Persistent Tongue Pain: Possible Causes and When to Seek Help

There is a persistent sensation of a sore or burn on the right side of my tongue?

Hello Doctor: I have been experiencing a sensation on the right side of my tongue for the past 13 days, similar to that of a self-inflicted bite or burn.
This feeling extends from the tip of my tongue along the right edge towards the back of my throat.
It does not affect my ability to speak or eat, but it feels quite unusual.
Additionally, it seems that two small lesions have developed near the tip of the right side of my tongue, which are similar in color to the tongue itself; they feel slightly itchy and have a mild painful sensation, akin to a minor bite.
Six days ago, I visited an ENT clinic, and they diagnosed it as a tongue ulcer, but there has been no improvement since then.
The biting sensation persists, and the two lesions on my tongue appear to be more pronounced.
I have searched online and found no similar symptoms, but I am somewhat concerned that it might be warts.
I would like to ask: 1) What type of inflammation does this symptom resemble? Could it really be warts? 2) Is the incubation period for oral warts the same as that for genital warts? (I honestly cannot think of how I might have come into contact with it.) 3) If there is no improvement, which specialist should I see? Is it necessary to go to a large hospital? Thank you for your time, Doctor.

EW, 40~49 year old female. Ask Date: 2015/10/20

Dr. Zheng Jueyi reply Otolaryngology

Hello, the most common issue is still glossitis.
The symptoms described do not resemble those of warts.
It is advisable to drink more water and reduce the intake of spicy foods.
If there is no improvement, you may consider consulting an otolaryngologist or a neurologist to check for possible sensory nerve abnormalities.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/10/20

More Info

Persistent tongue pain can be a concerning symptom, and it's understandable that you're seeking clarity on what might be causing it. Based on your description, there are several potential causes for the pain and the small lesions you've noticed on the right side of your tongue.

1. Possible Causes of Tongue Pain:
- Trauma or Injury: If you've bitten your tongue or experienced some form of trauma, it can lead to localized pain and swelling. This could explain the sensation of a burn or bite.

- Oral Candidiasis: A fungal infection can cause white patches or lesions on the tongue, which may be mistaken for other conditions. This is more common in individuals with weakened immune systems or those who use inhaled corticosteroids.

- Geographic Tongue: This benign condition can cause patches on the tongue that may feel sore or sensitive. The exact cause is unknown, but it can lead to discomfort.

- Oral Lichen Planus: This inflammatory condition can cause white patches and soreness in the mouth, including the tongue.

- Viral Infections: Certain viral infections, including herpes simplex, can cause lesions and pain in the oral cavity.

- Human Papillomavirus (HPV): While you mentioned concern about "cauliflower" lesions (which may refer to warts), HPV can indeed affect the oral cavity, leading to lesions that may resemble warts.

2. Differentiating Between Conditions:
- The lesions you described could be indicative of several conditions, including benign ones like geographic tongue or more serious concerns like HPV-related lesions. The fact that you have not seen improvement after six days suggests that it may not be a simple case of trauma or irritation.

- The potential for HPV-related lesions in the mouth is real, but the transmission typically occurs through direct contact. If you have not engaged in activities that could expose you to HPV, the likelihood may be lower.

3. When to Seek Further Help:
- If your symptoms persist without improvement, it is advisable to seek further evaluation. Since you've already seen an ENT specialist, you might consider consulting with a dentist or an oral surgeon, as they can provide a more specialized examination of oral lesions.

- If the lesions continue to grow or change in appearance, or if you develop additional symptoms (such as difficulty swallowing, increased pain, or systemic symptoms like fever), you should seek immediate medical attention.

4. Next Steps:
- It may not be necessary to go to a large hospital unless your symptoms worsen significantly. A visit to a specialized oral health professional or a dermatologist who deals with oral conditions could provide you with the answers you need.

- In the meantime, maintaining good oral hygiene and avoiding irritants (like spicy or acidic foods) may help alleviate some discomfort.

In summary, while there are several potential causes for your tongue pain and lesions, the best course of action is to seek further evaluation from a healthcare professional who specializes in oral health. They can provide a thorough examination and possibly perform tests to determine the exact cause of your symptoms. Don't hesitate to advocate for your health and seek a second opinion if necessary.

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