Tongue Discomfort: Causes and Treatment Options

Q: Tongue Discomfort: Causes and Treatment Options

Hello Vantar： If the dentist has examined and found no sharp edges of teeth irritating the tongue causing inflammation, the recurrent tongue inflammation may be due to emotional stress or lack of sleep leading to immune system dysregulation. <br>It is advisable to consult an oral

Discomfort in the tongue?

Hello Doctor, my father visited an ENT specialist and a traditional Chinese medicine practitioner last November due to oral discomfort.
They diagnosed him with tongue inflammation and suspected it might be related to dental issues, so we consulted a dentist.
However, after several visits, the dentist found no problems and even removed a problematic dental crown.
Despite these efforts, my father continues to feel discomfort in his tongue, which has a sharp edge and feels prickly.
The dentist suggested that his tongue is overly sensitive.
Recently, my father experienced severe tongue pain that caused him to sweat profusely, prompting another visit to the ENT specialist.
The ENT doctor noted that the posterior and lateral aspects of his tongue (which I found online are the foliate papillae) appear to be injured and inflamed, likely due to abrasion from his teeth.
After this, we consulted an oral surgeon, who mentioned that my father’s alveolar bone is deformed but should not cause tongue injury, and it does not appear to be tongue cancer.
He applied an oral ointment, which has reduced the swelling and improved the wound, but after two weeks, it still hasn’t fully healed, and my father continues to experience intermittent pain in his tongue.
He also has insomnia, which he believes is related to the stress from his dental issues, tongue pain, and insomnia.
I would like to ask the doctor a few questions: 1.
Could stress or insomnia cause the wound to remain inflamed? 2.
After two weeks of inflammation, even though there has been some improvement, could the sudden pain in his tongue be due to inflammation or could it indicate cancer? 3.
Which specialist would you recommend we consult next?

Vantar, 20~29 year old female. Ask Date: 2020/07/22

Dr. Zeng Guanghui reply Dentistry

Hello Vantar: If the dentist has examined and found no sharp edges of teeth irritating the tongue causing inflammation, the recurrent tongue inflammation may be due to emotional stress or lack of sleep leading to immune system dysregulation.
It is advisable to consult an oral surgeon or an oral pathologist for further examination.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2020/07/22

More Info

Hello, thank you for reaching out with your concerns regarding your father's tongue discomfort. It sounds like he has been through a challenging journey with multiple consultations and treatments. Let’s address your questions one by one and provide some insights into the possible causes and treatment options for his condition.

1. Can stress or insomnia cause prolonged inflammation?
Yes, stress and insomnia can indeed contribute to prolonged inflammation and discomfort in the body, including the oral cavity. Stress can affect the immune system, making it less effective at healing and responding to inflammation. Additionally, lack of sleep can exacerbate pain perception and lead to increased sensitivity. If your father is experiencing significant stress related to his oral discomfort, it could potentially hinder his recovery. Encouraging relaxation techniques, proper sleep hygiene, and stress management strategies may be beneficial.

2. Is the ongoing pain after two weeks of treatment indicative of inflammation or cancer?
While it is common for inflammation to take time to heal, especially in sensitive areas like the tongue, persistent pain after two weeks of treatment should be taken seriously. The fact that the pain is intermittent and has not completely resolved could indicate that the inflammation is still active or that there may be another underlying issue. Although the oral surgeon has ruled out tongue cancer, it may be wise to consider further evaluation if the pain persists. Conditions such as oral lichen planus, geographic tongue, or even oral thrush could also cause similar symptoms and may require specific treatments.

3. Which specialist should we consult next?
Given the complexity of your father's symptoms, it may be beneficial to consult with an oral and maxillofacial specialist if you haven't already. These specialists have extensive training in both dental and medical aspects of oral health and can provide a comprehensive evaluation. Additionally, if there are concerns about the psychological impact of his condition, a consultation with a psychologist or psychiatrist may also be helpful, especially considering his insomnia and stress levels.

In the meantime, here are some general recommendations that may help alleviate your father's discomfort:
- Maintain Oral Hygiene: Encourage gentle brushing of the tongue and teeth to prevent further irritation. A soft-bristled toothbrush may be less abrasive.

- Avoid Irritants: Advise him to avoid spicy, acidic, or very hot foods that could exacerbate the pain.

- Hydration: Ensure he stays well-hydrated, as dry mouth can worsen discomfort.

- Topical Treatments: If prescribed, continue using any topical medications or mouth rinses recommended by his healthcare providers.

- Dietary Adjustments: A diet consisting of softer foods may help reduce irritation while eating.

It's essential to keep an open line of communication with healthcare providers and advocate for further testing or referrals if your father's condition does not improve. Persistent symptoms warrant thorough investigation to rule out any serious underlying issues. I hope this information helps guide you and your father towards finding relief and a resolution to his discomfort. Wishing you both the best in navigating this situation.

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