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Your eyes may be the window to your soul, but your mouth is the gateway to your health. After all, there’s a reason one of the first things doctors do at a checkup is make you open up and “say ahh.”
Clues to a number of conditions can manifest on the tongue, lips, teeth and gums. Here are a few to keep an eye on:
Lumps or lesions on the tongue
It’s completely normal to get a canker sore on the tongue or along the gums every now and then. But if you notice a lesion that doesn’t go away after a week or two, make an appointment with your health care provider. The concern: cancer.
Some cancers are in plain sight — you can see them when you stick out your tongue. But they can also lurk under the tongue or at the base, says Nadeem Karimbux, a periodontist and dean of Tufts University School of Dental Medicine in Boston. “So in order to do a good cancer screening, you really want to pull the tongue out and look on either side,” he says.
Smoking and drinking alcohol increase one’s likelihood of developing cancer on the tongue and other parts of the mouth. Age is another risk factor for oral cancer, including tongue cancer, and so is human papillomavirus (HPV), according to the National Institute of Dental and Craniofacial Research.
Look for an ulcer-like sore that is grayish-pink to red; it may also bleed easily, the experts at Cedars-Sinai say. Numbness on the tongue is another possible symptom. And don’t forget to check the rest of your mouth: Oral cancer can also pop up on the tissue lining the mouth and gums, and where the back of the mouth and throat meet.
While rare, psoriasis, a skin disorder, could be another cause of redness and bleeding in the mouth and on the tongue, the National Psoriasis Foundation says. Talk to your dentist or dermatologist if you experience these symptoms.
A white layer on the tongue
If your pink tongue has taken on a new hue, pay attention. A thin, white layer that looks similar to cottage cheese could indicate thrush, which is a fungal infection on the tongue, says Elena Zamora, M.D., assistant professor in the department of family medicine at McGovern Medical School at UTHealth Houston.
Oral thrush is most common in people who are immunocompromised, including those with HIV/AIDS and untreated diabetes. Taking drugs that suppress the immune system can also make developing thrush more likely — and so can using an inhaler for a condition like asthma.
Zamora explains that when people who regularly rely on inhalers don’t wash their mouth after each use, “then fungus can actually grow because you’re creating a more immunocompromised state by constantly [being exposed] to things like steroids just through an inhaler.”
Wearing dentures and having dry mouth can also increase risk for oral thrush. Reach out to your health care provider if you think you have it; an antifungal medication may be needed.
A condition known as leukoplakia could also be to blame for white patches on the tongue. According to the U.S. National Library of Medicine, the cause is unknown, but irritation from tobacco or alcohol may be an explanation. A weakened immune system could also be to blame, and age is another risk factor. Leukoplakia usually doesn’t lead to permanent damage in the mouth, but it can increase your risk of oral cancer, so it’s best to consult a health care provider if you recognize its symptoms.
A dry or swollen tongue
Your doctor may be able to tell if you’re dehydrated just by looking in your mouth. When you stick out your tongue, “there should be some sort of glare,” Zamora says. “Sometimes light bounces off the tongue, but if it’s very dry, you may only see some buildup of saliva” or a cracked tongue.
A dry mouth, which can also be a side effect of medication, can have some oral health implications, including tooth decay, Karimbux says. “Because saliva kind of bathes the teeth, and when you lose that … you can be more prone to getting cavities,” he says.
If you notice your tongue looking puffier than normal, especially after a meal, “you may be developing an allergy,” says Zamora, who adds that a scratchy feeling in the back of the throat can also signal an allergic reaction. It’s also possible to be allergic to toothpastes and mouthwashes, so start cataloging everything you put in your mouth.
