Does your tongue change when you get older? Exploring the oral signs of aging

According to the National Institute of Dental and Craniofacial Research, the percentage of older adults who have kept their natural teeth has increased over recent decades. While a positive trend, it also means that more attention is needed for overall oral health, which includes understanding how and why does your tongue change when you get older.

Quick Summary

As you age, your tongue can undergo several physiological and structural changes, including reduced taste sensitivity, altered muscle strength, and increased prevalence of conditions like fissured or hairy tongue, often influenced by medication, diet, and overall health.

Key Points

• Taste Bud Reduction: A natural part of aging includes the shrinking and reduction of taste buds, leading to a decreased ability to perceive flavors, particularly salty and sweet.

• Tongue Strength Decline: The tongue is a muscle, and its strength and endurance can decline with age, which may affect chewing and swallowing efficiency.

• Dry Mouth (Xerostomia): Older adults are more susceptible to dry mouth, often caused by medications, which can lead to a sore, bumpy tongue and an increased risk of infections.

• Common Conditions: Conditions like fissured tongue (deep grooves), geographic tongue (map-like patches), and hairy tongue (elongated papillae) become more prevalent with age.

• Nutritional Deficiencies: A smooth, glossy tongue (atrophic glossitis) can signal nutritional deficiencies, such as low levels of B12 or iron.

• Increased Vigilance Required: While many changes are normal, persistent sores, pain, or unusual patches on the tongue should be evaluated by a healthcare professional to rule out more serious conditions.

Common physiological changes to the tongue with aging

Beyond just getting older, several physiological shifts can affect the appearance and function of your tongue. Understanding these natural processes can help distinguish between normal aging and a more serious condition.

Alterations in taste perception

The loss of taste sensitivity is one of the most well-known changes associated with aging. The number of taste buds decreases as you age, and the remaining ones may also shrink. This reduction can lead to a diminished ability to detect certain flavors. For many seniors, salty and sweet tastes are often the first to fade, which can sometimes lead to adding excessive amounts of salt or sugar to food to compensate.

Reduced tongue strength and endurance

The tongue is a muscle, and like other muscles in the body, it can be affected by age-related sarcopenia, or muscle loss. Studies have shown a decline in tongue strength and endurance in healthy older adults, which can impact chewing and swallowing efficiency. While these changes may not cause significant issues in normal aging, they can become more problematic in conjunction with other health issues.

Decreased saliva production (dry mouth)

Saliva is crucial for oral health, but as people age, they often experience decreased saliva production, a condition known as xerostomia. This is not a direct result of aging itself, but rather a side effect of many medications commonly taken by seniors, such as those for high blood pressure, depression, and anxiety. Dry mouth can affect the tongue by making it feel dry, bumpy, or sore, and it increases the risk of tooth decay and fungal infections like oral thrush.

Common age-related tongue conditions

In addition to general physiological changes, older adults may also experience specific conditions that affect the tongue's appearance.

Fissured tongue

A very common condition in older adults, a fissured tongue is characterized by deep grooves or furrows on the surface. While often harmless and without symptoms, the fissures can sometimes trap food debris and bacteria, which may lead to inflammation. Regular, gentle brushing of the tongue is recommended to prevent this.

Geographic tongue

Also known as benign migratory glossitis, geographic tongue presents as smooth, red patches on the surface of the tongue that are surrounded by slightly raised white or yellow borders. The pattern can change locations over time, resembling a map. It is generally harmless but can sometimes cause sensitivity or a burning sensation, especially with certain foods.

Atrophic glossitis

This condition results in a smooth, glossy, and often red or pink appearance of the tongue, caused by the atrophy or loss of the tiny bumps (papillae) on the surface. Atrophic glossitis is frequently linked to nutritional deficiencies, such as low levels of iron, folic acid, or vitamin B12.

Hairy tongue

Black or brown hairy tongue occurs when the filiform papillae on the tongue's surface fail to shed properly and grow longer than normal, trapping food particles and bacteria. This benign condition is more common in individuals with poor oral hygiene, those who smoke, or those with certain health conditions like diabetes.

Lingual varicosities

These appear as small, dark, and swollen veins, usually on the underside of the tongue. They are a normal sign of aging and generally pose no threat to health.

Comparison of age-related tongue changes

Condition	Appearance	Cause	Symptom Severity
Fissured Tongue	Deep grooves on the surface.	Age-related, sometimes associated with other conditions.	Mostly asymptomatic; can cause inflammation if food is trapped.
Geographic Tongue	Smooth, red, map-like patches with white borders.	Unknown, but linked to genetics; sometimes triggered by irritants.	Mild to moderate sensitivity or burning.
Atrophic Glossitis	Smooth, glossy, red/pink surface.	Often linked to nutritional deficiencies (e.g., B12, iron).	Can cause a painful, burning sensation.
Hairy Tongue	Elongated papillae that appear black/brown.	Poor oral hygiene, smoking, medication use, diabetes.	Mostly harmless, but can be unsightly.
Lingual Varicosities	Dark, swollen veins on the underside of the tongue.	Normal part of the aging process.	Asymptomatic.

How to maintain a healthy tongue as you age

Fortunately, many age-related tongue changes can be managed with good oral hygiene and attention to overall health. Simple preventative measures can make a significant difference.

• Brush or scrape your tongue daily: In addition to brushing your teeth, gently brushing or using a tongue scraper can help remove bacteria and food debris, which is especially important for those with fissured or hairy tongues.
• Stay hydrated: Drinking plenty of water is essential for stimulating saliva production, which helps keep the mouth clean and reduces the risk of dry mouth and related infections.
• Use an alcohol-free mouthwash: An antibacterial, alcohol-free mouthwash can help kill germs without contributing to dry mouth.
• Maintain a healthy diet: Eating a balanced diet rich in vitamins and minerals can prevent nutritional deficiencies that cause conditions like atrophic glossitis. Incorporating crunchy fruits and vegetables can also help naturally clean the tongue's surface.
• Avoid tobacco and limit alcohol: Both substances are known to contribute to dry mouth, alter the tongue's appearance, and increase the risk of more serious conditions, including oral cancer.
• Schedule regular dental check-ups: Regular visits to your dentist are crucial for early detection of any oral issues, including potential pre-cancerous or cancerous lesions on the tongue. They can also provide guidance tailored to your specific needs.

When to see a doctor

While many age-related changes to the tongue are benign, some signs warrant medical attention. It's important to consult with a healthcare provider if you notice any persistent or concerning symptoms. See a doctor if you experience:

• A sore or lesion that does not heal within two weeks.
• Persistent pain or burning sensations.
• Significant swelling of the tongue.
• White or red patches that do not scrape off and cannot be explained.
• Difficulty chewing, swallowing, or speaking.

For more in-depth information about oral health for older adults, the American Dental Association offers valuable resources on its website: https://www.ada.org/resources/ada-library/oral-health-topics/aging-and-dental-health.

Conclusion

Yes, the tongue does undergo various changes with age, from altered taste perception and reduced muscle strength to the increased likelihood of conditions like fissured or hairy tongue. While many of these are benign and part of the natural aging process, it is important to practice good oral hygiene, stay hydrated, and maintain a healthy diet. Most importantly, regular dental check-ups and vigilance for any persistent or unusual symptoms will ensure that your tongue remains a healthy and functional part of your overall well-being as you age.

Frequently Asked Questions

Is it normal for my sense of taste to change as I get older?

Yes, it is common to experience a natural decline in your sense of taste with age, especially after 60. This is because the number of your taste buds decreases and they can also shrink, often affecting your perception of salty and sweet foods first.

What is fissured tongue, and is it a problem?

Fissured tongue refers to the deep grooves or fissures that appear on the surface of the tongue and become more common with age. For most people, it is a harmless condition and doesn't require treatment. However, maintaining good oral hygiene is important to prevent food and bacteria from getting trapped in the grooves, which could cause inflammation.

Why do older people often get dry mouth?

Dry mouth, or xerostomia, is very common in older adults but isn't a direct result of aging itself. The most frequent causes are side effects from medications, such as those for blood pressure and depression, as well as certain health conditions and dehydration.

Can a vitamin deficiency cause my tongue to change?

Yes, a vitamin deficiency can cause changes in your tongue's appearance. Atrophic glossitis, for example, results in a smooth, red, and glossy tongue and is often caused by a deficiency in nutrients like iron, folic acid, or vitamin B12.

What does a 'hairy tongue' mean for seniors?

A 'hairy tongue' refers to elongated papillae that can trap bacteria, often turning the tongue a dark color. This benign condition is more common with poor oral hygiene, smoking, or certain health issues like diabetes. It can often be resolved with better cleaning habits.

When should I be concerned about a tongue change?

You should see a doctor or dentist if you have a sore or lesion on your tongue that doesn't heal within two weeks, experience persistent pain, or notice any unusual white or red patches. These symptoms could indicate a more serious condition, like oral cancer, and require evaluation.

How can I improve my sense of taste as I get older?

If you experience a reduced sense of taste, experiment with different flavors and seasonings, but be cautious with adding too much salt or sugar. Quitting smoking, avoiding certain irritants like alcohol, and addressing any underlying medical issues with your doctor can also help. Staying well-hydrated is also beneficial.