Dear Doctors column, April 23, 2007

Burning Tongue Frustrating, Common Problem

Question:

Please tell me the reason for a burning tongue. Also, the left side of my tongue becomes sore at times. It eventually goes away, but always returns. Could it be caused by an allergy? I haven't changed toothpastes. Can you shed some light on this?

Answer:

We get this question quite frequently, and unfortunately, there's not an easy answer. Your sore and burning tongue — known medically as glossodynia — can be a source of frustration for both patients and doctors. It can occur by itself or with changes in the sense of taste. In the vast majority of cases a specific cause is never identified.

People who suffer from a burning tongue often compare the sensation to drinking extremely hot liquids. They also may describe it as soreness, pain, or a stinging sensation. Glossodynia can be acute (lasting for days or weeks) or chronic (lasting for longer periods of time), depending on the underlying cause, and may vary in intensity. Generally, the problem is limited to the tongue but can include the lips, the roof of the mouth, and the cheeks.

Because there are many medical reasons for the symptoms you describe, a complete medical history and a thorough physical examination are necessary to help determine the cause. During the examination, doctors pay particular attention to the oral cavity including the tongue, floor of the mouth, and throat. Cranial nerves (nerves that originate in the brain and control taste, smell, and movement and sensation of the tongue, among other functions) are closely examined for possible damage.

A sore and burning tongue also can be caused by dental trauma, a yeast infection of the mouth, anemia, diabetes, hormonal changes, physiological conditions such as anxiety and depression, and deficiencies of certain vitamins and minerals (vitamin B-12, niacin, iron, or folic acid). Tobacco use also has been linked to a sore and burning tongue, and at worst, the symptoms could be indicative of oral cancer. Additionally, medications, such as diuretics, oral diabetes medications, and some blood pressure medications, as well as various over-the-counter medicines, can cause symptoms of glossodynia.

Allergies to products that come in contact with the tongue and lining of the mouth are to blame in some instances. This problem, called contact stomatitis, can be caused by allergy to toothpastes, mouthwashes, or chewing gums. Even allergy sprays can be suspect. In addition, a number of skin conditions can involve the tongue and lining of the mouth and throat.

Make an appointment with your dentist to rule out any oral problems that may be causing your symptoms, and see your family doctor to exclude any medical condition that may be the cause of your glossodynia. Also, talk to your doctor, dentist, and pharmacist about products or medications you can try to help relieve your symptoms.