4.10 Burning tongue

agk’s Library of Common Simple Emergencies

Presentation

The patient is very uncomfortable with a burning sensation of the tongue or mouth. There may be xerostomia (reduced salivary flow), dental disease, geographic tongue, candidiasis or no visible explanation for the pain.

What to do:

• Treat specific causative factors such as candida infections or dental problems.
• Provide symptomatic relief with a one-to-one mixture of Benadryl elixir and Kaopectate, or prescribe viscous lidocaine.
• If the etiology is uncertain, refer the patient for a comprehensive medical evaluation.

Discussion

Burning tongue or burning mouth symptoms are usually caused by xerostomia, candidiasis, other chronic infections, referred pain from the tongue muscles, dental disease, reflux of gastric acid, medications, noxious oral habits, blood dyscrasias, nutritional deficiencies, allergies, inflammatoriy disorders, psychogenic factors, or unknown causes. Geographic tongue results from loss of filiform papillae from patches on the dorsal surface of the tongue. The location of the patches may appear to shift over a period of weeks. It is usually not painful and does not require specific treatment.

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