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What Causes Swollen Tingling Tongue?

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Posted on Mon, 23 Feb 2015
Question: I have asked about this before, but I have small spots under my tongue. My dentist was not too concerned. I have TMJ so I have been wearing a mouthguard at night. But the entire side of my tongue looks like raw hamburger. the spots have not gone away and my tongue tingles every now and then. It feels rather swollen at times also and is usually covered with a film. I use Qvar, but I make sure I rinse afterwards. any suggestions what could be causing this?
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Could be due to vitamin B deficiency, Kawasaki disease, or Scarlet fever

Detailed Answer:
Thanks for asking on HealthcareMagic.

Red raw looking tongue ("strawberry tongue") could be caused due to a vitamin B deficiency, Kawasaki disease, or a strep infection (Scarlet fever). Had I been able to take a look, I would perhaps have been better able to comment. There is an option to upload pictures and reports on this page. Can you upload good quality pictures of the affected area.

Qvar contains beclomethasone which is supposed to reduce inflammation. It is right to be applied. But the underlying cause needs to be identified and treated.

Hope that helps.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha (1 hour later)
I attached 3 pictures (the best I could get with camera). The first one has the bumps under my tongue. There are probably 4 or 5 of them on the ridge (I circled location). Small, but red with a white top.

The second is of the side of my tongue. Looks very red and swollen on both sides.

I also have a white spot on the top of my tongue that comes and goes. Again, my dentist blew it off as nothing, but it has been over a year since I first noticed it. It never grows in size and sometimes seems to completely clear up.

I worry about oral cancer - I'm a former smoker. I have started taking B-12 daily (began about a month ago). These problems all seemed to start in the past year, and I have been using Qvar for about a year and a half. I also have very bad acid reflux if I do not use my PROTONIX daily. But suffered for years with that. Any insight would be great.
doctor
Answered by Dr. Prof. Kunal Saha (1 hour later)
Brief Answer:
Erythroplakia needs to be excluded,periodic dermatological followup advised

Detailed Answer:
Thanks for writing back and for attaching the images.

It does not seem to be scarlet fever or Kawasaki disease. You definitely seem to have glossitis. So, it is more likely to be due to Vitamin B12 deficiency.

About the white spot, I would not really worry. Applying candid (clotrimazole) mouth paint topically may help.

About the swellings below the tongue, you need not worry. They may have been caused due to blockage of the openings of the saliva secreting glands.

But, I would request you to be cautious about the lesion on the side of your tongue. If you have already used Qvar for more than a week, I suggest that you stop using it any further. A precancerous condition called Erythroplakia needs to be excluded and I would strongly insist that you visit a dermatologist, get it examined and remain under periodic follow up with him.

Hope that helps.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prof. Kunal Saha (16 minutes later)
I have another dentist appointment in 2 months. Do you think I should get it checked sooner?
doctor
Answered by Dr. Prof. Kunal Saha (1 hour later)
Brief Answer:
Dentist unlikely to be able to help. A sooner appointment with a different doctor suggested.

Detailed Answer:
Thanks for writing back.

I do not think that a dentist would be able to help. You need not reschedule the appointment with your dentist.

Rather, I would insist you to schedule a differnt earlier appointment with a dermatologist or a ENT doctor (otorhinolaryngologist). If that is going to take long, you visit the ER or can schedule an appointment with a general physician.

Hope that helps.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha (4 days later)
I visited my regular doctor and she was not concerned about the below. She thinks it may just be irritation from my mouth guard or I may be biting my tongue at night. I am still concerned though about oral cancer. Any other signs I should be watching for? I know that catching it early is important and if my doctor misses something I would like to know what to look for.

Your reply:
But, I would request you to be cautious about the lesion on the side of your tongue. If you have already used Qvar for more than a week, I suggest that you stop using it any further. A precancerous condition called Erythroplakia needs to be excluded and I would strongly insist that you visit a dermatologist, get it examined and remain under periodic follow up with him.
doctor
Answered by Dr. Prof. Kunal Saha (13 hours later)
Brief Answer:
You must not be oblivious of whether you could be getting tongue bites

Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.

You need to understand that there is some difference between examining directly as well as looking at an image. If it is due to inadvertent bite at the side of the tongue, you know for yourself whether you are getting such bites. Moreover, these should gradually heal up. If it does not, you need to look out whether it is spreading. If the lesion is spreading, it can be regarded as an alarming sign. In any case, I would not advise continuous use of Qvar.

In case, you land up in a confusion about oral cancer, there is always scope for a second opinion by visiting a doctor directly.

Hope that helps.

Regards
Dr. Kunal Saha
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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What Causes Swollen Tingling Tongue?

Brief Answer: Could be due to vitamin B deficiency, Kawasaki disease, or Scarlet fever Detailed Answer: Thanks for asking on HealthcareMagic. Red raw looking tongue ("strawberry tongue") could be caused due to a vitamin B deficiency, Kawasaki disease, or a strep infection (Scarlet fever). Had I been able to take a look, I would perhaps have been better able to comment. There is an option to upload pictures and reports on this page. Can you upload good quality pictures of the affected area. Qvar contains beclomethasone which is supposed to reduce inflammation. It is right to be applied. But the underlying cause needs to be identified and treated. Hope that helps. Regards Dr. Kunal Saha