Recurrent Tongue Ulcers: Causes and Treatment Options - Otolaryngology

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Recurrent tongue ulcers can be a frustrating and uncomfortable condition, often leading to anxiety and discomfort for those affected. The symptoms you describe—small ulcers on the tongue that expand and then heal, only to reappear—are characteristic of several potential underlying causes. Understanding these causes and exploring treatment options can help manage your symptoms effectively.


Possible Causes of Recurrent Tongue Ulcers
1. Aphthous Stomatitis: This is one of the most common causes of recurrent mouth ulcers. These can appear on the tongue, inside the cheeks, or on the gums. The exact cause is not well understood, but they may be triggered by stress, certain foods (like citrus or spicy foods), hormonal changes, or deficiencies in vitamins such as B12, folate, or iron.

2. Infections: Viral infections, such as those caused by the herpes simplex virus, can lead to ulcerations in the mouth. While these typically cause painful sores, some individuals may experience milder forms that are less painful.

3. Systemic Conditions: Conditions such as Behçet's disease, inflammatory bowel disease (like Crohn's disease), or celiac disease can manifest with recurrent oral ulcers. If you have other symptoms, such as gastrointestinal issues or skin lesions, it may be worth discussing these possibilities with your healthcare provider.

4. Allergic Reactions: Allergies to certain foods, dental products, or medications can also lead to the development of ulcers in the mouth.

5. Stress and Hormonal Changes: Emotional stress and hormonal fluctuations can exacerbate the frequency and severity of mouth ulcers.


Treatment Options
1. Topical Treatments: Over-the-counter topical medications, such as benzocaine or hydrocortisone, can provide temporary relief from discomfort. However, these should be used sparingly and not as a long-term solution.

2. Oral Rinses: Antiseptic mouthwashes can help reduce the risk of secondary infections and promote healing. Rinses containing chlorhexidine are often recommended.

3. Dietary Adjustments: Keeping a food diary may help identify any dietary triggers. Avoiding spicy, acidic, or abrasive foods can reduce irritation.

4. Nutritional Supplements: If deficiencies in vitamins or minerals are suspected, supplements may be beneficial. Consulting with a healthcare provider for blood tests can help identify any deficiencies.

5. Stress Management: Techniques such as mindfulness, yoga, or counseling may help manage stress, which can be a contributing factor.

6. Medical Evaluation: Since you have already consulted with ENT specialists, it may be beneficial to see a dentist or an oral medicine specialist. They can provide a more focused evaluation of your oral health and may recommend further tests to rule out systemic conditions.


When to Seek Further Help
If your symptoms persist or worsen, or if you develop additional symptoms such as fever, significant pain, or difficulty swallowing, it is essential to seek further medical evaluation. A referral to a specialist in oral medicine or a dermatologist may provide additional insights and treatment options.


Conclusion
Recurrent tongue ulcers can be a complex issue with various potential causes. A thorough evaluation by a healthcare professional, along with a tailored treatment plan, can help manage your symptoms effectively. If you are in Taipei, consider visiting a reputable dental school or a hospital with a specialized oral medicine department for comprehensive care. Remember, maintaining good oral hygiene and managing stress can play significant roles in preventing future outbreaks.