Incorrect bite as a cause of injury to the tongue and cheeks

The diagnosis of macroglossia is made if the tongue becomes excessively enlarged and thickened. With macroglossia, this muscular organ is pathologically changed or has some anomalies in its structure. This usually occurs due to developmental disorders of the fetus or is a consequence of some pathological process in the body. With this disease, the tongue becomes covered with folds, which further interfere with its proper dynamics. More often the disease occurs in childhood.

If the normal weight of the tongue is from 60 to 80 grams, then with this pathology it “grows” to 120 grams or more.

Both the entire organ and its individual parts (lateral surfaces, back or tip) can increase in size. Because of this, teeth marks may be imprinted on it. Often the tongue may not fit in the mouth and protrude outward.

Macroglossia - causes of tongue enlargement and consequences of the anomaly

From time immemorial, language has served as the main indicator of human health. Any changes in its appearance and structure, the appearance of plaque and neoplasms are all direct signals that some pathological processes are occurring in the body. One of the most serious phenomena is considered to be an increase in the size of the main speaking organ. This condition is medically called macroglossia. Further in this material we will talk about what it is, why such an anomaly occurs in adults and children, what methods are used today to treat the pathology.

What is a pathological phenomenon?

Macroglossia or enlarged tongue syndrome can be regarded as an anomaly in the development of an organ or a pathological deformation of its shape due to a certain disease. The tongue becomes denser, may partially or completely increase in size and even protrude outside the mouth if it no longer fits inside. Certain changes occur in the structure of the organ, due to which its surface becomes covered with numerous folds and becomes rough. All this leads to severe discomfort, the inability to fully chew food and breathe freely.

Enlarged tongue syndrome

Carrying out diagnostics

It is best to diagnose macroglossia in utero. Currently, with ultrasound of the fetus, norms for the size of any of its organs at various stages of pregnancy have been developed. There are optimal sizes for the length and width of the tongue. Often, during intrauterine examination, protrusion of the tongue outside the mouth is noticeable.

The final conclusion is given by specialists after several ultrasound examinations over 1 – 2 months.

More often, a full diagnosis can be established only by the 30th week of pregnancy.

After the birth of a baby with this pathology, he will need a number of consultations with an ENT doctor, an infectious disease specialist, a geneticist, an endocrinologist, and an oncologist.

And only after a detailed examination (using clinical analysis and instrumental methods) is a treatment plan for the disease developed.

Causes of macroglossia

Most often, the cause of the development of anomalies is congenital pathologies. Thus, the cause of the problem in newborns may be a benign neoplasm that began to grow at the stage of intrauterine development of the fetus, or an idiopathic disease with muscular hypertrophy of the tongue. Other possible prerequisites, dental experts include, are negative influences and conditions during pregnancy, acute infections, radiation exposure, alcohol poisoning, and hereditary factors. Experts also identify a number of genetic disorders, including the formation of cysts in the oral cavity during the formation of the tongue muscles1.

Read more about childhood tongue diseases in our special article>>>

“By the way, I also had no idea about this disease until a work colleague encountered something similar. As far as I understand, something went wrong during pregnancy, and the child was diagnosed with a congenital cyst on the tongue. I had to undergo surgery, and rehabilitation was not easy. It seems like everything is fine with the baby now...”

Kim7, Izhevsk, from correspondence on the woman.ru forum

As for adult patients, in this case macroglossia can result from the following phenomena and processes:

• malfunction of the thyroid gland, hormonal disorders,
• absence of all teeth in the mouth - complete edentia,
• open bite,
• amyloidosis – a disorder of protein metabolism,
• glycogenosis – disorders of the synthesis and breakdown of glycogen,
• pellagra is one of the forms of vitamin deficiency,
• rhinoscleroma – formation of nodules on the mucous membrane of the oral cavity and nasopharynx,
• syphilis, tuberculosis,
• neoplasms of both benign and malignant nature,
• inflammatory processes accompanied by the formation of pus,
• angioedema in acute form,
• “flaccid” tongue syndrome, characteristic of neurological disorders,
• intramuscular hemorrhage,
• candidiasis (fungal infections),
• malfunctions of the hematopoietic system,
• catarrhal glossitis.

There can be many causes of the pathology.
Sometimes a severe allergic reaction can provoke the problem. Also in medical practice, there are cases when the patient’s overweight becomes a prerequisite for pathology.

Treatment

Professional oral hygiene plays an important role in the overall health of the patient. It should be done regularly in the dentist's office. This is the only way to prevent the disease or provide quick treatment in the initial stages. What to do when a muscle organ is swollen? The cause should be determined and the underlying disease treated.

• In case of glossitis, for example, it is necessary to eliminate the inflammatory process with prescribed medications.
• For hypothyroidism, hormonal therapy is used. First, it is determined which hormones are deficient.
• If a patient has anaphylactic shock, an emergency room should be called immediately.
• Disorders of a genetic nature are treated symptomatically.

Allergic edema

This condition is very life-threatening, especially if it is Quincke's edema. It develops rapidly, instantly spreads to the larynx, cheeks, lips, and it becomes difficult to breathe. Only a doctor can provide professional assistance. It is important to avoid contact with allergens. Therapy is carried out with anti-inflammatory and antihistamine drugs. They block the negative effects of histamines. Suprastin, Loratadine, Tavegil are often prescribed. According to indications, the doctor may prescribe Prednisolone. Miramistin or chlorhexidine solution are used for rinsing. If an allergy occurs after the installation of dentures, you should contact a dentist who will select a safe material.

Infectious swelling

If the swelling is caused by an infection, therapy is given against a specific type of virus or strain of pathogenic bacteria.

1. For herpes, a drug such as Acyclovir is used.
2. Fungal infections are treated with Clotrimazole, Fluconazole, Flucostat.
3. To treat syphilis, antibiotics from the group of tetracyclines or penicillins are needed.
4. For scarlet fever, penicillin and antihistamines are prescribed.

If complications arise from secondary infection, therapy is prescribed for infected wounds.

Traumatic edema

A burned or bitten swollen tongue should be treated by a dentist. He will establish an accurate diagnosis and develop a treatment regimen. The area affected by the piercing will heal if the jewelry and inflammation are removed. Constant injury from braces is eliminated by their correction. Infection of the mucous membrane by spicy food is treated with antiseptic agents. Therapy for acid burns is carried out using a disinfectant rinse, as well as lubricating the affected areas with aniline-based paints. Patients are prescribed a solution of dicaine.

Treatment at home

When the muscle organ begins to increase in size, discomfort and unpleasant sensations appear, you should immediately consult a dentist. Healing will accelerate when traditional methods of treatment, agreed upon with the doctor, are added to the main therapy.

• Rinsing with a decoction of chamomile, calendula and sage. The oral cavity is treated with a warm solution several times a day.
• Juice from raw potatoes is used as a rinse. This solution is good at soothing the affected mucous tissues. To prepare, you will need several potatoes, which are crushed in a blender. Then the juice is squeezed out of the pulp through cheesecloth.
• Applying ice wrapped in cloth to the affected area helps.
• Baking soda is an excellent antiseptic. To rinse, it is simply diluted in water.
• A good mouth rinse is dissolved furatsilin tablets (2 pieces per 250 ml of water). The tablets must first be crushed.

When to see a doctor

If the size of the tongue constantly increases and the general condition worsens, you should immediately visit the dentist. In difficult situations, the patient may have difficulty breathing, as well as a sensation of a foreign body in the mouth. Often the mucous tissues become loose, the papillae stand out, and imprints of the masticatory organs appear. The lower part of the tongue is covered with pronounced blood vessels.

Do not delay visiting your doctor if:

1. The sense of taste has changed dramatically.
2. The mucous membrane has acquired an unusual color.
3. There was heaviness when swallowing and chewing.
4. Body temperature has increased.
5. There is hyperemia of the mucous tissues.
6. The skin became pale.

If your tongue hangs out for several days because it does not fit in your mouth, you should not self-medicate and neglect the help of a dentist. You may need to consult a gastroenterologist, therapist, endocrinologist, or infectious disease specialist.

Characteristic symptoms

In order to respond to a problem in a timely manner, you need to know what signs to recognize it. Here are the main symptoms of macroglossia:

• enlarged tongue, to the point where the organ no longer fits in the oral cavity,
• dryness of mucous membranes,
• difficulty breathing, asthma attacks,
• difficulty chewing and swallowing food,
• lumpy surface of the tongue
• enlarged taste buds
• excessive salivation,
• inability to close your mouth normally,
• formation of bleeding cracks on the back,
• diction problems,
• often an increase in temperature, the addition of common infections.

With this pathology, it is impossible to close the mouth normally.
Gradually, the patient’s condition worsens, the bite is deformed, and ulcers appear on the back of the organ. The area around the mouth becomes inflamed and irritation occurs.

How is macroglossia treated today?

The treatment method is selected taking into account the reasons that led to the increase in the size of the tongue. The doctor also takes into account all the changes that have occurred during the development of the disease. In the event that macroglossia is the result of some systemic disease, the root cause of the disease is treated first.

Drug therapy

We already said above that the problem may be the result of an infectious infection. In this case, specialists usually prescribe drug therapy aimed at eliminating the causative factor. As a rule, these are antibiotics, drugs that help normalize metabolic processes, restore the functioning of blood and lymphatic vessels, and agents that stimulate tissue regeneration. Special medications may also be prescribed to treat the surface of the tongue and oral mucosa in order to relieve swelling and inflammation.

If the cause of the pathology is an infection, then antibiotics are prescribed

Surgery

When the situation becomes more serious, surgery may be required. Typically, the surgical method is used to correct a birth defect, immediately after the birth of a child. There are several methods of such treatment:

• resection of the affected organ area,
• phlebectomy or sclerotherapy - usually performed when the cause of the disease is malfunction of the blood vessels. When performing a phlebectomy, the doctor removes damaged vessels, and in the second, he injects a special drug that stimulates the restoration of their functionality,
• blocking the lingual artery - this method is usually used when a child needs treatment at the stage of active growth. In this way, it is possible to minimize the supply of hormones, and the size of the tongue begins to return to normal,
• trimming the frenulum - the organ is raised to maximum tension, after which the frenulum is shortened to 1.5 cm. An advantage is the fact that the operation does not require sutures.

In some cases, surgical intervention is required.
The optimal treatment option is an integrated approach to treatment. The fastest and highest quality results can be achieved by combining drug therapy and surgical treatment.

Star Smile plates to help a child’s healthy bite

The standard Star Smile plate is more often used as a preventative when there are no changes in the bite and tongue position yet, but factors predisposing to this have already appeared. The child's need to suck often continues until school age and is sometimes unwisely encouraged by parents who want “a little peace.” Research has shown that more than 20% of children starting primary school still suck their thumb. But the older the child, the more firmly his bad habits are ingrained, and the more difficult it is for him to give up sucking his finger, tongue, or foreign objects. The authority of the dentist or orthodontist will help convince the child that the habit of sticking out the tongue and keeping a finger in the mouth can lead to serious problems. And only in this case will the treatment be successful if the doctor’s authority works. Treatment even in adulthood can always be successful, but it will simply take more time and money.

What could be the consequences if treatment is not started on time?

Macroglossia is not just an aesthetic defect, but a serious pathological phenomenon that can lead to dangerous consequences. Among the possible negative developments, dental experts highlight the following phenomena:

• serious disruptions in the functioning of the lungs, frequent cases of asphyxia, which in the worst circumstances can even lead to death,
• the formation of malocclusion in children, which also negatively affects the condition of the body as a whole,
• disturbances in the functioning of the gastrointestinal tract, since with such a pathology it is quite difficult to chew food thoroughly,
• deformation of teeth and soft tissues of the oral cavity,
• speech dysfunction and problems with the patient’s social adaptation.

Frequent biting of the organ, the appearance of cracks and microtraumas cannot be avoided - all this causes serious inconvenience and can provoke the development of an infectious process. It is important to respond to the problem in a timely manner in order to prevent possible complications.

1. Matveev, PC Clinical system for diagnosing macroglossia, 2013.