Tongue Impressions: When to Seek Medical Advice - Internal Medicine

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When it comes to tongue impressions, particularly when you notice indentations or "tooth marks" on the sides of your tongue, it can be indicative of several underlying issues. In your case, the presence of these impressions, along with an increase in tongue coating and pain on both sides and the top of the tongue, suggests that it may be time to seek medical advice.

First, let's break down the symptoms you are experiencing. The indentations on the sides of your tongue, also known as scalloping, can occur due to various reasons. Common causes include:
1. Dehydration: When the body is dehydrated, the tongue can become swollen, leading to impressions from the teeth.

2. Nutritional Deficiencies: Deficiencies in vitamins, particularly B vitamins, can lead to changes in the tongue's appearance and texture.

3. Oral Health Issues: Conditions such as bruxism (teeth grinding) can cause pressure on the tongue, leading to indentations.

4. Allergic Reactions or Irritation: Certain foods, medications, or oral hygiene products can cause irritation, leading to swelling and pain.

5. Underlying Medical Conditions: Conditions such as hypothyroidism, diabetes, or autoimmune diseases can also manifest with changes in the tongue.

The increase in tongue coating can be a sign of oral thrush, a fungal infection, or it could indicate an imbalance in the oral microbiome. The pain you are experiencing, particularly if it affects your ability to eat and drink, is concerning and should not be ignored.

Given these symptoms, it is advisable to consult a healthcare professional. The best starting point would be to see a dentist or an oral medicine specialist, as they can evaluate your oral health comprehensively. They can check for signs of infection, nutritional deficiencies, or other oral health issues. If necessary, they may refer you to a specialist, such as an ear, nose, and throat (ENT) doctor or a gastroenterologist, especially if they suspect that your symptoms may be related to systemic issues or gastrointestinal problems.

In the meantime, here are some general recommendations:
- Stay Hydrated: Ensure you are drinking enough water throughout the day.

- Maintain Oral Hygiene: Brush your teeth and tongue gently but thoroughly to reduce coating and irritation.

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

- Monitor Your Diet: Consider if you have made any recent changes to your diet that could be causing these symptoms.

In conclusion, while some tongue changes can be benign, the combination of symptoms you are experiencing warrants a professional evaluation. Early intervention can help address any underlying issues and alleviate your discomfort. Don't hesitate to seek medical advice, as your health and well-being are paramount.