Tongue problems

Alternative names:

dark tongue

Home care:

Follow the health care provider's recommendations for treatment.

Good oral hygiene is recommended for hairy tongue and black tongue. Be sure to eat a well-balanced diet.

For tongue problems caused by canker sores, the viruses can't be cured by treatment and must heal on their own. Be patient.

For tongue problems caused by dentures, see your dentist about making adjustments.

For a swollen tongue caused by allergies, antihistamines can help. Avoid the offending food or drug.

Call your health care provider if:

• the tongue problem is persistent.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed with particular attention to the tongue.

Medical history questions documenting the tongue problem in detail may include:

• time pattern
  • When was it first noticed?
  • Have you had similar symptoms before?

• quality
  • Exactly what type of problem is it?
  • Is there pain?
  • Is there swelling?
  • Is there difficulty swallowing?
  • Does it look like a hairy tongue?
  • Does it look like a black tongue?
  • Does it look like an open sore?
  • Is there a tremor?
  • Does it look like a white tongue?
  • Does it look like a smooth tongue?
  • Does it look like a red tongue?
  • Does it look like a fissure?
  • Are there grooves in the tongue?

• location
  • Where is the problem located on the tongue (all over or just in one location)?

• aggravating factors
  • What makes the problem worse?
    • Eating?
    • Drinking?
    • Swallowing?
    • Talking?

  • Do you have dentures?
  • Do you have any orthodontic devices?

• relieving factors
  • What helps?

• other
  • What other symptoms are also present?
    • Is there enlargement of the tongue?
    • Are there swollen lymph nodes in neck?
    • Are there problems with the teeth, gums, lips, or throat?
    • Is the tongue bleeding?
    • Is there a rash?
    • Is there a fever?
    • Do you have allergies?
    • Are there problems with breathing?
    • Are there problems with speaking?
    • Is there difficulty moving tongue?

  • Have you noticed changes in taste?
  • What medications are being taken?
  • Are any medical conditions being treated?
  • Has there been a recent injury, such as having the tongue bitten?
  • Do you smoke cigarettes, cigars, or a pipe?
  • Do you use alcohol excessively?

Diagnostic tests will be determined by other symptoms. Blood tests may be used to confirm specific disorders, particularly systemic causes of tongue disorders. Biopsy of tongue lesions may be required in some cases.

Intervention:
Treatment depends on the cause of the tongue problem.

• Cranial Nerve (CN) XII paralysis is usually treated by treating the cause of the disorder if possible. Therapy may be needed to improve speech and swallowing ability.
• Ankyloglossia (tongue-tie) may not require treatment unless speech or swallowing difficulties occur. Surgical division of the frenulum will release the tongue and relieve the problem.
• Mouth ulcers, leukoplakia, oral cancer, and other lesions can be treated by surgical removal of the lesion and/or various medications (see the specific disorder).
• Glossitis and geographic tongue are treated by treating the cause of irritation or inflammation.
• Medications prescribed may include corticosteroids to reduce inflammation, and antibiotics or antifungal medications.
• Other treatments may include treatment for anemia and other disorders, and removal of the source of irritation.

After seeing your health care provider:
You may want to add a diagnosis related to tongue problems to your personal medical record.