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Tongue problems

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Definition:

Tongue problems include pain, swelling, or a change in how the tongue looks.

Alternative Names:

Dark tongue; Burning tongue syndrome

Considerations:

The tongue is mainly composed of muscles. It is covered with a mucous membrane . Small bumps (papillae) cover the upper surface of the tongue. Between the papillae are the taste buds, which allow you to taste. The tongue moves food to help you chew and swallow.

The tongue also helps you form words.

There are many different reasons for changes in the tongue's function and appearance.

DIFFICULTY MOVING THE TONGUE

Tongue movement problems are most often caused by nerve damage. However, problems moving the tongue may also be caused by ankyloglossia, a disorder where the band of tissue that attaches the tongue to the floor of the mouth is too short. Tongue movement disorders may result in speech difficulties or difficulty moving food during chewing and swallowing.

TASTE ABNORMALITIES

Taste problems can be caused by damage to the taste buds, nerve problems, side effects of medications, an infection, or other condition. The tongue normally senses sweet, salty, sour, and bitter tastes. Other "tastes" are actually a function of the sense of smell.

ENLARGEMENT OF THE TONGUE

Tongue swelling occurs with Down syndrome , acromegaly , myxedema , amyloidosis , rhabdomyoma, and other disorders. The tongue may get wider in persons who have no teeth and do not wear dentures.

COLOR CHANGES

Color changes may occur with inflammation of the tongue ( glossitis ). Papillae are lost, causing the tongue to appear smooth. Geographic tongue is a patchy form of glossitis where the location of inflammation and appearance change from day to day.

HAIRY TONGUE

Hairy tongue is a harmless condition in which the tongue looks hairy or furry. Its appearance can be worrisome. The disorder usually goes away with antibiotics.

BLACK TONGUE

Sometimes the upper surface of the tongue turns black or brown in color. This is an unsightly condition but not harmful.

PAIN IN THE TONGUE

This may occur with glossitis and geographic tongue. Tongue pain may also occur in with diabetic neuropathy , oral cancer , mouth ulcers , and leukoplakia .

After menopause, some women have a sudden feeling that their tongue has been burned. This is called burning tongue syndrome or idiopathic glossopyrosis. There is no specific treatment for burning tongue syndrome.

Common Causes:

Minor infections or irritations are the most common cause of tongue soreness. Injury, such as biting the tongue, can cause painful sores. Heavy smoking will irritate the tongue and make it painful.

A viral ulcer, also called a canker sore, commonly appears on the tongue (or anywhere in the mouth) for no apparent reason. Some doctors believe that these ulcers are linked to emotional stress or fatigue, although this has not been proven.

Possible causes of tongue pain include:

• Anemia
• Cancer
• Dentures that irritate the tongue
• Oral herpes (ulcers)
• Neuralgia
• Referred pain from teeth and gums
• Referred pain from the heart

Possible causes of tongue tremor :

• Neurological disorder
• Overactive thyroid

Possible causes of white tongue:

• Local irritation
• Smoking and alcohol use

Possible causes of smooth tongue:

• Anemia
• Vitamin B-12 deficiency

Possible causes of red (ranging from pink to magenta) tongue:

• Folic acid and vitamin B-12 deficiency
• Pellagra
• Pernicious anemia
• Plummer-Vinson syndrome
• Sprue

Possible causes of tongue swelling:

• Acromegaly
• Allergic reaction to food or medicine
• Amyloidosis
• Angioedema
• Beckwith syndrome
• Cancer of the tongue
• Congenital micrognathia
• Down syndrome
• Hypothyroidism
• Infection
• Leukemia
• Lymphangioma
• Neurofibromatosis
• Pellagra
• Pernicious anemia
• Strep infection
• Tumor of the pituitary gland

Possible causes of a hairy tongue:

• AIDS
• Antibiotic therapy
• Drinking coffee
• Dyes in drugs and food
• Chronic medical conditions
• Overuse of mouthwashes containing oxidizing or astringent agents.
• Radiation of the head and neck
• Tobacco use

Possible cause of grooves in the tongue:

• Birth defect -- normally occurs in 10% of population

References:

Rakel P, ed. Conn ’s Current Therapy 2006 . 58th ed. Philadelphia, Pa: WB Saunders; 2005:1038.

McKenna JK. Dermatologic drug reactions. Immunol Allergy Clin North Am . Aug 2004; 24(3): 399-423, vi.

• Review Date: 2/12/2007
• Reviewed By: Alden J. Pearl, M.D., Clinical Assistant Professor, Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Brooklyn, NY. Review provided by VeriMed Healthcare Network.

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