[Conspicuous Conditions of the Tongue: Normal Variants vs. Pathological Findings]

With its sensitivity, taste buds and complex anatomical structure of various muscles, the tongue is a central organ for speaking, tasting and food intake, especially oral food transport, chewing and swallowing. Changes in the tongue 's condition are frequent and often lead to uncertainty among patients and eventually to a visit to the family doctor, to the ear, nose and throat specialist, dentist or maxillofacial surgeon. The question whether the condition of the tongue is a lesion requiring treatment or just a variant can quite often prove a major challenge. The differential diagnoses are wide-ranging from harmless changes to alarming signs of disease. The time and duration of occurrence, the accompanying symptoms such as a burning sensation or taste disorders as well as risk factors such as nicotine and alcohol consumption are important anamnestic elements. Possible causes can be malnutrition, systemic diseases, inflammatory processes or malignancies. Accordingly, a blood test and a smear or a biopsy may be necessary as the first diagnostic step. The aim of this review is to explain the different types and causes of tongue problems and to explain in which cases further clarifications are necessary.