January 19, 2007

Glossodynia

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Glossodynia refers to painful or burning sensations of the tongue. Glossodynia can be associated with chronic irritations in the mouth, nerve damage from tooth extractions, trauma, dry mouth (xerostomia), thrush (candidiasis), vitamin deficiencies, allergies, changes in hormones or the immune system, tobacco use or psychological conditions such as anxiety or depression. It also can be related to the use of some medications (such as diuretics, oral diabetes medications and some blood pressure medications).

Some people experience glossodynia together with actual physical changes of the tongue, sometimes called glossitis. In some people, it is not clear if the two conditions are related or if they just occur at the same time.

Glossodynia may be a sign or symptom of burning mouth syndrome (BMS). BMS is a burning condition that often affects various areas of the mouth, not just the tongue.


Symptoms
Symptoms are burning or pain of the tongue.

Diagnosis
Your dentist will ask you about the location, duration and severity of your pain and examine your mouth for irritants, such as rough or broken teeth, broken crowns, appliances or dentures, and yeast infections (thrush). Your dentist also will look in your mouth for any ulcers or redness. In order to check for severe dry mouth, which can cause pain, the salivary glands can be examined for proper quality and quantity of saliva. Persistent areas of pain or burning that are associated with long-lasting mouth sores (lesions) should have a biopsy to rule out oral cancer or pre-cancer. Your dentist can order blood tests to evaluate changes in the blood count, glucose (sugar) and vitamins.

Expected Duration
Glossodynia can be acute (lasting for days or weeks) or chronic (lasting for longer periods of time). The duration often depends on the underlying cause.

Prevention
Obviously sharp or broken teeth or dentures that could irritate the tongue should be smoothed by your dentist. Otherwise, there is no way to prevent glossodynia.

Treatment
Treatment is often different for each person and can include:

Removal of oral irritants (rough edges on fillings, crowns or dentures
Construction of a soft plastic tray to correct or cover irregularities of the teeth
Topical pain relievers
Treatment of conditions known to cause oral burning (for example, vitamin deficiencies, diabetes or changes in blood counts)
Microsurgery to repair the lingual nerve, if nerve damage is a cause
Low doses of benzodiazepine, antidepressant or anticonvulsant medications

When To Call a Professional
Glossodynia can be a symptom of an underlying condition. Contact your dentist or physician if the pain is severe or lasts longer than two or three weeks.


Prognosis
Glossodynia without an underlying cause is often not a significant threat to health, but the pain can interfere with daily quality of life. Persistent glossodynia should be observed for changes in the actual tongue surface and in the type or severity of pain. When glossodynia is associated with a clear cause that can be easily treated (for example, thrush or a sharp tooth), the prognosis is good. However, the outlook is often guarded, even if a cause is discovered and treated, because it can take months for the tongue to respond. Sometimes, glossodynia will disappear on its own over time, or it may respond to low doses of benzodiazepine, antidepressant or anticonvulsant medications. Most cases are difficult to cure.


Adapted from: Columbia University Medical Center, School of Dental & Oral Surgery