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The following conditions affect the tongue (see Chapter 8 for more detail/images):

 Glossitis (inflammation of the tongue) – a symptom of conditions such as dry mouth, infections, injury from a burn, irritants, vitamin B complex deficiency, skin conditions (e.g. lichen planus), or an allergic reaction. The underlying cause needs to be treated.

 Soreness of the tongue, which may be due to a variety of reasons, including anaemia, vitamin B complex deficiency, and hormonal imbalance.

 Black hairy tongue – due to overgrowth of tongue papillae, stained by chromogenic bacteria, mouthwash (e.g. chlorhexidine gluconate), or smoking. Looks alarming, but is not serious.

 Geographic tongue (also called benign migratory glossitis) – smooth map‐like irregular areas on the dorsal surface (where the papillae are missing), which come and go. It can be harmless, but is sometimes sore and often runs in families. It can also be an indication of other systemic conditions [7].

Piercing of the tongue can also cause problems and the educator should be able to advise patients on this matter (see Chapter 22).