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 facts
- 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 tongue swelling
- Growths on the tongue
- Abnormalities of the tongue surface
- Tongue pain
- Altered sensation of the tongue
- Taste problems
- Problems with tongue movement
- What are tongue problems in infants and children?
- What are tongue problems in pregnancy?
- What specialists treat tongue problems?
- How do health-care professionals diagnose tongue problems?
- Are there home remedies for tongue problems?
- What are the treatments for tongue problems?
- Is it possible to prevent tongue problems?
- What is the prognosis for tongue problems?
- Find a local Doctor in your town
What are the risk factors for tongue problems?
Color changes related to the tongue can range from a benign concern to one that requires medical attention. Often, a white tongue could be caused by a removable coating of food debris or bacterial plaque. Otherwise, the following are some common causes of white tongue -- a fungal infection referred to as oral thrush, leukoplakia, oral lichen planus, hairy leukoplakia, and linea alba.
Oral thrush (or candidiasis) is a caused by an overgrowth of yeast in the mouth. The white patches can be scraped off to expose a red surface on the tongue. Illnesses, medications, stress, and antibiotic treatment can cause oral thrush by throwing off the balance of natural bacteria in the mouth. Those with diabetes are more prone to fungal infections, such as oral thrush. Lozenges, tablets, or liquid antifungals are used for treatment.
Leukoplakia is characterized by white patches that cannot be scraped off and may be related to chronic irritation in the mouth, although the cause is not always known. Tobacco use is the most common factor that contributes to leukoplakia. The condition may resolve after smoking cessation. Sometimes the patches are on the sides of the tongue and could be related to constant rubbing next to the lower teeth. Although leukoplakia is usually benign, it can also be the precursor to oral cancer. The risk of cancer increases with the age of the individual, size of the lesion, and number of lesions present. A biopsy may be recommended after clinical evaluation by the doctor. Sometimes, the area can be monitored for changes by the doctor. Monitoring is usually performed during routine dental visits or during visits with an ear, nose, and throat (ENT) specialist.
Oral lichen planus on the tongue is a chronic inflammatory condition caused by an autoimmune response (the body's immune system attacking its own tissue). It is characterized by a white lace-like pattern called reticular lichen planus. (There is an erosive form that presents as shallow ulcerations and can be treated with topical steroids.) Regular monitoring of this condition is recommended for any changes that (although rare) could lead to oral cancer. A biopsy may be recommended.
Hairy leukoplakia is a white patch on the side of the tongue that appears hairy or rough. This condition is caused by the Epstein-Barr virus and is usually related to immunocompromised individuals. HIV testing should be considered if hairy leukoplakia appears without a known immunocompromising condition. Antiviral medications such as acyclovir (Zovirax) may be used. Recurrence of hairy leukoplakia is common.
Linea alba is a benign condition that is characterized by a thin white line at the lateral (side) borders of the tongue. It is caused by the thickening of the epithelium due to trauma or irritation from chewing. No treatment is necessary for linea alba.
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