I see all the filiform papillae from teeny red dots to large pale pink spots as representing an immune or lymph imbalance. Dots indicate heat coming from a deeper level up through the superficial tissues. The redder the dots are, the more active the inflammatory response. The more inactive pale, pink spots represent lymphatic stagnation.
The following table describes indications associated with tongue coating:
| Papillae description | Indications | Papillae description | Indications |
 Small dots, tend to be toward tip. Allergies. M.W. |
Allergic response- Look to red cheeks, red puffiness beneath eyes, inflammation. Hawthorn, M.F. |  Raised red papillae on back third / center |
Heat in intestines and urinary tract. Hemorrhoids, cystitis, Urethritis Heat in spleen, stomach, intestines. W. Le. |
 Larger dots, tend toward mid and lower. M.W. |
Swollen lymphatics Larger the dot the bigger the heat. Mid to lower region = lymph |
 Raised red papillae all over |
Systemic infection, septicemia, infection, heat in the blood (Echinacea, Baptisia). |
 Tiny dots on tongue body |
Swollen glands, systemic infection. Immune challenge |  Small red dots toward the tip |
Allergies or irritability of the mucosa Heat in the heart |
 Red or pink papillae with dry tongue M.W. |
Peach leaf. |  Dots toward the back of the tongue |
Heat in the intestines |
 Pink spots up and down the sides of the tongue. M.W. |
Old unresolved infections in the lymphatics. Calendula. M.W. |
 Dots at sides |
Heat in liver gallbladder |