Unexplained Tongue Pain: Causes and Treatments

Unexplained tongue pain?

A month ago, I experienced pain at the tip of my tongue and was concerned that it might be caused by frequently licking my teeth, which could have led to an abrasion.
I visited an ENT specialist who thought it didn't seem like an abrasion but rather a viral issue.
The pain subsided after three days, but then the symptoms reappeared intermittently.
After three weeks, the situation remained unchanged, which made me uneasy.
I went to a large hospital for an oral examination, where an initial assessment was done.
The doctor thought it looked fine and only asked if I often bit my tongue.
Later, the attending physician took over and noted that the mucosa appeared thin, suspecting a candidal infection.
The doctor also mentioned it didn't seem typical and asked if I was having sleep issues.
Coincidentally, I had not been sleeping well for a week.
The doctor advised me to improve my sleep and prescribed B vitamins and medicated toothpaste.
That day, I was very tired, didn't take the B vitamins, and didn't use the toothpaste, but I fell asleep immediately.
The next day, I felt better.

After four days, I thought I should start using the toothpaste and taking the B vitamins.
However, I developed a full-body heat sensation.
After two days, I stopped using the toothpaste but continued taking the B vitamins, and the heat sensation subsided.
My tongue continued to have intermittent issues until yesterday when I woke up with pain at the tip, then experienced pain at the base of the tongue by noon, and later discomfort on the sides of the tongue and in the oral cavity (but the tongue pain subsided).
Last night, I ate curry (which I mistakenly overcooked), and despite the discomfort, I managed to finish it.
Surprisingly, the oral pain and discomfort disappeared, but just before bed, the initial pain at the tip of my tongue returned.
When I lay down, the pain seemed to move upward, and the tip no longer hurt.
Upon waking, the tip was still pain-free, but the sides and base occasionally hurt.

Could you please explain what might be happening? Additionally, I've been monitoring my diet and realized that for a while, I was only consuming half of the recommended daily intake of zinc.
Could this have an impact? I have started taking zinc supplements for about five days now.

Niming, 30~39 year old female. Ask Date: 2018/05/08

Dr. Zeng Guanghui reply Dentistry

If the tongue does not have any obvious lumps or ulcerative lesions but still feels burning and painful, it may be due to inflammation of the lingual papillae or a candidal infection.
If the symptoms recur, it is advisable to consult an oral surgeon for further evaluation.

Reply Date: 2018/05/08

More Info

Understanding unexplained tongue pain can be quite complex, as there are numerous potential causes ranging from minor irritations to more significant underlying health issues. Based on your description, it seems you have been experiencing intermittent pain in different areas of your tongue for about a month, which has been evaluated by various healthcare professionals.

Possible Causes of Tongue Pain
1. Trauma or Irritation: You mentioned the possibility of your tongue being injured by biting or scraping against your teeth. This is a common cause of localized pain and can lead to inflammation or ulceration of the tongue's surface.

2. Infections: The mention of a potential candidiasis (thrush) infection is noteworthy. Oral thrush can cause white patches and soreness in the mouth, including the tongue. It is often associated with a weakened immune system, antibiotic use, or other factors that disrupt the normal flora of the mouth.

3. Nutritional Deficiencies: Zinc deficiency, as you pointed out, can lead to various oral health issues, including glossitis (inflammation of the tongue), which may present as pain or discomfort. Vitamins B12 and folate deficiencies can also contribute to similar symptoms.

4. Systemic Conditions: Conditions such as autoimmune diseases, diabetes, or even stress and anxiety can manifest as oral symptoms, including tongue pain. Stress, in particular, can lead to bruxism (teeth grinding), which may cause tongue irritation.

5. Allergic Reactions: Sometimes, food allergies or sensitivities can lead to oral discomfort. The fact that you experienced pain after consuming a spicy dish like curry could suggest a reaction to certain ingredients.

Treatment Options
1. Oral Hygiene: Maintaining good oral hygiene is crucial. Using a medicated toothpaste, as prescribed, can help reduce inflammation and promote healing.
2. Nutritional Supplements: Since you've started taking zinc supplements, continue to monitor your intake of essential vitamins and minerals. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and potentially alleviate symptoms.

3. Hydration: Ensure you are well-hydrated, as dry mouth can exacerbate tongue discomfort. Drinking plenty of water can help maintain moisture in the oral cavity.

4. Avoid Irritants: Try to avoid spicy, acidic, or abrasive foods that may aggravate your symptoms. If certain foods consistently cause discomfort, it may be best to eliminate them from your diet temporarily.

5. Stress Management: If stress is a contributing factor, consider incorporating relaxation techniques such as mindfulness, meditation, or gentle exercise into your routine.

6. Follow-Up Care: Since your symptoms have been persistent and variable, it may be beneficial to follow up with a healthcare provider, such as an oral specialist or a dermatologist, for further evaluation. They may recommend additional tests or treatments based on your ongoing symptoms.

Conclusion
In summary, unexplained tongue pain can arise from various causes, including trauma, infections, nutritional deficiencies, and systemic conditions. Your recent dietary changes and the introduction of supplements may help, but it is essential to monitor your symptoms closely. If the pain persists or worsens, seeking further evaluation from a specialist may provide more targeted treatment options. Remember, maintaining a balanced diet and managing stress are key components in promoting oral health and overall well-being.

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