The tongue is a muscular organ with no intrinsic bony structures. It plays vital roles in the communication, mastication & swallowing, and taste perception processes. There are numerous pathological processes that manifest signs within the oral cavity. Additionally, there are several primary pathologies of the tongue as well. This article aims to give an overview of some congenital and acquired disorders of the tongue.
There are many possible causes of tongue problems, ranging from harmless to serious. Individuals can be born with a tongue condition that is harmless. A more serious condition such as tongue cancer can be related to risk factors such as smoking and drinking alcohol. Additionally, a tongue problem may be a result of an underlying medical condition.
Possible symptoms that you may experience related to your tongue include:
• a partial or complete loss of taste or changes in your ability to taste sour, salty, bitter, or sweet flavors
• difficulty moving your tongue
• tongue swelling
• a change from the normal color of your tongue or patches of color that are white, bright pink, black, or brown
• pain either all over the tongue or only in certain spots
• a burning sensation either all over the tongue or only in certain spots
• white or red patches, which are often painful
• a furry or hairy appearance of the tongue
You should make an appointment to see your doctor for diagnosis and treatment if your tongue problem is severe, unexplained, or persists for several days with no signs of improvement
• larger sores than you’ve previously had
• recurring or frequent sores
• recurring or frequent pain
• a persistent problem lasting greater than two weeks
• tongue pain that doesn’t improve with over-the-counter pain (OTC) medications or self-care measures
• tongue problems with a high fever
• extreme difficulty eating or drinking
During your appointment, your doctor will thoroughly examine your tongue and ask you several questions about your tongue and your symptoms. They’ll want to know:
• how long you’ve had the symptoms
• whether your ability to taste has changed
• what kind of pain you have
• if it’s difficult to move your tongue
• if you have any other issues in your mouth
If your doctor isn’t able to make a diagnosis based on the exam and the answers to your questions, they may order some tests. Most likely, your doctor will want to take a sample of blood to test for or rule out various disorders that could be causing your tongue issues. Once you have a diagnosis, your doctor will recommend treatments for your specific problem.
Creamy white spots could be thrush, a fungal infection (shown here). It often happens after an illness or medications throw off the balance of bacteria in your mouth. White patches that look lacy could be lichen planus, which means your immune system is attacking the tissues in your mouth. If you see hard, flat, white areas that can’t be scraped away, it could be leukoplakia, which is linked to cancer. Let your dentist know about any white patches you see.
If your tongue has a coating that looks like black, brown, or white fur, you might have hairy tongue. Those “hairs” are proteins that turn normal, small bumps into longer strands, where food and bacteria get caught. It should go away when you brush or scrape your tongue. If you have hairy, white patches that you can’t scrape off, it might be oral hairy leukoplakia. It can happen to people infected with viruses like Epstein-Barr or HIV.
Hairy tongue can be black in color. But your tongue can also go dark after you take an antacid with an ingredient called bismuth. For some people, it stains the tongue black when it mixes with saliva. It’s harmless and goes away once you stop taking the medicine.
A strawberry-red tongue could be an early sign of Kawasaki disease, a rare, serious illness that inflames blood vessels all over the body, most often in children. It’s also a symptom of scarlet fever. If your red tongue is also smooth and you have pain in your mouth, it might be a sign that your body doesn’t have enough vitamin B3.
The treatment of a tongue problem depends on the underlying cause. For some tongue problems, no treatment is necessary whereas for other conditions, medications, surgery, or radiation may be needed. If the tongue issue is a result of an underlying medical condition, treatment of the underlying problem can be key to solving the problem.
Some tongue problems are preventable by practicing good oral hygiene and eating a healthy, nutritious diet. Some tongue conditions cannot be prevented at all, but symptoms may be managed with treatment. Other tongue problems may be a byproduct of an underlying medical condition that needs to be addressed. For example, signs of an HIV infection (or final stage of HIV infection, AIDS) often appear in the mouth along with other bodily symptoms. HIV testing is important in determining if HIV treatment and care is needed.
Exercising moderation or altogether quitting the habit of smoking and drinking alcohol will decrease the risk of developing oral cancer. A vaccine for HPV is being studied, and it may help in guarding against oral cancers, as well. Oral cancer screenings should always take place during routine dental visits. Screenings can also take place with an ear, nose, and throat (ENT) physician. These oral cancer screenings involve an examination of all the soft tissues in the mouth, including the tongue, floor of the mouth (under the tongue), palate (roof of the mouth), inside of the cheeks, and throat area.
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Dr. Seif received an award in Aesthetic Dentistry and an Advanced Standing Achievement Certificate and held a position as a part-time clinical instructor.
Dr. Seif has more than 15 years of experience as a dentist and has obtained two dental degrees. Dr. Seif earned his first degree in dentistry in Syria in 1998 and practiced general dentistry until coming to the US to advance his education by earning a second dental degree from Loma Linda University School of Dentistry, a world-renown dental institute. While at Loma Linda, Dr. Seif received an award in Aesthetic Dentistry and an Advanced Standing Achievement Certificate and held a position as a part-time clinical instructor.
Dr. Seif’s compassion and friendly nature is evident to his patients. He believes that every individual should be treated in a kind, caring and respectful manner. Dr. Seif is dedicated to life-long learning and enjoys participating in post-graduate courses that enable him to provide his patients and community with the excellent dental care he believes every person deserves.
Moving from the Dallas-Fort Worth area in 2014, Dr. Seif now calls Baytown his home. Along with cooking, friends, family and his dog, Sophie, he enjoys southern culture. He is enthralled by the friendliness and hospitality he finds in Texas, saying, “This is exactly the kind of community I want to live and practice in!”