Persistent Tongue Discomfort: Seeking Answers After Two Years

The tongue appears normal, but there has been discomfort for two years?

Hello doctor, about a year ago, I started experiencing a noticeable stabbing pain, dryness, and a burning, tingling sensation on a specific area on the right side of my tongue.
Previously, I had a large cavity in one of my back teeth that had been left untreated for three to four years.
This year, due to the discomfort in my tongue, I finally had that tooth extracted.
However, I did not get a replacement, so there is now a gap.
I have already rounded off any potentially sharp teeth around it, but the discomfort persists.

Interestingly, this discomfort tends to start in the afternoon and becomes particularly sensitive into the night.
However, eating, drinking, and sleeping seem to alleviate the sensations until the next morning.
Then, the discomfort gradually returns in the afternoon.
If I intentionally roll my tongue to the left, I do not feel uncomfortable, as the natural resting position of my tongue is right in the middle of the gap left by the extracted tooth.
Sometimes, I go two or three days without any discomfort, but then it suddenly returns for several days when I think about it.

I live in Penghu and have visited every dental and ENT clinic here.
The doctors have all said there are no abnormalities.
I even went to a major hospital in Taiwan, and the doctors there also said everything is fine.
Yet, I still feel uncomfortable.
I am very worried that it might be tongue cancer, but every doctor has assured me it is not.
What should I do? This has already affected my daily life, but I cannot find a solution.
(I tend to stay up late.) Please help me.
Thank you.

Ting Er, 20~29 year old female. Ask Date: 2015/07/22

Dr. Zheng Jueyi reply Otolaryngology

Hello, if examinations have ruled out any growths, it is likely that you are experiencing chronic inflammation of the tongue.
It is recommended to reduce late nights and maintain a regular schedule, as well as to limit the intake of spicy foods.
Most cases will gradually improve.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/07/22

More Info

Persistent tongue discomfort can be a frustrating and concerning issue, especially when it has lasted for an extended period, as in your case. Based on your description, it seems that you have experienced a range of sensations, including sharp pain, dryness, and a burning feeling on the right side of your tongue. You also mentioned that this discomfort tends to worsen in the afternoon and evening, while it subsides during the night and after eating or drinking.
Given that you have already consulted multiple specialists, including dentists and ENT doctors, and they have not found any abnormalities, it is important to consider several potential causes for your symptoms. Here are some possibilities:
1. Post-Extraction Sensitivity: After having a tooth extracted, especially if it was a significant tooth, the surrounding tissues, including the tongue, can become sensitive. The absence of the tooth may change how your tongue rests in your mouth, leading to discomfort.
2. Nerve Irritation: The area where the tooth was extracted may have affected nearby nerves, leading to sensations of pain or discomfort in the tongue. This can sometimes happen after dental procedures.

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

4. Oral Mucosal Conditions: Conditions such as oral lichen planus or geographic tongue can cause discomfort and may not always be easily diagnosed. These conditions can lead to changes in the texture and sensitivity of the tongue.

5. Psychological Factors: Anxiety and stress can exacerbate sensations of discomfort in the mouth. If you are particularly worried about your symptoms, this could lead to increased awareness of the discomfort.

6. Allergic Reactions or Sensitivities: Sometimes, certain foods, dental products, or medications can cause allergic reactions or sensitivities that manifest as discomfort in the mouth.

Given that you have already seen multiple doctors without a definitive diagnosis, it may be beneficial to consider a few steps:
- Keep a Symptom Diary: Document when the discomfort occurs, its intensity, and any potential triggers (foods, activities, stress levels). This information can help your healthcare provider identify patterns.

- Consult a Specialist: If you haven't already, consider seeing an oral medicine specialist or a neurologist who may have more experience with complex oral pain syndromes.

- Explore Treatment Options: Depending on the underlying cause, treatments may include topical medications, oral rinses, or even therapies aimed at managing nerve pain.

- Lifestyle Modifications: Since you mentioned that you tend to stay up late, consider adjusting your sleep schedule and stress management techniques, as these can impact overall health and potentially contribute to your symptoms.

- Follow-Up: If your symptoms persist or worsen, don’t hesitate to return to your healthcare provider for further evaluation. Sometimes, a second opinion can provide new insights.

In conclusion, while it is understandable to be concerned about serious conditions like tongue cancer, the fact that multiple healthcare professionals have evaluated you and found no abnormalities is reassuring. Focus on managing your symptoms and exploring potential underlying causes with your healthcare provider. Your well-being is important, and finding a resolution to your discomfort is achievable with the right approach.

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