Persistent Tongue and Oral Pain: Seeking Solutions and Expert Advice

Pain in the tongue and oral cavity?

Hello, Doctor! I have been troubled by tongue pain for a long time.
It started one day and has been a recurring pain in my tongue and oral cavity for three months.
I haven't bitten my tongue or eaten any irritating foods, and there are no obvious lumps on my tongue; it feels smooth to the touch.
However, I sometimes experience pain at the base of my tongue, the tip, the sides, and around the oral cavity.
I went to the ENT department at Luodong Boai Hospital, where I was diagnosed with glossitis and given antibacterial medication, but it only made the pain worse.
I then consulted the oral and maxillofacial surgery department at the same hospital and explained my symptoms to the doctor, who looked puzzled.
After examining my tongue, the doctor noted no significant abnormalities and prescribed an ointment for me to apply at home.
It has now been three months, and the pain in my tongue and oral cavity has been intermittent.
Today, I visited a dental clinic in Luodong for a cavity treatment and also inquired about my tongue pain.
The dentist also looked puzzled, as it seems they rarely encounter patients with tongue pain.
After examining my tongue, they felt there was no apparent issue but recommended that I see a specialist at a major hospital in Taipei.
The persistent pain in my tongue and oral cavity has been very distressing for me.
Doctor, what should I do now? Should I continue seeking medical attention? Should I see an ENT specialist, an oral and maxillofacial surgeon, or a dentist? Most internal and external medicine doctors (including emergency physicians) seem unfamiliar with my symptoms and appear unsure of how to help.
Is tongue pain treatable? Can you recommend any doctors for me? Thank you very much.

Fang, 20~29 year old female. Ask Date: 2018/09/19

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Fang,
Hello! Indeed, glossitis can be quite bothersome.
It may be necessary to consult an internist to check for any underlying medical issues, such as anemia or the use of specific medications.
From a dental perspective, maintaining better oral hygiene can help reduce the risk of infection and facilitate a quicker recovery from glossitis.
Mouthwash can also be beneficial! Please communicate frequently with your physician.
Thank you! Wishing you safety and health!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2018/09/19

More Info

Persistent tongue and oral pain can be a challenging issue to deal with, especially when multiple healthcare professionals have been unable to provide a clear diagnosis or effective treatment. Based on your description, it seems that you have already consulted with specialists in ENT (Ear, Nose, and Throat), oral and maxillofacial surgery, and dentistry, but the pain persists without a definitive cause.
First, let's consider some potential causes of your symptoms. Oral pain, particularly in the tongue and surrounding areas, can arise from various conditions, including:
1. Oral Thrush: A fungal infection that can cause pain and discomfort in the mouth and tongue. This is often treated with antifungal medications.

2. Burning Mouth Syndrome: This condition is characterized by a burning sensation in the tongue and mouth without an obvious cause. It can be associated with hormonal changes, nutritional deficiencies (like vitamin B12 or iron), or even anxiety and stress.

3. Allergic Reactions: Sometimes, reactions to certain foods, dental products, or medications can cause oral pain.

4. Nerve Damage or Neuropathy: Conditions affecting the nerves in the mouth can lead to pain that may not be easily diagnosed.

5. Systemic Conditions: Conditions like Sjögren's syndrome, which affects moisture-producing glands, can lead to dry mouth and oral pain.
Given that you have already seen multiple specialists, it might be beneficial to consider a comprehensive approach. Here are some steps you can take:
1. Keep a Symptom Diary: Document when the pain occurs, its intensity, any potential triggers (foods, stress, etc.), and any treatments you have tried. This information can be invaluable for your healthcare provider in diagnosing the issue.

2. Consult a Pain Specialist: If the pain persists, a specialist in pain management may provide insights into chronic pain conditions and potential treatments.

3. Consider a Multidisciplinary Approach: Sometimes, a team approach involving an ENT specialist, a dentist, and a neurologist can help in diagnosing complex cases.
4. Explore Nutritional Deficiencies: A blood test to check for deficiencies in vitamins and minerals may be warranted, especially if you have dietary restrictions or other health conditions.

5. Stress Management: Since stress can exacerbate pain conditions, consider exploring stress management techniques such as mindfulness, yoga, or cognitive behavioral therapy.

6. Follow-Up with a Specialist: If you feel that your concerns are not being adequately addressed, seeking a second opinion from a different ENT or oral surgeon who specializes in oral pain may be beneficial.
7. Oral Hygiene Products: Sometimes, using a mild mouthwash or avoiding certain toothpaste ingredients can help alleviate symptoms.
In terms of treatment, the effectiveness will largely depend on the underlying cause of your symptoms. If it is a case of burning mouth syndrome, for instance, treatment may involve managing underlying conditions, using topical medications, or even medications that help with nerve pain.
In conclusion, while persistent tongue and oral pain can be frustrating and difficult to diagnose, taking a proactive approach by documenting your symptoms, consulting with specialists, and considering a multidisciplinary treatment plan can help you find relief. Don't hesitate to advocate for yourself and seek further evaluations until you find a solution that works for you.

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