Operational Medicine 2001
Sore Tongue

A sore tongue has many causes, most of which are benign and self limited.  

A large number of individual lesions may cause a sore tongue are discussed and described in the  “Tongue Lesions” section.  Other causes include glossodynia, contact stomatitis, and oral burns.

Glossodynia is the name for a painful, burning tongue.  There are usually no findings on exam, and most cases are idiopathic…unless an obvious injury or burn has just occurred.  A workup to rule out organic disease may be indicated, especially in patients with lesions on exam or a loss of taste perception.  Possible underlying causes include:

• Diabetes

• Nutritional deficiencies (iron, folate, zinc)

• Xerostomia

• Trigeminal neuralgia

• Vascular thrombosis

If no physical abnormalities or other causes are found, the patient may be reassured that glossodynia is not a serious disorder.  Maintenance of  good oral hygiene, adequate nutrition, and symptomatic treatment are all that is needed (see “Tongue Lesions” section).  Elavil 25-75mg PO QHS may provide additional relief.  Although a diagnosis of exclusion, neuropsychiatric conditions are the most frequent cause of glossodynia in the general population (most common in middle-aged women), and psychiatric consult may be required for persistent complaints.

Contact stomatitis due to topical irritants may cause a sore tongue as well as sore lesions throughout the mouth and lips.  Possible irritants should be eliminated, including:

• Aspirin

• Strong mouthwashes

• Hot spicy foods

• Citrus foods

• Lozenges

• Candies

• Chewing gums

Gargling with Benadryl elixir (5cc) may be used for symptomatic relief.

Oral burns secondary to thermal, chemical, or electrical injury may occur in a young, healthy working population.  Such lesions are usually mild and completely resolve within one week.  Topical viscous lidocaine or Benadryl elixir  may be used for symptomatic relief.

This section provided by LT April A. Truett, MC, USNR, Naval Medical Center Portsmouth

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001
Health Care in Military Settings

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