Dear Doctor,

I develop painful wounds on my tongue especially during cold weather. I was told it is an allergy. I take antibiotics and vitamins and the wounds go away in about a week, but come back. Can I get a permanent cure?

Mugisha

Dear Mugisha,

The tongue though a small part of the body is used for multiple functions like speaking, swallowing. Hence even a small problem over the tongue causes much discomfort. Recurrent painful wounds on the tongue can be due to multiple causes, most common being chronic irritation. This can be due to a lose tooth or denture, spicy food.

Chronic irritation over a time period can also lead to formation of white patches inside the oral cavity including tongue. These patches carry potential risk of becoming malignant later on. Chronic or recurrent infections of the teeth, dental root or gums can affect the tongue causing recurrent sores or ulcers. Infections of the tongue whether bacterial, fungal or viral can also cause recurrent sores or wounds over the tongue. One can have ulcers or wounds over the tongue in secondary stage of syphilis. Those with uncontrolled diabetes or infections like HIV are more prone to develop recurrent infections.

Deficiency of vitamin B.complex can cause ulcers or sores over the tongue. One can have sores over the tongue due to allergy to something eaten or in the atmosphere. It may be part of systemic manifestations of S.L.E.(Systemic lupus erthymatosis) a collagen vascular disease affecting joints and multiple parts of body. Sometimes the tongue may be dry and thickened due to chronic constipation, giving sensation of sores.

Avoiding irritation of any part of oral cavity and tongue, taking a balanced diet which includes whole grains and fresh fruits, avoiding very spicy food, drinking adequate amount of water, maintaining good oral hygiene are measures that can prevent recurrent wounds on the tongue. Any dental problem should be corrected at the earliest.

If recurrent wounds are already present, investigations to find the cause is useful. Treatment of the cause would correct the condition.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital