Tongue Inflammation: Causes, Symptoms, and When to Seek Help

Glossitis

Hello Doctor, regarding the previous issue, I have a small red area under the tip of my tongue since August 16, and it hasn't completely healed after a month.
Previously, on July 3, I had a small red area on both sides under the tongue, which healed by July 18.
Then, on August 3, I had another small red area on both sides, which healed by August 9.
This time, the larger red area on the right side appeared on August 16, and it is still red today, although it seems to be fading.
Last Tuesday, September 11, I went back to Zhongxiao Hospital for a follow-up, and the doctor said that it looked and felt fine.
However, it is strange that the redness hasn't completely faded after a month, so he advised me to get a biopsy today.
Then, last Wednesday, September 12, I visited a doctor at National Taiwan University Hospital, who said my tongue looked normal and that I was deficient in B vitamins, recommending supplementation.
He mentioned it was just tongue inflammation and that a biopsy was unnecessary, suggesting I observe it for another month.
On Sunday, I visited another clinic, and the doctor also said it appeared to be tongue inflammation.
I mentioned that it has been a month, and he found it odd, stating it looked like simple inflammation.
All three doctors have palpated my tongue and said it was normal.
I would like to ask you, as I read online that oral inflammation typically heals completely within two weeks; otherwise, it could indicate something serious.
My tongue has been like this for a month.
Should I be concerned? Additionally, the redness from the first occurrence on July 3 looks similar to the redness from the third occurrence on August 16, and it is completely painless.
How can I send you the photos from my phone? Should I go for a biopsy or continue to observe?

Wenwen, 40~49 year old female. Ask Date: 2018/09/18

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there is no improvement or if you have concerns, it is recommended to undergo a biopsy for the most accurate diagnosis.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/09/18

More Info

Understanding tongue inflammation, also known as glossitis, is essential for identifying its causes, symptoms, and when to seek medical help. Based on your description, it seems you have been experiencing recurrent episodes of inflammation under the tongue, which has persisted for a month this time.

Causes of Tongue Inflammation
Tongue inflammation can arise from various factors, including:
1. Nutritional Deficiencies: Deficiencies in vitamins, particularly B vitamins (such as B12, B2, and folate), can lead to glossitis. This aligns with what your doctor suggested regarding vitamin B supplementation.

2. Allergic Reactions: Certain foods, medications, or oral hygiene products can trigger allergic reactions, resulting in inflammation.

3. Infections: Viral, bacterial, or fungal infections can cause inflammation of the tongue. For instance, oral thrush, caused by Candida yeast, can lead to a swollen and painful tongue.

4. Irritation: Mechanical irritation from dental appliances, rough teeth, or certain foods can cause localized inflammation.

5. Systemic Conditions: Conditions such as autoimmune diseases, diabetes, or inflammatory diseases can manifest as glossitis.

Symptoms of Tongue Inflammation
Common symptoms associated with tongue inflammation include:
- Redness and swelling of the tongue
- Changes in texture (smooth or bumpy)
- Pain or tenderness (though you mentioned yours is not painful)
- Difficulty in chewing, swallowing, or speaking
- Changes in taste sensation

When to Seek Help
Given that your symptoms have persisted for over a month without significant improvement, it is prudent to continue monitoring the situation closely. Here are some guidelines on when to seek further medical help:
1. Persistent Symptoms: If the inflammation does not resolve within two weeks or worsens, it is advisable to consult a healthcare professional.

2. New Symptoms: If you develop additional symptoms such as severe pain, fever, or difficulty swallowing, seek immediate medical attention.

3. Concern for Underlying Conditions: If there is a concern about potential underlying conditions, such as autoimmune disorders or malignancies, further investigation may be warranted.

4. Biopsy Consideration: If your healthcare provider recommends a biopsy to rule out any serious conditions, it may be a necessary step, especially if the inflammation is atypical or persistent.

Recommendations
1. Follow-Up: Since you have already seen multiple doctors, it is essential to follow their advice. If they suggest observation for another month, ensure you adhere to that while keeping track of any changes.

2. Nutritional Support: Consider incorporating foods rich in B vitamins into your diet, such as leafy greens, eggs, dairy products, and fortified cereals.

3. Oral Hygiene: Maintain good oral hygiene by brushing your teeth and tongue regularly and using an antibacterial mouthwash to reduce the risk of infections.

4. Avoid Irritants: Steer clear of spicy, acidic, or abrasive foods that may exacerbate the inflammation.

5. Document Changes: Keep a record of any changes in your symptoms, including the appearance of the tongue, and take photos to share with your healthcare provider during follow-ups.

In conclusion, while your symptoms may be indicative of a benign condition, the persistence of inflammation warrants careful monitoring. Continue to communicate openly with your healthcare providers, and do not hesitate to seek a second opinion if you feel uncertain about the management plan. Your health and peace of mind are paramount, and being proactive in your care is essential.

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