Tongue Diseases Explored: Lingual Disorders Decoded

Normally the tongue is moist and has a little fur on it. The papillae of the surface can be seen. Fur on the it is usually of no consequence in normal persons. Normally the breath does not have an odor. The various alterations seen commonly along with various types of smell from the breath. In this blog, we delve into differential diseases, their causes, symptoms and management strategies

Glossitis : Inflammation’s impact on tongue

Inflammation of tongue or alterations produced in the tongue due to any cause is known as glossitis. It can be secondary to nutritional deficiencies, drug reactions, dehydration, irritant food and liquids. Common glossitis symptoms includes : 

• Swollen tongue
• Glossy tongue
• Painful tongue
• Difficulty in swallowing 
• Difficulty in speaking 

There are few types of glossitis, which are atrophic glossitis ( takes place when you lose a lot of papillae ), geographic tongue ( an inflammatory condition ), median rhomboid glossitis ( a kind of fungal infection ), burning tongue syndrome ( common during menopausal period ). Major causes of glossitis are nutritional deficiencies, low iron level, xerostomia, hormonal change and allergic reactions to food, medicine and dental care products. Treatment includes antiseptic mouthwash, removal of an offending agent and B – complex administration. 

Thrush: Candida’s Intrusion on the Tongue

It is a condition in which the fungus candida albicans accumulates on the lining of the mouth. Basically, oral thrush is a minor problem, but if someone has a weakened immune system, it shows severe symptoms. Oral thrush usually takes place due to overgrowth of C. albicans. In some cases, certain illnesses or medications like corticosteroids, can disturb its balance. This can cause the fungus to grow out of control. Common severe symptoms include : 

• Burning in the mouth
• Difficulty swallowing
• Presence of yellow spots on tongue, cheeks, tonsils etc.
• Slightly bleeding, if the spots are scraped
• Redness and irritation 

Oral thrush can also affect infants and children. Infants can contract the fungus from the parent, during pregnancy, delivery and feeding, which can lead to difficulty in feeding and fussiness. Doctors will recommend specific treatment based on your age and the cause of the infection.

Burning Mouth Syndrome 

Burning mouth syndrome is a burning pain, which can take place on the tip of the tongue and roof of the mouth. Sometimes, pain can radiate in the inner part of the lips. There are many inflammatory conditions which can cause burning pain such as geographic tongue, oral lichen planus and yeast infection.

When the cause can’t be found, the condition is called primary burning mouth syndrome. When the burning pain is related or linked to underlying medical conditions like dry mouth, allergies, endocrine diseases etc, the condition is called secondary burning mouth syndrome. Common Symptoms may include 

• Dry mouth
• Loss of taste
• Presence of burning sensation on tongue, lips etc.
• Tingling and numbness in the mouth. 

Treatment depends on a specific type of burning mouth syndrome. Under primary burning mouth syndrome, treatments options may include : 

• Medications for blocking nerve pain
• Saliva replacement products
• Cognitive behavioural therapy 
• Specific oral rinses

For secondary burning mouth syndrome, treatment depends on the linked conditions that can lead to causing burning pain in the mouth.

Leukoplakia Of Tongue 

It is a chronic disorder of it characterised by small white smooth patches with firm margins on one side of the tongue and later on spreading over the dorsum of the tongue. In early stages, it is not painful but later on becomes painful and tender because of the appearance of fissuring and splitting of patches.

Leukoplakia can be caused due to harmful habits like smoking, chewing tobacco and prolonged alcohol use. Hairy leukoplakia is commonly seen in AIDS, while candida leukoplakia produces non-removable white patches on it. Common symptoms include : 

• White patches on tongue, gums and roof of the mouth
• Patches can be flat or slightly raised
• Patches can be white or gray with tiny red dots. 

Treatment includes removal of white patches from the mouth. Other potential procedures include, photodynamic and cryotherapy can be done for removal of patches. If leukoplakia is caused by smoking, patients should be encouraged to quit smoking or minimize using other tobacco products.

Carcinoma Of The Tongue

The carcinoma of tongue is common in smokers, tobacco chewers, alcoholics and individuals with poor oral hygiene. It may appear as an ulcer, which is usually painless. Common cancer symptoms include : 

• Presence of white or red patches on the tongue
• Sore throat
• Numbness on the tongue
• Swelling of the jaw
• Difficulty in swallowing and eating
• A change in voice. 

Testing for cancer includes examination of mouth and throat. Some imaging tests should be done. Sometimes an X-ray involves a barium swallow. In this type of X-ray, a liquid called barium helps to check for signs of cancer in the throat. 

Cancer surgery is the most common treatment for tongue cancer. Differential therapies are there, such as radiation therapy, chemotherapy, targeted therapy and immunotherapy. 

Conclusion 

As we conclude our journey through tongue diseases, it becomes clear that a healthy tongue plays a vital role in overall well-being. A healthy tongue should be pink in color with small nodules called papillae over the surface. By quitting bad oral habits and maintaining excellent oral hygiene, we empower ourselves to speak, taste, and live with comfort and confidence.