Tongue Blisters: When to See an ENT Specialist

Tongue issues?

Hello Dr.
Zheng, I recently noticed a blister forming under my tongue.
It was initially small, so I didn't pay much attention to it, but suddenly it has grown larger in the past few days, making it somewhat inconvenient for me to eat.
I'm worried about accidentally biting the blister, but I'm unsure whether I should see a dermatologist or an ENT specialist.
Should I go to a large hospital or a smaller clinic? Is there any significance to having a blister under the tongue? I'm concerned that a small clinic might not handle it properly, but I'm also worried about wasting medical resources at a large hospital.

Xiao Qiao, 20~29 year old female. Ask Date: 2010/11/11

Dr. Zheng Jueyi reply Otolaryngology

Dear Xiao Qiao,
Hello, based on the symptoms you described, it seems that you may have a cyst in the minor salivary glands located at the floor of the mouth.
This is often caused by inflammation leading to the obstruction of the ducts of these minor salivary glands.
After eating, as saliva production increases, the cyst may become larger and more noticeable.
I recommend visiting a nearby otolaryngology clinic where they can puncture the cyst to drain the saliva.
Along with oral medication, some patients may experience improvement.
However, some patients may still have recurrences, in which case surgical intervention under local anesthesia, such as cyst excision or marsupialization, may be necessary to prevent further recurrence.
Wishing you health and safety.
Sincerely,
Dr.
Cheng Jue-Yi
Attending Physician, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2010/11/11

More Info

When it comes to understanding tongue blisters, particularly those that appear under the tongue, it’s important to recognize the potential causes and when to seek medical attention. The presence of blisters or lesions in the oral cavity can be indicative of various conditions, ranging from benign to more serious issues.

Firstly, tongue blisters can arise from several factors, including irritation, allergic reactions, infections, or systemic diseases. Common causes include:
1. Trauma or Irritation: Biting the tongue, friction from dental appliances, or consuming hot foods can lead to localized swelling or blistering.

2. Infections: Viral infections, such as herpes simplex virus, can cause painful blisters. Canker sores (aphthous ulcers) are another common cause of painful lesions in the mouth.

3. Allergic Reactions: Certain foods, medications, or oral hygiene products can trigger allergic responses, resulting in blisters.

4. Systemic Conditions: Conditions like pemphigus vulgaris or Behçet's disease can manifest as oral blisters and require specialized treatment.

Given that your blister has increased in size and is causing discomfort while eating, it is advisable to seek medical attention. The choice between seeing a dermatologist or an ENT (ear, nose, and throat) specialist can depend on the specific characteristics of the blister and any accompanying symptoms.

- ENT Specialist: If the blister is part of a broader issue involving the oral cavity, throat, or if you have symptoms like difficulty swallowing, persistent pain, or other systemic symptoms, an ENT specialist would be appropriate. They can evaluate the oral cavity comprehensively and determine if there are underlying issues that need to be addressed.

- Dermatologist: If the blister appears to be isolated and you suspect it may be related to skin conditions or allergies, a dermatologist could provide insight and treatment options.

In terms of where to seek treatment, both small clinics and larger hospitals have their merits. Smaller clinics may offer a more personalized experience and shorter wait times, while larger hospitals may have access to specialized care and advanced diagnostic tools. If you are concerned about the severity of your symptoms or if they persist or worsen, it might be prudent to visit a larger facility where specialists are available.

In conclusion, while tongue blisters can often be benign and self-limiting, the increase in size and associated discomfort warrants a professional evaluation. It is always better to err on the side of caution when it comes to changes in your health. If you decide to visit a healthcare provider, be prepared to describe your symptoms in detail, including when the blister appeared, any associated pain, and any other symptoms you may be experiencing. This information will help the healthcare provider make an accurate diagnosis and recommend appropriate treatment.

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