Small red fleshy grains on the tongue are usually tongue papillae with taste buds that can sense taste, so if they are not accompanied by abnormal symptoms such as pain, they do not need to be treated. If there is painful sensation, it is considered as lingual papillitis, which is commonly known as lobar papillitis or fungal papillitis. In addition, if the red granules appear on the lateral edge of the tongue, the possibility of tongue cancer cannot be ruled out.1. Tongue papillitis: usually considered to be related to factors such as anemia, vitamin deficiency, local irritation, pathogenic bacterial infection, etc. Usually, the tongue papillae will become congested, swollen and enlarged, and patients will find red granules on the tongue, often with pain and discomfort. The main treatment is to give symptomatic treatment, such as correcting anemia if it is anemic, and anti-infective treatment or antifungal treatment if it is infected. At the same time, supplement nutrition, eat more fruits and vegetables rich in vitamins, keep the mouth clean and hygienic, reduce local stimulation, use anti-inflammatory mouthwash or pain relievers, and eat less overly hot or spicy stimulating food, usually tongue papillitis can gradually subside after a period of time; 2, tongue cancer: small hard nodules can appear on the lateral edge of the tongue in the early stage of tongue cancer patients, which can be manifested as red grains, and may also appear as ulcers, lumps, erosions, pain and other symptoms. The symptoms are considered to be related to smoking, drinking, betel nut chewing and poor hygiene habits, etc. The diagnosis can be clarified by tissue biopsy. Early stage highly differentiated tongue cancer can be treated with radiotherapy, surgical resection or cryotherapy, while advanced stage requires radiotherapy combined with surgery or combined with immunotherapy.