Persistent Tongue Pain While Eating: When to See a Specialist?

The surface of the tongue hurts while eating, similar to the sensation of the skin being scraped by food?

This condition has persisted for several months, especially when eating hard foods, which causes significant pain in the tongue, and there are red patches on the tongue's surface.
There is also discomfort with some soft foods, such as cooked tomatoes.
I would like to ask Dr.
Zeng, which specialty should I consult for this issue?

fanny, 60~69 year old female. Ask Date: 2016/03/23

Dr. Zeng Guanghui reply Dentistry

The above condition is likely due to inflammation and atrophy of the filiform papillae on the tongue, which causes discomfort when exposed to irritating or hard foods.
This is generally caused by interference from the autoimmune system.
It is recommended to consult an oral surgeon or an oral pathologist for diagnosis and treatment.

Reply Date: 2016/03/23

More Info

Persistent tongue pain while eating can be a concerning symptom, especially when it has lasted for several months. Given your description of pain occurring with both hard and soft foods, along with the presence of red patches on your tongue, it is advisable to seek medical attention. The symptoms you are experiencing could be indicative of several underlying conditions that require evaluation by a specialist.

First and foremost, it is essential to consider the possibility of oral lesions or conditions such as oral thrush, geographic tongue, or even allergic reactions to certain foods. Geographic tongue, for instance, is a benign condition characterized by irregular patches on the surface of the tongue, which can sometimes cause discomfort or pain, especially when consuming certain foods. The red patches you mentioned could be related to this condition or other inflammatory processes.

Another potential cause of your symptoms could be oral lichen planus, an inflammatory condition that can lead to painful lesions in the mouth. This condition often presents with white lacy patches or red areas and can be exacerbated by certain foods, particularly acidic or spicy items.
Additionally, if you are experiencing pain specifically when consuming hard foods, it could be due to mechanical irritation or trauma to the tongue. This is particularly relevant if you have been eating foods that are tough or abrasive, which can lead to localized inflammation and pain.

Given the chronic nature of your symptoms, it is recommended that you consult with an Ear, Nose, and Throat (ENT) specialist or a dentist who specializes in oral medicine. They will be able to perform a thorough examination of your oral cavity, assess the condition of your tongue, and possibly conduct further tests, such as a biopsy if necessary, to rule out any serious underlying conditions.

In addition to seeing a specialist, it may be beneficial to keep a food diary to track which foods exacerbate your symptoms. This information can be valuable for your healthcare provider in determining potential food sensitivities or allergies.
In the meantime, consider avoiding foods that trigger your symptoms, such as hard, spicy, or acidic items, until you can receive a proper diagnosis. Maintaining good oral hygiene is also crucial, as it can help prevent secondary infections or complications.

In summary, persistent tongue pain, especially when associated with visible changes like red patches, warrants a visit to a healthcare professional. An ENT specialist or an oral medicine dentist would be the most appropriate choice for evaluation and management of your symptoms. Early intervention can lead to better outcomes and relief from discomfort.

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