Tongue Problems (cont.)
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 treatments for tongue problems?
- White tongue
- Red tongue
- Black tongue
- Increased size/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?
- What is the prognosis for tongue problems?
- Can tongue problems be prevented?
- Find a local Doctor in your town
What are common tongue problems in infants and children?
The most common tongue problem found amongst infants and young children is oral thrush characterized by white patches on the tongue. It often occurs after a course of antibiotics is taken by the infant or breastfeeding mother. “Good bacteria” is killed off allowing for an overgrowth of yeast. Treatment involves antifungal medications for the infant and, if breastfed, the mother to avoid passing the infection back and forth.
Other common tongue problems found in children are fissured tongue, geographic tongue, traumatic injury, and aphthous ulcers (canker sores).
What are common tongue problems in pregnancy?
A small percentage of pregnant women experience a sore tongue. This could be related to the hormonal changes taking place during pregnancy. The soreness could also be in combination with geographic tongue where bare areas are present and disappear as well as reappear. These conditions usually resolve after the pregnancy ends.
How are tongue problems diagnosed?
If there isn't a unique sign or symptom to distinguish the tongue problem, a differential diagnosis is reviewed. A differential diagnosis is a systematic process of weighing the probability of one disease versus that of other diseases that may account for the tongue problem. For example, a white tongue lesion may have the differential diagnosis of lichen planus, leukoplakia, or contact inflammation from dentures. Each of these causes can be carefully considered and weighed based on what is observed. From there, a plan can be made for treatment.
For many tongue conditions that carry the risk of malignancy, a special dye called toluidine blue has been useful. Toluidine blue staining is able to help in early identification of premalignant or malignant lesions.
A definitive diagnosis may require a biopsy with microscopic examination. This is crucial when the area appears atypical or when very specific treatment requires a definitive diagnosis.
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