Have you ever heard of glossitis? I have. The patient comes in and reports a sore tongue that hurts to drink, eat or even talk. My questions usually determine that there is a persistent burning sensation on the tongue with extreme tenderness. The color is often red with swelling present. With the tongue protruded a smooth glossy surface is seen rather than the rough little bumps normally seen. Unfortunately we are faced with glossitis.
The most common reasons for the inflammation are substances that are irritants to the sensitive tissues. Tobacco, alcohol, spices, hot foods and hot liquids all apply. Sometimes the cause is simple to determine and at other times it is almost impossible. It can be very frustrating for all. Not to be forgotten as a possible cause is hormone problems of menopause. Who could forget that?
Less often the culprit is an allergic reaction to some unusual ethnic foods, toothpastes and mouthwashes. Some medications have been found to cause glossitis by creating dry mouth. Dry mouth actually was the subject of my last great blog. These all have been known as common causes of glossitis. Viral problems such as herpes simplex and canker sores are also on the long list. Irregular or red areas of a whitish film are called geographic tongue and are somewhat unusual but not a problem. It just sits on the tongue and does not go away. It is not pathology.
The first most important thing to do is to determine the source. Once the cause of the inflammation is removed problem almost always disappears. Taking vitamin B complex and vitamin C have been associated with eliminating the problem and are worth a try.
It is very interesting to note that stress and depression are also common causes of the glossitis. I always like to talk to my patients and get an idea of their stress levels as a first step. Certain diseases can also be factors. Phemphigus, iron deficiency anemia, hypothyroidism, and lichen planes are mentioned in the text books but are rarely seen.
Few people know that the tongue is a good indicator of general health and it was widely used before modern medicine arrived on the scene. By looking at the tongue doctors long ago could diagnose many diseases. Of course back then there was not a heck of a lot that
they could do about disease but at least they knew you were sick. Today we run 500 tests.
First step in treatment is to eliminate all items in your daily life that may be a cause, especially new items that may have been recently added to your regimen. If the painful tongue does not improve in a few weeks further investigation is appropriate. Medical and dental examinations are in order.
Note: Rapid extreme swelling of the tongue is a medical emergency. Call 911 at once. Death can occur in just a few minutes. DON’T WAIT.
Best regards, AM
Tip of the day: Try the Oral B electric tooth brush. I think it works great and I use it myself.