Tongue Disorders
What is it?
Tongue disorders are characterized by changes in the texture and appearance of the tongue's surface. Glossitis is inflammation of the tongue, whereby the tongue becomes extremely smooth, swollen, red, and painful. Geographic tongue also involves inflammation, but in focal, sensitive, migrating patches. Macroglossia is an abnormally enlarged tongue. Hairy tongue and discolored tongue are more unsightly than painful, and both can usually be remedied by good oral hygiene. Tongue cancer, the most serious disorder, primarily affects people over 40. A small ulcer or a raised white patch (leukoplakia) may be the earliest sign of cancer.Most leukoplakias do not become malignant, however a leukoplakia must be evaluated and biopsied—and it must also be monitored if not removed entirely. Tongue cancer may spread rapidly to surrounding tissues in the gums, lower jaw, or lymph nodes in the neck; detection before cancer spreads is essential for a favorable prognosis.
What Causes It?
- Hairy tongue and discolored tongue (in which papillae, the small projections on the tongue, become elongated or darkened) may be caused by tobacco, foods, or medications such as antibiotics. Poor oral hygiene is a contributing factor.
- Tongue disorders may be a sign of an underlying ailment, such as systemic lupus erythematosus, candidiasis, psoriasis, or syphilis. Disorders associated with glossitis include a deficiency of vitamin B12 (pernicious anemia) or other B vitamins, scarlet fever, toxic shock syndrome, and infection (particularly herpes simplex, which may also cause cold sores on the tongue). Down syndrome, intrauterine hypothyroidism (cretinism), amyloidosis, and overproduction of growth hormone by a pituitary tumor (see Acromegaly) can cause macroglossia.
- Chronic irritation due to smoking, alcohol, jagged teeth, or dentures can cause leukoplakia or glossitis.
- Tongue cancer is often associated with smoking and alcohol use (especially in combination).
- Hairy leukoplakia may be a complication of HIV.
Prevention
- Brush or scrape the tongue when you brush your teeth to promote good oral hygiene.
- See a dentist at least once a year.
- Avoid tobacco and excessive use of alcohol.
Diagnosis
- Examination and patient history are often sufficient.
- Tongue biopsy may be performed when cancer or mucous membrane disease is suspected.
How to Treat It
- Treatment is directed at the underlying cause. For example, if a tongue disorder is caused by a vitamin deficiency, dietary guidelines or vitamin supplements may be recommended. Ill-fitting dentures or jagged teeth should be remedied by a dentist.
- A mild salt solution, antiseptic mouthwash, or topical ointment may soothe discomfort.
- Antibiotics or antifungual medication may be used when the disorder includes minor bacterial or fungal infections (as in glossitis).
- Tongue cancer may require surgical excision of all affected tissue, followed by radiation therapy. Tumors that have spread may also require chemotherapy.
When to Call a Doctor
- Call a doctor if your tongue is sore, swollen, or stiff, or if symptoms persist for more than a few days.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.