake. In such situations, a sudden onset of tongue discolouration should be treated as a medical emergency. If accompanied by symptoms like gasping for breath, breathing difficulties, chest pain, dizziness, or fainting, immediate medical attention, often via calling 911, is essential.

Vitamin B-2 deficiency

Vitamin B-2, also known as riboflavin, is a water-soluble vitamin found in various foods, including milk, dairy products, meat, fish, and certain fruits and vegetables. Deficiency in this vitamin is not common in Western countries, but when it occurs, it can lead to several health issues, including anaemia. This deficiency can affect the tongue and mucous membranes, leading to swelling and discolouration. Other signs of a vitamin B-2 deficiency may include fatigue, mouth sores, cracked lips, mood changes, and skin inflammation.12

Bacteria and oral health

The tongue is home to a variety of bacteria, with over 25,000 different types residing in the mouth. While most bacteria are harmless, an excessive amount of certain types can lead to discolouration of the tongue. However, it is more common to see a white film coating on the tongue rather than other colours. To prevent the buildup of bacteria, dead cells, and debris, it is recommended to gently brush the tongue using a toothbrush or tongue scraper. If persistent coating, discolouration, or pain is observed, it is advisable to seek evaluation and treatment from a dentist.

One condition that can affect the tongue is sublingual varices, which are varicose veins appearing as purple or blue lines along the underside and sides of the tongue. These varices become more noticeable with age and are generally not a cause for concern. However, they can be associated with high blood pressure. Another condition that may cause a purple tongue is Addison's disease, also known as adrenal insufficiency. Alongside a purple tongue, individuals might experience darkening of the skin, extreme fatigue, and weight loss. Although brown or tan spots are more common, there have been reported cases of a bluish tongue due to Addison's disease.

Certain medications, such as those containing bismuth (e.g., Pepto-Bismol), have the potential to cause tongue discolouration. This discolouration may appear as a dark purple or black hue and can also affect the colour of one's stool. Typically, discontinuing the use of such medications resolves the discolouration within a few days.

The importance of regular oral check-ups for early detection and treatment

Oral health is not limited to just brushing and flossing; it also involves being aware of any potential abnormalities in the oral cavity. Noncancerous growths, such as hemangiomas, can develop in the mouth, including on the tongue, resulting in a distinct purple swelling resembling a raised bruise or bump. If any new growth appears on the tongue, it is crucial to seek a dentist's evaluation. A biopsy might be necessary to diagnose any lesions and rule out the possibility of oral cancer.

The Oral Cancer Foundation advises against ignoring any persistent lump, sore, or discolouration on the tongue that lasts for more than 14 days. Such symptoms could indicate oral cancer, which may also bring about pain, difficulty chewing, swallowing, or speaking, hoarseness, swollen lymph nodes in the neck, or a persistent earache.13

Understanding the significance of various tongue colours, coatings, and shapes, and their associations with underlying health conditions, emphasizes the importance of regular oral health check-ups. By seeking professional evaluation and timely medical attention, potential concerns can be detected and treated early on. This proactive approach, coupled with maintaining proper oral hygiene practices and adopting a balanced diet, can significantly contribute to overall well-being and oral health.


The colour of our tongue is a huge indicator of our health. Oral health should not be neglected and is just as important as our physical health so it is important to brush twice a day, floss and have regular check-ups with your dentist. If you notice any abnormalities within your mouth it is always good to go straight to your GP and get it checked out.


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  • Dehydrated tongue signs & health issues | colgate® oral care [Internet]. [cited 2023 Oct 20]. Available from:
  • Sugiya R, Higashimoto Y, Shiraishi M, Tamura T, Kimura T, Chiba Y, et al. Decreased tongue strength is related to skeletal muscle mass in copd patients. Dysphagia [Internet]. 2022 [cited 2023 Oct 20];37(3):636–43. Available from:
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  • Mouth Cancer Foundation | Helpline: 01924 950 950 [Internet]. [cited 2023 Oct 20]. Available from:
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Kiran Kaur Chima

Bachelor's degree, Biology/Biological Sciences, General, University of Lincoln, United Kingdom

Hi! Hope you found the article informative. I am a passionate biology student at the University of Lincoln, driven by an insatiable curiosity about drug development and the intricacies of disease treatment. My academic journey has allowed me to delve deep into the world of biology, where I have uncovered the fascinating mechanisms behind health and illness. I aspire to share my knowledge to make health more understandable for all, contributing to a world where cutting-edge science meets everyday understanding, ultimately improving lives through informed choices and innovation.

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