Tongue Pain Research Articles

Endovascular Revascularization of External Carotid Artery Occlusion Causing Tongue Infarction

A 62-year-old man with diabetes and a history of ischemic coronary disease visited the emergency department complaining of acute pain and swelling of the tongue. Physical examination found subtle swelling and pallor of the right side of the tongue, and he was initially diagnosed with glossitis. However, his symptoms were progressive, and the tongue had sustained serious tissue damage before the correct diagnosis was established. Digital subtraction angiography of the cervical vessels revealed occlusion of the right external carotid artery (ECA) and lingual artery without collateral circulation to the right side of the tongue from the contralateral ECA or ipsilateral vertebral artery (VA). Endovascular revascularization was performed to restore blood flow to the tongue using balloon angioplasty of the proximal segment of the right ECA followed by deployment of a self-expanding stent. Tongue pain subsided shortly after the procedure, and configuration of the tongue returned to normal 4 months after intervention. Tongue infarction is rare and usually associated with systemic vasculitides. Tongue infarction due to unilateral occlusion of the ECA is extremely rare because of the rich collateral circulation to the tongue from the ipsilateral VA and contralateral ECA. Atherothrombotic unilateral occlusion of the ECA should be included in the differential diagnosis of tongue infarction. Revascularization of the occluded ECA is worth attempting despite substantial tissue damage because of the viability of the tongue muscles and the minimal risk of complications in experienced hands.

放射性ヨード内服により生じたと考えられる口腔乾燥症の1例

Oral radioiodine （131I） therapy is known to be an effective treatment for differentiated thyroid carcinoma, but it can cause salivary gland impairment. We report a case of xerostomia caused by oral radioiodine therapy for thyroid cancer.A 47-year-old woman consulted our hospital because of tongue pain accompanied by xerostomia. The patient had a history of receiving radioiodine therapy for metastatic thyroid carcinoma 3 times （total 9,990 MBq）. Clinical examination demonstrated oral dryness and reduced salivary gland function. On the gum test, the salivary flow was 2 ml in 6 minutes. It was hard to continue chewing for more than 6 minutes because of irritation. A computed tomographic scan showed atrophic changes of both parotid glands. On radioiodine whole-body imaging, uptake of radioiodine was evident in both the parotid and submandibular glands. Based on these findings, xerostomia caused by salivary gland injury due to radioiodine therapy was clinically diagnosed. The salivary gland injury was irreversible, and the patient received symptomatic therapy and pilocarpine hydrochoride. Early intervention to avoid salivary gland injury is important in patients who receive radioactive iodine therapy.

일부 제조업 생산직 남성근로자들의 구강건강상태 및 관련요인

본 연구는 근로자들을 대상으로 구강건강상태 및 관련요인을 파악하여 구강건강증진을 향상시키기 위하여 경상남도지역 일부 근로자 178명을 대상으로 자기기입식 설문지를 작성하게 하여 다음과 같은 결론을 얻었다. 치아우식증이 있는 군에서 지난 1년간 치과방문경험이 있거나 치석제거경험이 있다고 응답한자에서 치아우식증이 없는 군보다 낮게 나타나 유의한 차이가 있었다(p<.05). 치아우식증이 있는 군에서 치아가 쑤시거나 욱신거리며 아픈 경험이 있다고 응답한 자가 51.3%, 잇몸이 아프거나 피가 난 경험이 있다 48.7%, 불쾌한 입냄새 경험이 있다 53.8%로 나타나 유의한 차이가 있었다(p<.05). 치은염증이 있는 군에서 지난 1년간 치석제거경험이 없거나 치은염증이 없는 군보다 낮게 나타났다(p<.001). 치은염증이 있는 군에서 하루 칫솔질 회수는 3회이상이 9.6%, 취침전 칫솔질을 항상 했다 4.7%, 구강위생보조용품 이용은 대부분 했다 5.9%로 나타나 유의한 차이가 있었다(p<.001) 치아우식증 유무에 영향을 미치는 변수로는 주관적 구강증상, 치실 또는 치간칫솔 사용여부, 구취증상 변인으로 파악되었고, 치은 염증 유무에 영향을 미치는 변수로는 취침직후 칫솔질 유무, 혀통증 증상, 구취증상, 시린치아증상, 스켈링경험여부 변인으로 파악되었다. 이상 구강검진을 통한 상담과 교육을 통해 근로자들의 구강건강에 대한 의식을 고취시켜 근로자들의 구강건강을 증진 유지시키는데 도움이 되는 방향으로 개선되어야 될 것이다. The Purpose of this study was to examine the factors affecting oral health status of some workers. Answer sheets for questionnarie for 178 workers at Changwon city, Korea, were collected and analyzed using SPSS 19.0. The number of respondents who have visited dental clinic is lower among group with dental caries than group without dental caries. The respondents who have scaling corresponds to 31.3% in the group with dental caries and a little bit lower percentage is shown in the group without dental cares(p<.05). Among those with dental caries, the respondents who experienced tooth pains are to 51.3% and those who had frequent blooding in gum 48.7% and those who had ordors inside the mouth 53.8%. The number of respondents who had scaling within last one year among the group with gingival inflammation is lower than those without it(p<.001). In the group with gingival inflammation, no smokers are corresponding to 13.9%(p<.01) and those with more than 3 times brush of tooth 4.7% and those with oral hygiene devices are to 5.9%. Important variables which have effects on dental caries are understood as self-evaluation for dental health, dental floss or interdental brush, ordors in the mouth. Also variables related with gingival inflammation are considered as tooth brush before bed time, tongue pain, orders in the mouth, the cold as ice tooth and tooth scaling experience. In summary, Oral health education is needed to increase the motivation of industrial workers to control their basic dental disease.

Does Propulsion Mechanism Influence the Long-term Side Effects of Oral Appliances in the Treatment of Sleep-Disordered Breathing?

Mandibular advancement appliances (MAAs) can be used to treat sleep-disordered breathing, and differences in their designs have been thought to influence the occurrence of secondary effects. With bibloc devices, the lateral attachments producing mandibular propulsion can be inserted to generate traction or compression. We evaluated the clinical impact of this difference by comparing the long-term secondary effects and compliance of two devices. One hundred sixty-two records of patients fitted with a traction-based or compression-based MAA before January 2008 were reviewed retrospectively for physical examination findings and cephalometry. Patients were sent a postal survey and contacted by phone 2 weeks later. They were offered a follow-up medical visit with repeat cephalometry. Main outcomes were long-term (> 2 years) secondary effects, compliance, or satisfaction. Of the patients who attended the follow-up visit, 48 had worn the MAA for > 2 years (16 traction based and 32 compression based), and nine for < 6 months (used as control subjects). Mean follow-up times for the traction and compression groups were 3.7 ± 1.2 years and 3.6 ± 1.2 years, respectively. No difference was found between the MAAs for subjective and objective side effects, except for greater early pain to the masticatory muscles (P = .02) and residual tongue pain (P = .04) in the compression group. However, pain intensity was low and clinical relevance was uncertain. No difference was found for compliance, satisfaction, and objective or subjective efficacy. This study suggests that traction-based appliances are similar to compression-based devices with regard to secondary effects and compliance.

Two Cases of Tongue Pain Patients with Physical Factors

Two Cases of Tongue Pain Patients with Physical Factors

Geographic tongue treated with topical tacrolimus

Geographic tongue, or benign migratory glossitis, is usually an asymptomatic inflammatory disorder of the tongue mucosa of unknown etiology. It is characterized by circinate, erythematous, ulcer-like lesions of the dorsum and lateral border of the tongue due to loss of filiform papillae of the tongue epithelium. Symptomatic treatments have not been evaluated rigorously. We describe herein two cases of adult patients with persistent and painful geographic tongue successfully treated with topical application of 0.1% tacrolimus ointment. To our knowledge, this is the first report of successful treatment with topical 0.1% tacrolimus for symptomatic geographic tongue. Clinical trials are needed to confirm the efficacy and the safety of topical tacrolimus in treating geographic tongue.

Lingual Abscess With Associated Abiotrophia/Granulicatella sp. Bacteremia in a Healthy Patient

Acute tongue swelling is an uncommon but important presenting complaint because it may represent a life-threatening disorder requiring emergent treatment. We present the case of a 52-year-old man with tongue swelling and pain who was initially diagnosed with angiotensin-converting enzyme inhibitor-induced angioedema but was later found to have a lingual abscess on a computed tomographic scan. Culture of the abscess grew oral flora, but blood cultures grew Abiotrophia/Granulicatella sp. These nutritionally variant streptococci (NVS) have not been previously reported in immunocompetent patients in the setting of lingual abscess. The patient ultimately did well after receiving needle drainage and antibiotics.

AKT Answer Relating to Management of Painful Tongue

AKT Answer Relating to Management of Painful Tongue

AKT Question Relating to Management of Painful Tongue

AKT Question Relating to Management of Painful Tongue

Toxicities of raw Alocasia odora

Alocasia, the Araceae family, is a genus of more than 100 species of perennial, herbaceous, diminutive to extremely large, usually robust herbs with a clear-to-milky latex. They are distributed throughout subtropical and tropical Asia and in the tropical western pacific as well as eastern Australia. Despite easy access to A odora, there have been no published reports in English regarding the toxic symptoms following the ingestion of raw A odora. Here, the clinical manifestations of 2 patients that ingested raw A odora are described. Two patients experienced oral numbness and intractable tongue pain, and 1 patient required endotracheal intubation because of upper respiratory tract obstruction. Although conservative treatment is the primary approach to A odora poisoning, physicians should be aware of the potential for upper respiratory obstruction in patients exposed to A odora, as well as the need for controlling tongue pain.

A Smooth Patch on the Tongue

A smooth, well-demarcated patch without papillae on the posterior portion of the tongue was discovered incidentally while the oropharynx of a 65-year-old woman was being examined. On inquiry, she said that she had been aware of the unusual appearance of her tongue since childhood and that the lesion's size and shape had been stable since that time. She reported no tongue pain, dysphagia, dysarthria, or bleeding. There was no evidence of candidiasis on the tongue or adjacent structures. There was no regional lymphadenopathy, and the patient reported no constitutional symptoms such as fever or weight loss. There was no history . . .

Evaluation of clinical usefulness of itraconazole oral solution on oral treatment candidiasis accompanied with tongue pain

Evaluation of clinical usefulness of itraconazole oral solution on oral treatment candidiasis accompanied with tongue pain

“Burning Tongue” and “Burning Tip”: The Diagnostic Challenge of the Burning Mouth Syndrome

To investigate the clinical features of burning mouth syndrome (BMS) in a large cohort of patients and to correlate them with the results of tongue biopsy. We screened 98 patients complaining of oral burning pain for at least 6 months. Forty-two patients were excluded after screening for contact sensitivity to dental materials, food allergies, tongue injuries, malignancies, connective tissue and metabolic disorders, oral infectious diseases, vitamin deficiencies, and other systemic diseases known to cause neuropathy. Fifty-six patients underwent neurologic examination and assessment of pain intensity, depression, anxiety, quality of sleep, and quality of life. Tongue biopsy with the quantification of epithelial nerve fibers (ENF) was performed in 51 patients. Compared with 9 healthy participants (4.13+/-1.85 SD), epithelial innervation density was significantly reduced in 38 patients (1.35+/-1.46 SD; P<0.0001) and normal in 13 patients (6.1+/-2.19 SD). The clinical features differed in the two groups: patients with reduced ENF density complained of pain in the whole tongue, lips, hard palate, and alveolar ridges, reported dysgeusia and xerostomia in 29% of cases (P<0.001), and 24% of them were depressed. Patients with normal innervation complained of pain on the tip of the tongue, reported dysgeusia and xerostomia in 7.7% of cases, and 54% of them were depressed (P<0.017). The diagnostic criteria for BMS are not defined yet and the relationship with depression and anxiety is debated. We proposed a biopsy-supported approach for the diagnosis. Our study shows that BMS can present with two distinct clinical pictures and that tongue biopsy can contribute to the assessment of the diagnosis. Mood disorders occur frequently and should be considered when approaching patients and treatment options. These observations could help physicians in identifying patients with BMS and addressing them with the appropriate diagnostic work-up and treatment.

Teaching Neuro Images : MRI in Ramsay-Hunt syndrome after trigeminal zoster

A 22-year-old man developed painful tongue swelling, a right facial rash, and right lower motor neuron facial palsy over 2 weeks. On examination he had a vesicular rash in a mandibular distribution and on the concha of …

Tongue Necrosis: A Rare Complication of Oral Intubation

(1) Present a unique case of partial necrosis of the dorsal tongue caused by an endotracheal tube; (2) highlight the importance of verifying proper endotracheal tube positioning during cases requiring prolonged intubation. Case report and literature review. A 50 year-old man underwent total thyroidectomy and bilateral lymphadenectomies for papillary thyroid carcinoma. A nerve monitoring endotracheal tube was used during the case. Postoperatively, the patient reported tongue pain and examination revealed partial necrosis of his dorsal tongue. On follow up, the patient had improved tongue pain and well-healing dorsal tongue. We present the a case of tongue ischemia and partial necrosis due to oral endotracheal intubation, specifically with a nerve monitoring endotracheal tube, which has not previously been reported in the English literature. Tongue necrosis due to compression by an endotracheal tube during prolonged intubation is unusual, however surgeons, anesthesiologists and those involved in the care of intubated patients should consider the potential for this complication when orienting and securing endotracheal tubes. This unique case of tongue necrosis underscores the importance of proper endotracheal tube positioning during prolonged intubation.

The prevalence of tongue lesions in Libyan adult patients

This is the first ever-detailed study of tongue diseases in Libyan population, where the tongue conditions found in 320 patients (9.2%) of 3,460 consecutive patients screened in the department of Oral Medicine and Oral Diagnosis at faculty of dentistry, Benghazi Libya. Both sexes were affected almost equally and only 25 patients were aware of their tongue disease. Forty patients had one or more systemic illness, 34 of them was on regular medications. Fissured tongue was the most prevalent condition, as it has been found in 155(48.4%) patients, depapillated tongue in 82(25.6%) patients and geographic tongue in 55(17.2%) patients, other disease conditions were found in a lesser number of patients. Fifty-four patients had painful tongue conditions; other complaints included malodor, speech interferences or swallowing difficulties. Most conditions were confined to the tongue and in more than 90%, there had been involvement of the dorsum of the tongue. Fortunately, most tongue conditions can easily be diagnosed on clinical grounds by any experienced clinician, hence, the histopathological examination and other investigations are needed in only few cases. There is a wide variation in the prevalence of most of tongue diseases worldwide due to the lack of uniformity in criteria of the studies. Thus, more studies are needed in this regard.

Riga-Fede-Like disease in a 70 year old woman

Riga-Fede disease (RFD) describes a benign, ulcerative lesion resulting from the repetitive trauma of contact of the oral mucosal surface of the tongue with the teeth. Although the name applies primarily to small children, similar clinical and histopathological findings can also be found in adults. We describe here a 70 year-old woman showing a painful tongue ulcer with elevated borders and whitish discoloration for the past four years. Repeated histological investigations revealed a benign leukoplakia without dysplasia. Replacement of an ill-fitting prosthesis led to complete remission within two weeks. RDF-like disease is thus a problem in elderly patients for whom topical treatment is insufficient to induce healing.

A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances

The aim of this prospective longitudinal study was to compare pain experiences among Chinese adult patients treated with labial and lingual orthodontic appliances. Sixty patients, 30 with labial appliances (18 females and 12 males, mean age 20.33 years, SD +/- 4.205) and 30 with lingual appliances (22 females and 8 males, mean age 21.63 years, SD +/- 2.236), rated their overall pain experience on a 100 mm visual analogue scale (VAS) at three time points: 1 week (T(1)), 1 month (T(2)), and 3 months (T(3)) after bracket placement. In addition, on a separate 100 mm VAS, they rated their pain experience at the locations of the tongue, lips, cheeks, gums, face, and jaw at T(1), T(2), and T(3). Changes in pain VAS were conducted using Friedman analysis of variance, area under the curve (AUC) analysis and the data were compared using a t-test. There was no significant difference in global ratings of pain among those treated with labial or lingual appliances (P > 0.05). Among both groups, global ratings of pain decreased over the study period (P < 0.001). Patients treated with lingual appliances reported higher ratings of tongue pain (P < 0.001), while those treated with labial appliances reported higher ratings of lip (P < 0.001) and cheek (P < 0.001) pain. The findings indicate that patients treated with labial and lingual appliances rate similarly the level of overall pain they experience during treatment. Ratings of overall pain experienced decreased for both treatment groups with time. However, ratings of pain differed at various sites with respect to the type of orthodontic appliance. These findings have implications in informing patients' treatment decision-making processes regarding labial and lingual appliances and in the management of discomfort associated with different treatment modalities.

Clinical study of tongue pain: Serum zinc, vitamin B12, folic acid, and copper concentrations, and systemic disease

The aim of this retrospective study of patients with tongue pain who showed no improvement after initial treatment and examination was to find out if their lack of response correlated with serum concentrations of zinc, vitamin B12, folic acid, and copper, and if it was associated with coexisting systemic diseases. We studied 311 patients for whom we had data about serum concentrations of these elements, and recorded whether they had any systemic diseases and were taking medicines regularly. One patient (0.3%) had a copper concentration outside the reference range; 2 patients (0.6%) had folic acid concentrations outside the reference range. The corresponding number for vitamin B12 was 5 (2%), and for zinc 30 (10%). The systemic diseases with the highest rates were: hyperlipidaemia ( n = 53, 17%), gastritis or gastric ulcer ( n = 51, 16%), angina pectoris ( n = 39, 13%), diabetes mellitus ( n = 31, 10%), thyroid disease ( n = 31, 10%), mild mental disorder ( n = 27, 9%), hypertension ( n = 18, 6%), cerebral infarction ( n = 17, 6%), leiomyoma ( n = 15, 5%) and anaemia ( n = 15, 5%). Roughly 10% of the patients were deficient in zinc. This study suggested that the serum concentration of zinc was most important to the patients with tongue pain. Many patients had more than one systemic condition, and all were taking various drugs.

Chronic tongue ulceration resolved by sulpiride: a report of two cases

We report two patients with chronic tongue ulceration who were successfully treated using sulpiride. The clinical diagnosis was oral candidiasis related to long-term steroid treatment. The results of the culture test and cytological examination supported this diagnosis, but antifungal treatment was ineffective and the tongue pain in these patients became more severe. Furthermore, the pain could not be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). We therefore prescribed sulpiride in addition to NSAIDs to reduce the tongue pain. A consequent improvement in both pain severity and ulceration was observed 2-3 weeks after sulpiride administration.