What are tongue problems in infants and children?

The most common tongue problem found amongst infants and young children is oral thrush characterized by white patches on the tongue. It often occurs after a course of antibiotics is taken by the infant or breastfeeding mother. "Good bacteria" is killed off allowing for an overgrowth of yeast. Treatment involves antifungal medications for the infant and, if breastfed, the mother to avoid passing the infection back and forth.

Other common tongue problems found in children are:

fissured tongue,
geographic tongue,
traumatic injury, and
aphthous ulcers (canker sores).

A less common tongue problems in children is "strawberry tongue," as seen in Kawasaki's disease.

What are tongue problems in pregnancy?

A small percentage of women experience a sore tongue while pregnant. This may be related to the hormonal changes taking place during pregnancy. The soreness could also be in combination with geographic tongue where bare areas are present and disappear as well as reappear. These conditions usually resolve after the pregnancy ends.

What specialists treat tongue problems?

Depending on the tongue problem, there is a specific doctor for treatment. Initially, evaluation of tongue problems can be assessed by a dentist and if needed, an appropriate specialist can be recommended for further evaluation and subsequent treatment.

For tongue lesions such as changes in color, growths, or texture changes, an oral surgeon or an otolaryngologist (ear, nose and throat specialist, also known as an ENT specialist) can evaluate the area, perform a biopsy, and follow up or refer for appropriate treatment such as surgery or medication. Tongue pain may also be addressed with an oral surgeon or ENT, but a neurology specialist may be appropriate if the pain is related to neuralgia. Tongue movement problems stemming from injury may also be treated by a neurology specialist in conjunction with occupational or physical therapists.

For tongue cancer, a group of specialists could be involved depending on the spread of the disease. A head and neck surgeon, an oncologist, a radiation oncologist, an oral surgeon, and a dentist could comprise the team of doctors that help in treating the oral cancer patient.

How do health care professionals diagnose tongue problems?

During an examination with a physician or dentist, information based on symptoms and clinical appearance is collected. Imaging may also be needed to aid in diagnosis. The different imaging modalities include magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET). Based on the collective information, a diagnosis is made. However, if there isn't a unique sign or symptom to distinguish the tongue problem, a differential diagnosis is reviewed. A differential diagnosis lists all the possible causes of the signs and symptoms. It is a systematic process of weighing the probability of one disease versus that of other diseases that may account for the tongue problem. For example, a white tongue lesion may have the differential diagnosis of lichen planus, leukoplakia, or contact inflammation from dentures. Each of these causes can be carefully considered based on what is observed. Subsequently, a plan of treatment can be made.

For many tongue conditions that might be cancer, a special dye called toluidine blue has been useful to aid during the initial evaluation. Toluidine blue staining is able to help in early identification of precancerous or cancerous lesions.

A more definite diagnosis requires a biopsy. A biopsy is a procedure whereby a sample of cells or tissue is evaluated under a microscope. Optimal treatment requires a precise diagnosis.

Are there home remedies for tongue problems?

For pain related to the tongue, over-the-counter pain-relief medications such as ibuprofen (Advil) or naproxen (Aleve) may help. "Burning tongue" pain may be alleviated with sucking on ice or bathing the tongue in cold water. Such home remedies, however, may provide only temporary relief.

For the most part, tongue conditions that appear to have no known cause (such as an obvious injury) should be evaluated by a physician or dentist for appropriate diagnosis, monitoring, and possible treatment.