Tongue Symptoms: Causes

What causes tongue symptoms?

Tongue symptoms can be related to a wide variety of diseases, disorders and conditions. Some causes of tongue symptoms are serious or life threatening, such as an anaphylactic reaction.

Infectious causes of tongue symptoms

Viral and bacterial infections that can cause tongue symptoms include:

• Hairy leukoplakia (caused by the Epstein-Barr virus; occurs most often in people with HIV/AIDS infection)

• Hand-foot-and-mouth disease (caused by the coxsackie virus)

• Oral herpes virus infection (also known as herpetic stomatitis)

• Oral thrush (also called candidiasis, which is caused by the yeast Candida albicans)

• Streptococcal or staphylococcal bacterial infection

• Syphilis (sexually transmitted disease caused by bacteria)

Allergic causes of tongue symptoms

Tongue symptoms, particularly a swollen tongue, can be due to allergic reactions including:

• Anaphylactic allergic reaction, which is a life-threatening emergency

• Drug allergy (penicillin or codeine)

• Food allergy

• Insect bite allergy, such as from a bee sting

Traumatic causes of tongue symptoms

Tongue symptoms can be caused by tongue injury or irritation, which make the tongue more susceptible to infection. Potential traumatic causes of tongue symptoms include:

• Acid or corrosive chemical burn

• Biting the tongue

• Burning the tongue, such as with hot liquids, hot food, or spicy food

• Dental appliances, dentures, or jagged or misaligned teeth

• Injury or trauma to structures in your mouth including your gums, oral cavity, and tongue

• Laceration (cut), contusion (bruising), or abrasion of the tongue

Common habits that can cause tongue symptoms

Tongue symptoms can also be due to the following conditions or habits:

• Alcohol consumption

• Breathing through your mouth, which leads to a dry mouth

• Poor oral hygiene

• Smoking and other forms of tobacco use, such as chewing tobacco

Genetic disorders that can cause tongue symptoms

Tongue symptoms can be due to genetic diseases, disorders and conditions including:

• Beckwith Wiedemann syndrome (congenital disorder)

• Down syndrome

• Hereditary angioedema (serious genetic disorder that causes periodic swelling of the throat and other areas)

• Lymphangioma (birth defect)

Other diseases, disorders and conditions that can cause tongue symptoms

Tongue symptoms can be due to a variety of other diseases, disorders and conditions including:

• Acromegaly (hormonal disorder)

• Dehydration

• Geographic tongue (an inflammatory disorder)

• Hypothyroidism (underactive thyroid)

• Leukoplakia (precancerous sores in the oral cavity that can lead to cancer)

• Oral lichen planus (inflammatory disorder)

• Oral neurofibroma (benign tumor possibly due to an inherited disorder called neurofibromatosis type 1)

• Pellagra (skin lesions and other problems caused by deficiency in vitamin B₃, which is also known as niacin)

• Pernicious anemia (decrease in red blood cells due to poor vitamin B₁₂ absorption)

• Pituitary gland disorder

• Salivary duct stone

• Tongue or oral cancer (most commonly caused by smoking and alcohol)

Questions for diagnosing the cause of tongue symptoms

To diagnose the underlying cause of tongue symptoms, your doctor or licensed health care practitioner will ask you several questions related to your symptoms. Providing complete answers to these questions will help your provider in diagnosing the cause of tongue symptoms. Questions asked during your examination generally include:

• Is your tongue swollen? If so, is the whole tongue swollen or just a portion of the tongue? When did the tongue swelling start?

• Are you taking any medications, supplements, or herbal drugs? Do you smoke or use smokeless tobacco products?

• Did you eat any foods or have contact with any unusual substances before the symptoms started (for example, seafood, shellfish, latex, or an insect bite)?

• Do you have any pain?

• Have you had any changes in the texture or appearance of the tongue? Have you noticed any mouth sores or lesions?

• Have you had any recent infections or injuries to the mouth?

• What is your medical and dental history? Explain any current or past medical and dental conditions.

• When did the symptoms first appear?

What are the potential complications of tongue symptoms?

Complications associated with tongue symptoms can be progressive and vary depending on the underlying cause. Because tongue symptoms can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to contact your health care provider when you experience any kind of persistent tongue swelling or other unusual symptoms. Once the underlying cause is diagnosed, it is important to follow the treatment plan you and your health care practitioner design specifically for you to lower your risk of potential complications including:

• Difficulty breathing due to obstruction of the airway

• Difficulty with speaking, chewing or swallowing

• Respiratory arrest from anaphylactic shock

• Spread of infection

• Tongue or oral cancer and spread of cancer (metastasis)

• Tongue removal due a serious infection or malignant condition