Tongue Problems (cont.)
Donna S. Bautista, DDS
Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Tongue basics
- What are common tongue problems?
- What causes tongue problems?
- What are the risk factors for tongue problems?
- White tongue
- Red tongue
- Black tongue
- Increased size or swelling
- Abnormalities of the tongue surface
- Tongue movement
- What are common tongue problems in infants and children?
- What are common tongue problems in pregnancy?
- How are tongue problems diagnosed?
- Are there home remedies for tongue problems?
- What are the treatments for tongue problems?
- Can tongue problems be prevented?
- What is the prognosis for tongue problems?
- Find a local Doctor in your town
Increased size or swelling
Swelling or enlargement of the tongue, referred to as macroglossia, can be caused by allergies, medications, injuries, or an underlying medical condition such as amyloidosis. Addressing the underlying condition is the usual treatment for macroglossia.
Allergic reaction to medications, food, or even a bee sting can cause swelling of the tongue. In the case of sudden and rapid onset of swelling of the tongue, one should seek emergency care as breathing can become compromised.
Tongue swelling may also be a side effect of medication. Some medications that have this side effect are ACE inhibitors (to treat high blood pressure) and NSAIDs (nonsteroidal anti-inflammatory drugs) such as Aleve, Advil, and aspirin.
An injury from hot food or liquid that burns the tongue or simply biting the tongue can inflame the tongue and cause swelling.
Conditions such as oral thrush or oral herpes viruses can cause the tongue to swell due to inflammation. Other medical conditions include tumorous cancer, acromegaly (giantism), amyloidosis, sarcoidosis, hypothyroidism, and Kawasaki disease. Tongue swelling can also be found in individuals with Down syndrome.
Traumatic fibroma is commonly found on the tongue and appears as a raised, thickened nodule that is dome-shaped, pink, and smooth. It is the result of chronic irritation of one area of the tongue, particularly along the bite line of the tongue. It is considered benign. Excisional biopsy is usually performed to definitively diagnose the lesion and completely excise it from the tongue.
Previously mentioned colored lesions, leukoplakia (white), erythroplakia (red), and erythroleukoplakia (red-white), are also classified as growths of the tongue. In most instances, biopsy is recommended for these lesions to rule out premalignancy.
Squamous cell carcinoma (SCC) is the most common cancer related to the oral cavity, making up 90% of all oral cancers. Oral cancer makes up approximately 2% of all cancers in the U.S. It commonly involves the lateral surface of the tongue. Risk factors for SCC are older age (age 40 and up), tobacco use, and alcohol use. In younger individuals, cases of SCC are associated with human papillomavirus (HPV). In recent years, HPV has been found to contribute more to the incidence rate of oral cancers. SCC clinically presents as a thickened rough surface over a red or white base. Nodules and ulcerations may follow as the growth progresses. In some cases, the tumor will be present at the base of the tongue and will be difficult to detect until it reaches its late stage of development. Treatment for SCC involves a mix of surgical removal, chemotherapy, and/or radiation therapy. Immunotherapy and gene therapy are examples of newer treatments being investigated. Clinical trials of new treatment may be a possible option for advanced cancers. Each individual should understand the nature of the cancer and options available for treatment in order to make the best decisions.
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