Basic Tongue Problems

AnnC

Ann Clark, RDH

Basic Tongue Problems

The tongue is often known as the “strongest muscle in the body”.  It is made up of a group of muscles and allows us to swallow, talk, taste, and clean the mouth.  A healthy tongue is pink and covered with small bumps we call taste buds or papillae.

When your tongue experiences soreness or discoloration it can be frustrating due to its constant use.  The majority of tongue problems are not serious and most can be cared for quickly; however, sometimes a discolored or painful tongue can be something more serious like a vitamin deficiency, oral cancer, or AIDS.  Any persisting concerns should have medical advice.

White tongue:
-Leukoplakia: this condition causes excessive cell growth in the mouth causing white patches to grow.  Although not always dangerous they can be a precursor to cancer so let your dentist be the judge.  It can develop from irritation and is more often found in those using tobacco products.
-Oral thrush: also known as candidiasis.  This is a yeast infection of the mouth.  It shows up as white patches like cottage-cheese.  It is more common in infants and the elderly, especially denture wearers or those with weakened immune systems.  Medical conditions like diabetes, or inhaled steroids for asthma or lung disease can increase your risk.  Antibiotics can kill off “good” bacteria resulting in this condition.  Eating plain yogurt and medications can combat this infection.
-Oral lichen planus: this manifests itself as lacey-white lines on your tongue.  Although hard to determine the cause, it often resolves on its own.  Keeping up good hygiene and avoiding tobacco can help the healing process.
Other Conditions: 
-Scarlet fever: contact a doctor if you have a red tongue along side a high fever.  An antibiotic is necessary for this condition.
-Geographic tongue: this is known dentally as benign migratory glossitis and looks like a map pattern of reddish spots with a white border;  their location often shifts.  They are usually harmless and acidic foods can often sting.  If discomfort persists you can be prescribed a topical medication.
-Red or strawberry tongue: many factors can cause a normally pink tongue to turn red or even look strawberry-like with enlarged, red taste buds.  Vitamin deficiencies like B12 and folic acid can cause such an appearance.
-Black hairy tongue: although this looks scary it is typically non-serious.  The small bumps on your tongue grow continually in your lifetime and in some people become excessively long, making it easier to harbor bacteria and cause a dark “hair-like” appearance to form.  This is more commonly found in those with poor hygiene, individuals on antibiotics or chemotherapy and those with diabetes.
-Sore or bumpy tongue:
*Trauma can usually occur from biting or burning your tongue. Grinding and clenching can irritate the sides
your tongue.
*Canker sores or ulcers cause soreness.  Their cause is unknown but stress can aid their development.
*Burning tongue syndrome can occur in post menopausal women.
*Smoking is an irritant to the tongue manifesting in soreness.
*Medical conditions like diabetes and anemia can result with a sore tongue.
*Enlarged papillae can result from irritated taste buds.
*Oral cancer- a spot that doesn’t resolve in a 2 week period needs to be checked.  Many oral cancers do not
hurt in the early stages so don’t assume a lack of pain means you are okay.

Please consult your friendly dental office for an evaluation if any of these conditions arise.  It’s better to be safe.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:
http://www.webmd.com/oral-health/guide/tongue-problem-basics-sore-or-discolored-tongue-and-tongue-bumps?page=3
University of Maryland Medical Center: “Tongue Problems”
University of Maryland Medical Center: “Oral Cancer”
American Dental Association: “Common Mouth Sores”
Familydoctor.org: “Mouth Problems”
Familydoctor.org “Canker Sores:  What they are and what you can do about them”
Columbia University College of Dental Medicine:  “Black Hairy Tongue”
Columbia University College of Dental Medicine:  “Painful Papillae of the Tongue”

What is Normal?

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Becky Larson RDH

In my short time as a dental hygienist I have had many patient ask me about “weird” things they have noticed inside their mouths. Many patients are worried or scared they might have oral cancer. While oral cancer should be checked regularly, many times the things patients are worried about are completely normal. In general, most mouths have the same or similar anatomy. However, there are variants of normal that one person may experience over another. I have listed a few of these normal variants here:

Tori: A torus or tori (plural) is simply an excessive growth of normal compact bone, either on the floor or roof of the mouth. They develop gradually and are asymptomatic. Tori can grow into many different shapes and sizes and are covered by the normal soft tissues of the mouth. Tori may make taking radiographs very uncomfortable or painful. No treatment is needed unless the patient is having problems speaking or swallowing. Even upon removal tori may grow back.

 

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Fordyce granules: Fordyce granules are simply a cluster of sebaceous glands (glands that secrete oil, similar to a pimple) inside the mouth. Usually they occur on the inside of the cheeks or on the lips. They are yellow in color and more than 80% of adults over the age of 20 experience them. Fordyce granules are also asymptomatic and do not require treatment.

Lingual varicosities: Lingual varicosities are veins under and on the sides of the tongue. They can be red, blue, or purple in color and generally occur in clusters. Everyone has veins in and around the tongue that may vary in size, shape, or color.

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Linea alba: Linea alba is a raised, white line usually along the inside of the cheek. It occurs as a result of clenching or biting the inside of one’s cheek. No treatment is necessary.

Luekoedema: Leukoedema is a generalized opalescent appearance of the inside of the mouth. It most commonly occurs in black adults but can be seen with any ethnicity. When the mucosa is stretched the opalescence is less noticeable. No treatment is necessary.

Amalgam tattoo: Believe it or not, I have seen tattoos inside the mouth! However, an amalgam tattoo is a little different. These “tattoos” result from previous amalgam (silver) fillings where part of the filling material seeps into the tissue. It creates a bluish-gray lesion and they can occur anywhere an amalgam filling has been placed. Amalgam tattoos can look very similar to oral cancer because of their color. A biopsy can determine the difference. Amalgam tattoos generally do not require treatment.

 

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Fissured tongue: Believed to be a result of familial genetic patterns, this variant is seen in about 5% of the population. It involves deep fissures or grooves on the dorsal (backside) of the tongue. Sometimes the tongue can become irritated if food or bacteria remain in the grooves for an extended period of time. No treatment is needed other than brushing the tongue to remove food/bacteria from the surface.

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Geographic tongue: Geographic tongue appears as small, red patches on the dorsal (backside) of the tongue that are surrounded by a yellow or white perimeter. The appearance is similar to that of landmasses on a globe, hence the name “geographic” tongue. The patches may go away and return again in different areas. Stress can be a contributing factor to this condition. No treatment is needed.

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   Make sure to be aware of what is inside your mouth. We recommended oral cancer screenings at least once per year.

As always, please go see your physician if you experience any of the following:

  • Spots, lesions, or discolorations that remain longer than 2 weeks that were not previously present.
  • Any changes is size, shape, or color to pre-existing lesions.
  • Anything that causes you pain or that your dentist recommends getting checked

Happy Oral Cancer Awareness Month!

Want to learn more? Visit us at http://www.alamedadentalaz.com

Information taken from:

Ibsen, O., and Phelan, J. (2009) Oral Pathology for the Dental Hygienist. St. Louis, Missouri: Saunders Elsevier.