Which doctor should I consult for tongue diseases, and what will be the treatment?

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• What to look for during a self-examination
• Choosing a specialist depending on symptoms

Today, a problem such as pathology of the oral mucosa is often diagnosed.
The disease can affect the lips, tongue, and cheeks. What to do? You need to go to the doctor! The dentist will provide assistance to the patient. If the disease is associated with therapeutic problems, you should visit a therapist. If necessary, narrow specialists will be invited for consultation. Note! For any abnormalities of the oral cavity and its organs, you should consult a doctor promptly. Ignoring the disease can lead to serious complications. The sooner the patient gets to the doctor, the faster and easier the therapy will be.

Many ailments of the chewing organs and oral cavity can be treated by a dentist. The tongue is a mirror of the body. His condition allows us to judge:

• About the work of the heart;
• Spleen and liver;
• Kidney, when the pathology is detected from the side;
• Stomach or pancreas;
• Teeth, gums;

Based on the nature of the patient’s complaints, plaque, color, smell, and tests, the doctor determines the problems that have arisen. It is important not to delay going to the medical center. When the disease concerns the chewing organs or mucous tissues of the mouth, you need to consult a dentist. Dentistry in St. Petersburg is a department where they will provide professional assistance to any patient. Diseases are often caused by bacterial, viral, fungal infections, and improper functioning of internal organs.

1. Go to the dentist if the burning sensation bothers you, the problem is related to the gum tissues, teeth. Inflammation can be caused by a denture, periodontal disease, or an unsuccessful filling.
2. Visit an ENT specialist to rule out tonsillitis and tonsillitis.
3. For no apparent reason, make an appointment with a therapist. The doctor will determine the provoking factor and refer you to the right specialist.

This could be an endocrinologist, a neurologist, an infectious disease specialist and other doctors.

What is glossitis?

What do we know about the tongue as an organ? We know that it is located in the mouth, which helps us articulate and pronounce words correctly, helps us mix food, feel all the diversity of existing tastes, that they can be shown indignation, and in some African countries, a demonstration of it can be used to declare war.

Such a significant number of different physiological and social functions may one day be compromised. And the name of this threat is glossitis.

Despite the absolutely clear location of this organ, there are big questions about which doctor deals with its problems: a dentist, gastroenterologist, maxillofacial surgeon or otolaryngologist. This is not an easy question, and sometimes you can endlessly go from one specialist to another. But let's finally understand this intriguing matter.

Who should I turn to for help?

The tongue can hurt for a variety of reasons: from ordinary stomatitis to serious disorders in the functioning of internal organs.
The etiology of tongue disease may have completely different roots, but regardless of this, it will be necessary to take a number of measures to improve the health of this organ, even if the cause of the disease lies in another part of the body. That is why no pathology of the tongue should be treated without the participation of a professional dentist: contrary to popular belief, the responsibility of this specialist includes not only teeth and gums.

Having extensive knowledge about all the probable causes of tongue disease, the general dentist will make a preliminary diagnosis and decide whether he can cope with the pathology himself, or whether it is necessary to send the patient to a more specialized specialist.

At the same time, the patient needs to know in case of tongue disease which doctor to contact if it is not possible to visit a dentist. Taking into account the most common causes of the disease, as well as the characteristics of their course, you can make an additional list of doctors to whom it makes sense to go first:

• general practitioner (family doctor);
• therapist;
• dermatologist;
• oncologist.

Important! The healthcare systems of many countries in the world are designed in such a way that the patient always first sees a family doctor, who then writes a referral to a specific specialist based on his examination.

If you don't know which doctor to see, make an appointment with a therapist.
The second “echelon” of specialists likely to be visited includes those doctors who deal with diseases of other internal organs and body systems. As a rule, we are talking about a gastroenterologist, otolaryngologist, pulmonologist or endocrinologist; less often, a specialist such as a cardiologist, neonatologist and others may be needed.

In all these cases, we are talking about eliminating the underlying disease, the course (or complication) of which led to one or another lesion of the tongue. However, to determine such a need, you will first need to conduct a series of studies, tests and analyzes used in differential diagnosis.

Forms and types of disease

Inflammation of our organ of taste occurs frequently and does not always manifest itself with symptoms, proceeding completely hidden from us.

There are several forms and types of the disease:

• According to the duration, the disease is divided into acute (develops quickly and lasts no more than a month) or chronic glossitis (lasts more than a month);
• According to the form of the lesion, the catarrhal form (proceeding with redness and swelling) and the desquamative form (proceeding with a change in appearance) are distinguished;
• purulent forms - phlegmon and abscess (a purulent focus in the thickness of the organ tissue itself);
• a separate group includes neurological diseases of the nerves innervating this organ.

Cellulitis and abscess occur acutely, they are associated with infection and require urgent surgical intervention. They manifest themselves as severe pain, chills and swelling of the lymph nodes of the neck - this form can be confused with acute inflammation of the salivary glands, so diagnosis using ultrasound and x-rays is needed. It is better not to delay these symptoms and seek medical help as an emergency.

The catarrhal form of glossitis manifests itself with a sharp blood supply - the tongue swells, becomes bright red - this can manifest itself, for example, with scarlet fever, or an allergic reaction, which, in addition to the organ of taste itself, spreads to the soft palate with the tongue. Treatment in this case is aimed at eliminating the allergic reaction and inflammation.

The largest and most heterogeneous group is desquamative glossitis. It is difficult to list the number of factors (external, internal) that can provoke this form of the disease. We will not make a mistake if we say that “the tongue is the mirror of the digestive tract.” Since it contains many nerve receptors and papillae of different shapes and purposes (filamentous, cone-shaped, mushroom-shaped, leaf-shaped, groove-shaped), a change in each link of its anatomy outwardly reveals a hidden disease. Let's take a little look at the most common diagnostic signs of these conditions.

Leukoplakia

This tongue disease in most cases occurs in mature men and is usually associated with metabolic disorders or pathologies of the digestive organs. Leukoplakia does not cause pain, but the patient may experience discomfort when eating spicy foods. Usually this causes the tongue to tingle. The symptoms of this disease are characterized by the fact that the mucous membrane of the organ begins to become covered with whitish plaques, spreading to other parts of the oral cavity. Spots can even appear in the corners of the mouth. With the development of leukoplakia, therapy for the disease that provokes it is necessary. The affected parts of the tongue are cleaned with:

• radio waves;
• laser therapy;
• electroexcision;
• diathermocoagulation.

If a specialist suspects the cells have degenerated into cancer cells, surgical treatment is performed.

Changes in appearance depending on the disease

One of the common types is “geographical tongue,” in which its upper surface resembles a map with the borders of countries and continents. This is the most common form of glossitis, which does not manifest itself in any way and does not require medical intervention unless complications arise (numbness, burning). This form occurs in waves, provoked by rough or spicy food, and hormonal cyclic changes. But the loss of the pattern of the papillae may indicate the presence of hypo- or hyperacid gastritis (that is, with increased or decreased acidity of gastric secretions) - such symptoms are typical for patients with gastroesophageal reflux, when hydrochloric acid and bile are thrown from the stomach into the oral cavity.

"Geographical language"

The second most common type of glossitis is a folded tongue. This is an independent type of glossitis. In this case, the back of the tongue seems to be riddled with deep cracks and it feels like there are folds in it. This form of glossitis sometimes accompanies neurological diseases (for example, Melkerson-Rosenthal syndrome) and is present in people with acromegaly (hormone-active pituitary tumor).

"Folded tongue"

Also characteristic are manifestations of various anemias, which are reflected in the appearance of the organ: iron deficiency anemia can manifest itself as a burning sensation on the tip of the tongue, the appearance of cracks on it and an erased pattern of taste buds. Pernicious anemia (B12 deficiency), in which the tongue has a “varnished” appearance with a smooth, swollen surface, sometimes quite painful, with burning symptoms, is the main cause of Gunther-Miller glossitis.

"Lacquered Tongue"

A large group of pathological conditions of this organ are ENT-associated symptoms associated with chronic tonsillitis - here the symptoms are non-specific, ranging from a dirty coating on the tongue to manifestations of diphtheria with white masses that are difficult to remove.

They also distinguish the formation of ulcers on the tongue - aphthous glossitis, which, as a rule, has a viral cause and goes away on its own. This is a recurrent disease, with more frequent episodes it is necessary to exclude pathology of the immune system.

When visiting a doctor, you will often notice pronounced teeth marks on the side of the tongue - a sign of long-term swelling. This occurs in patients with enterocolitis, kidney disease and cardiovascular diseases. The reason for this condition is water retention in the body.

Imprints from teeth on the lateral surface of the tongue

In the presence of abundant white plaque, accompanied by pronounced redness of the oral mucosa, one should suspect a fungal infection, often of a candidal nature. In this case, HIV must be excluded. Also with HIV, “hairy leukoplakia” occurs, when the tongue appears to have white hairs on the side surface, similar to flames - this condition is specific to HIV.

"White Hairy Tongue"

It is worth noting the existence of a “black hairy tongue”, which is a symptom of gastrointestinal disorders, less commonly a fungus.

"Black Hairy Tongue"

As you can see, our organ of taste reflects deep processes in the body, and it is difficult to single out one specialist responsible for its treatment. It is worth involving doctors of different spectrum in therapy, conducting studies based on data from smears and blood tests. But what general recommendations can we, as doctors, give to patients?

Symptoms

• edema;
• redness;
• dryness;
• increased salivation;
• pain and burning that worsens while eating or talking;
• change in tongue mobility;
• hyperthermia.

Usually these signs are enough to give the patient an adequate diagnosis. However, to determine the specific causes, additional studies may be needed, for example, a general or biochemical blood test, serological and bacteriological analyzes of smears, histological examination of tissues, and tongue biopsy.

Care instructions

• Hygiene. We brush our teeth, but forget about our tongue. Thanks to advertising in the media, people are more likely to buy toothbrushes with a special brush for cleaning the tongue - and this is important. After all, bacteria live in the gap between the taste buds and food particles remain that must be removed from there.
• Caring for your oral health. Do not forget about the cleanliness of the palatine tonsils and the presence of reflux of gastric contents into the oral cavity.
• And the most important thing is to monitor your general health, undergo a timely examination by a doctor to identify the cause of inflammation - primarily to the dentist, but if you even consult a therapist or an infectious disease specialist, or an ENT doctor - you will not be mistaken, since there are almost no diseases, which would not affect such an important organ one way or another.

Treatment at home

Treatment of glossitis at home in adults and children should be carried out only after consultation with an experienced specialist, since independent experiments can only worsen the disease. If the disease is not severe, glossitis is treated with medications (prescribed by the doctor) at home, and the patient comes to the clinic for examinations throughout the entire period of rehabilitation. Doctors often prescribe treatment for glossitis with hydrogen peroxide, since it is an inexpensive and fairly effective antiseptic. The same can be said about chlorhexidine solution - one of the most common means of treating and preventing several types of glossitis.

Traditional medicine is actively used in the treatment of oral diseases, including glossitis. As a rule, various tinctures and decoctions are used. First of all, these are chamomile, calendula, basil and sage, which have antibacterial properties. Aloe, carrot and sea buckthorn juices help restore the supply of vitamins and also have a tonic and restorative effect.

Candidal stomatitis

This pathology of the tongue is provoked by Candida fungi from the yeast category, which can be classified as a conditionally pathogenic microflora. In small quantities they live on the mucous membranes of a healthy person, without contributing to the development of any diseases. Most often, children and elderly people who have decreased immunity are susceptible to this disease.

The main factors that provoke thrush in the mouth and tongue are:

• immune system diseases;
• long-term use of antibacterial medications;
• infection of the child by the mother during childbirth;
• insufficient or lack of oral hygiene;
• intestinal diseases;
• changes in hormonal balance.

For young children, switching to artificial formula with a large amount of sugar, as well as parents’ failure to comply with the requirements for cleaning feeding supplies, pose some danger.

Among adult patients, the risk group includes people with impaired immune systems due to HIV, cancer, and diabetes. Candidal stomatitis is often provoked by smoking and frequent rinsing of the mouth with lotions, which contributes to drying of the mucous surface of the tongue and the creation of a favorable environment for the colonization of Candida fungi.

Who is a periodontist?

A periodontist is a highly qualified dentist with a higher medical education who specializes in the correction and prevention of pathologies of soft tissues that fix segments in the jaw bone. The concept of “periodontium” includes:

• mucous membranes that line the surface of the mouth;
• soft gum tissue surrounding the segments;
• periodontium is a thin layer of connective tissue between the alveolar process and the cementum of the tooth;
• dental cement - mineral tissue surrounding the root;
• alveolar process - a dental bed penetrated by capillaries and nerve endings.