Tongue problems - what they mean

You use your tongue for licking, tasting, swallowing and articulating speech. You clean it every morning when you brush your teeth. But when was the last time you actually observed it? Numerous problems can affect this organ and cause changes in its appearance. Some changes can be very subtle. Watch out for these signs and read on to find out what they mean and what you can do about it.

1. Discoloured Tongue

Are you worried about the change in the colour of your tongue? A healthy tongue is pink in colour and covered with papillae. A discoloured tongue may occur due to various problems. The most common cause of a red tongue is inflammation. Your tongue can also be red if you have a deficiency of folic acid and vitamin B12 or an infection. A healthy diet coupled with a tablet of folic acid a day is the treatment for folic acid deficiency. Your doctor will advise you to increase the amount of vitamin B12 in your diet and also may prescribe vitamin B12 oral tablets or injections for deficiency of the vitamin.

Swollen and red papillae (bumps on the tongue) can give the tongue an appearance of a ‘strawberry tongue.’ It could be a sign of scarlet fever which needs to be treated with antibiotics.

Do you notice red and white patches on your tongue surface that shift their location often? It could be an unusual condition called geographic tongue (benign migratory glossitis). The patches heal only to reappear in another location. The condition may persist for weeks and then regress spontaneously.

You could have a white tongue due to bacterial growth on food debris lodged on your tongue surface. Use a tongue scraper to gently brush the tongue. Alcohol, smoking and dehydration are the other possible culprits. Cut down on these and keep yourself hydrated.

A white tongue can also be a result of whitish coating caused by infection or irritation of its surface. Factors like tobacco, misaligned teeth, ill-fitting dentures and others can cause irritation. Medications are prescribed for an infection.

If the white, creamy patches on your tongue bleed easily on touching, it could be a sign of fungal infection called thrush. Mostly seen in the mouth, this infection can also affect other parts of the body. Antifungal medications are usually prescribed by a dentist to treat this condition.

Consult your dentist if you notice a white patch that can’t be removed by scraping or rubbing on the inside of the cheek, the tongue or the floor of the mouth. Chronic irritation can cause changes in the lining of the oral cavity and lead to leukoplakia, a pre-cancerous condition. Since there is a risk of developing oral cancer, you may need regular checkups to ensure that the condition isn’t progressing.

White lacy patches or streaks on the tongue could be a sign of lichen planus. It frequently accompanies or precedes the skin lesions. There is no cure for lichen planus, but antiseptic mouthwash or steroid sprays may be prescribed to give you symptomatic relief. A study has found that turmeric ointment applied twice a day regularly can be very effective in relieving the symptoms.¹ Read about the two effective home remedies for oral lichen planus.

2. Changes in the texture of the tongue

Thousands of taste buds present on the surfaces of the tiny bumps (papillae) on your tongue give the tongue its rough texture. If you are a heavy smoker, have undergone extensive radiotherapy or have been on oral antibiotics for a long time, you may feel a change in the texture of your tongue. Check out if there is a thick matted patch on its surface. The size of your tongue papillae increases and at the same time, there is a lack of normal shedding, causing a ‘hairy’ tongue. If the papillae grow to a considerable length, they may occasionally brush the palate and produce gagging.

Does your tongue feel ‘bald?’ The smooth feeling is due to gradual degeneration of the papillae of your tongue. The papillae degeneration could be a result of pernicious anaemia, pellagra, o other problems. And if you have a ‘strawberry’ tongue, i.e. your tongue is red and bumpy, it could be a sign of scarlet fever or Kawasaki disease.

3. Fissured tongue

Does your tongue have numerous small fissures of varying depth on the surface of the tongue? Be assured that this is normal and its incidence increases significantly with age. Food debris may build up in the fissures and cause bad breath (halitosis). Make tongue cleaning a part of your oral hygiene routine. Here are tips for keeping your tongue clean.

Consult a doctor if you develop tongue fissures along with recurring swelling of the face and lips and facial paralysis. It could be a sign of a rare condition called Melkersson-Rosenthal syndrome.

4. Swelling

If you notice a sudden swelling of the tongue, it could mean inflammation, infection or allergy. An allergic reaction is the most common cause of tongue swelling. You could be allergic to certain medications or food or insect bites. An allergy can cause a rapid swelling below the surface of the tongue (angioedema). Tongue swelling may develop less rapidly in certain conditions like amyloidosis, pellagra or myxedema (severe hypothyroidism).

5. Soreness

A sore tongue may not be something to worry about. But it surely could be an annoyance. The reason for your painful or painless bumps on the tongue may be an accidental bite, stress, smoking, certain food or hormonal changes. Painful sores can also be a symptom of herpes simplex infection or hand, foot and mouth disease. Sores typically go away on their own within a week or two. Rinsing with salt water, sipping on an ice cube and using pain relieving mouthwash or gels can help soothe the sore. Though most sores on the tongue are not a cause for concern, a sore that is persistent on your tongue needs doctor’s attention. It could be a sign of oral cancer.

6. Altered taste sensation

Aren’t you able to enjoy your once favourite meal because the food doesn’t taste good anymore? Are you finding it difficult to savour the flavour? You could be having a problem with your sense of taste. Ageusia is loss of taste while dysgeusia is ‘taste confusion.’ Phantogeusia or phantom taste is a lingering unpleasant taste in the mouth in the absence of any food. Complete loss of taste sensation is a rare condition. Alteration in the taste sensation is a sign or side effect of medical conditions or procedures. A decrease in the taste bud receptor functioning may be the reason for taste disturbances as you age. Infection or inflammation, damage to the taste buds, dry mouth, chemotherapy, denture or dental surgeries may cause taste disturbances and so do medications, smoking, alcohol, zinc deficiency or suboptimal oral hygiene. Psychiatric conditions like anorexia or depression may also be the reason for a change in the taste perception.

There are no specific treatments for your altered taste sensation. However, treating the cause of your change in taste perception can help. In most cases, stopping the offending medication or treatment can reverse the taste alteration. Zinc supplementation can increase the number of taste bud cells and treat taste disturbances. Artificial saliva or sugar-free candy can help in cases of dry mouth.

7. Pain

A painful tongue makes it difficult to eat, drink, brush and speak. Accidental biting is the most innocuous reason for tongue pain. Pain in the tongue is also most commonly associated with sores. Pain, burning, itching and stinging sensation in the tongue may implicate anaemia, pellagra, gastric disturbances, dry mouth, irritating new dental prosthesis, electro-galvanic discharge between dissimilar metallic teeth fillings, hypothyroidism or psychogenic factors. The pain could also arise from nerve-related problems like trigeminal neuralgia and glossopharyngeal neuralgia. Pain may be referred from an abscessed tooth or tonsils. A burning or tingling sensation that may last for months known as burning tongue syndrome frequently occurs in women past the menopause. Cancer of the tongue, usually painless in the initial stage, can be unbearable in the advanced stages. Treating the cause of your tongue pain can help relieve your agony. If the reason for the pain in your tongue is a sore, then soothing measure like rinsing with salt water, sipping on an ice and using pain relieving mouthwash or gels can help.

8. Tongue-tie

You can be tongue-tied due to a problem with your tongue movement. Ankyloglossia is a congenital abnormality that causes restricted tongue movement. Ankyloglossia causes difficulty in eating and speech. In infants, it can cause inability to breastfeed successfully. Some cases of ankyloglossia are self-corrective. But most need a surgical procedure to correct the condition. If you have an otherwise normal tongue but develop a sudden tongue-tie, it could be a result of nerve or brain injury or infection.

9. Microglossia (small or rudimentary tongue)

Microglossia, a rare congenital anomaly, means the presence of a small or rudimentary tongue. Aglossia is a complete absence of tongue, especially at birth. The conditions cause difficulty eating and talking.

10. Macroglossia (enlarged tongue)

Macroglossia is a congenital abnormality characterised by overdevelopment of tongue muscle. It may also be seen as a result of a tumour, neurofibromatosis, acromegaly (abnormal growth of the hands, feet and face due to increased production of growth hormone) and Beckwith’s hypoglycemic syndrome. The enlarged tongue may obstruct the airway and lead to obstructive sleep apnea. The excess pressure exerted by the tongue on the teeth can cause displacement of teeth and malocclusion. Mild cases of enlarged tongue require no treatment. In other cases, surgical trimming of the tongue can help reduce the bulk of the tongue.

11. Cleft tongue (bifid tongue)

Do you notice a deep groove in the middle of the upper surface of your tongue? A complete cleft tongue occurs due to lack of merging of the two structures or processes that make up the tongue before birth. An incomplete merging of the processes causes a partially cleft tongue. Food debris and microorganisms may collect at the base of the cleft.

Reference:

1. Singh V, Pal M, Gupta S, Tiwari SK, Malkunje L, Das S. Turmeric – A new treatment option for lichen planus: A pilot study. National Journal of Maxillofacial Surgery. 2013;4(2):198-201.

Image source: Shutterstock (Image for representational purpose only)

Published : August 9, 2016 12:40 pm

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