Tongue disorders

From olden days, the world of medicine has treated tongue as a diagnostic tool (traditionally as well as scientifically) to know the body’s health status. Tongue is the first platform in our food track. Cleanliness and its perfect functioning are very essential in the food journey. Even though tongue can reflect changes in internal health status with variation in colour and texture, usually no one goes for treatment for just colour or texture changes. Commonly, a layman becomes aware of the tongue when one feels an altered sense of taste for things that used to taste good or when there is a disgust for food or when the tongue is sensitive to even mild spicy / hot foods or while having sores or ulcers in the tongue with redness and swelling or when they have bad odour of mouth.

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Tongue problems can be functional and structural. Functionally, it will be associated with pain, taste and movement. Structurally, it will analysed by size, shape, colour, moisture, papillae, coating, ulcers, venous engorgements, swelling, deformities, extra growth, etc. Tongue problems can affect tongue functions on the whole or in some functions / places – for example - ulcers in tip of tongue, tumours in the base or bottom, coating in dorsum of tongue (in anterior part or in posterior part or in both). Common tongue problems are ulcers, coating and discolouration. Tongue usually looks different in colour and texture for different diseases. Most often, it seems to have white coating with cold or flu or indigestion or with other diseases. Tongue commonly gets discoloured or coated or disfigured in case of poor oral hygiene, nutritional deficiencies, fungal infection, weakened immune system (AIDS, cancer and auto immune disorders) and their treatment (like chemotherapy, radiation, etc.,).

Functional complaints

• Pain (due to injury, nervous disorders, pressure of tumour, obstruction of blood vessels, vesicles, eruptions, ulcers)

• Altered or loss of taste – Hypogeusia, Dysgeusia

• Numbness – in Bell’s palsy, paresis, paralysis

• Movement disorders – tremors (nervousness, stammering, delirium tremens, Parkinsonism), paralysis, tongue tie, etc.

Structural complaints

• Small tongue – Microglossia – hypothyroidism, Down Syndrome

• Large tongue – Macroglossia - acromegally, myxoedema

• Swollen tongue – allergy, injury, tumours

• Inability to move due to short freneulum / tongue tie / ankyloglossia

• Haemangioma / lymphangioma / Ranula (tumours of tongue)

• Discolouration and coating of tongue – Anaemia, flu, glossitis, Lichen planus, syphilis, leukemia

• Ulcers or sores or eruptions or vesicles– pellagra, pernicious anaemia, leukemia

• Deep grooves / furrows / ribs / wrinkles in tongue – hairy tongue, syphilis

• Dryness and shriveling of tongue – due to fasting and diseases

Causes – In most of the tongue disorders, causes are often found to be unknown. Tongue problems can occur due to the following reasons.

External factors

• Poor oral hygiene

• Unhygienic foods and nutritional deficiencies

• Infections and inflammations (bacterial or fungal or viral)

• Mechanical injuries from any hard food substances, sharp edge teeth, dentures, etc.

• Chemical reactions from preservatives and colouring pigments

• Strong chemical toothpaste / mouthwash.

• Very hot drinks / foods

• Foods containing excess spices, salts and chilli, likewise strong, sour foods / fruits / juices too

• Habit of smoking cigarettes, tobacco chewing and drinking large quantities of alcohol

• Drugs - heavy antibiotics and pain killers

• Treatments given for weakened immune system (chemotherapy, radiation therapy, strong chemical drugs, etc., especially in case of AIDS, cancer and auto immune disorders)

Internal factors

• Mind - stress, anxiety, tension, worries

• Deficiency of vitamins, minerals and zinc

• Weakened immune system and diseases - systemic lupus erythematosus, AIDS, cancer, tuberculosis, diabetes

Diagnosis – On ruling out external causes (heavy smoker, tobacco chewer), tongue problems should be investigated all the way with routine blood and urine analysis. If necessary, ultra sound scan or CT scan for abdomen or endoscopic procedures should be done when there arises a suspicion of digestive tract involvement. Other important tests which can guide for diagnosis are

• Scraping and culture – to identify Candidal fungal or bacterial infection

• Biopsy – to diagnose cancer

Complications

• Disgust for food / drinks

• Affects general health by blocking nutrition supply (food intake)

Prevention – To avoid tongue problems, maintain oral hygiene with good and nutritious diet.

Take

• Nutritious diet (especially fruits, vegetables and greens)

• Plenty of water before and after meal

• Take right medicines in right dosage from right doctor in case of any disease

Use

• Tongue scrapper gently whenever there arises a need

• Mild toothpaste and mouth rinse / wash

Avoid

• Habits of smoking, drinking and chewing tobacco / Betel nut

• Strong toothpaste or mouthwashes

• Drinking aerated drinks, coffee and tea often

• Tin-packed or preservative-added foods / snacks / toffees

• Unnecessary medications, especially pain killers and antibiotics, for prolonged period

• Self medication

• Drug cocktails, like adding a pill for each complaint or symptom / mixing variety of medicines from variety of doctors.

• Foods containing excessive amount of spices, chillies, pepper and pickles

• Getting injuries from sharp teeth / hard brushing / hard bristled toothbrushes and dentures.

• Dentures at night.

• Very hard food substances / snacks which may cause injury
  Tension and hurried life

General treatment – The treatment point of view usually differs according to various tongue disorders and nature of complaints. It also varies from person to person and disease to disease. In general, when there is infection, the required antibiotic / antiviral / antifungal tablets will be prescribed. In addition, antibacterial mouthwash and gel will also be prescribed to combat infection and pain. Unless otherwise there is infection (bacterial or viral or fungal), modern system usually prescribes only vitamins and minerals with advice for good nutritious food intake.

In case of inner diseases which reflect its nature through tongue disorders / discolouration, the core of the disease / cause will be targeted with proper treatment. When the cause is unknown, treatment seems to be out of our hands and the doctors will prescribe just vitamins and minerals again with gel or external applications as supportive management and rarely steroids will be prescribed. This will provide only temporary care or betterment (suppression of disease).

Homeopathy treatment – Even though tongue is used as a tool to diagnose the disease and to aim for treatment in the modern system of medicine, it is given less importance in treatment - once they have corrected the problem, they won’t care to get the tongue back to normal - for example in case of anaemia, once they correct the haemoglobin level, they won’t care for correcting the smooth, glistening, ulcerated tongue. Here, they will let the curing process take its time. But in Homeopathy, the tongue plays a major role in individualisation of patient, selection of medicines and analysing the complete cure.

In Homeopathy, there are lots and lots of medicines for tongue disorders, discolouration, disfigurement, etc. It will act to the core of the disease and clear the tongue problems simultaneously. The drugs prescribed on the basis of individualisation help in treating the patient as a whole. Even in case of incurable diseases where the cause is unknown, Homeopathy can treat the patient in a better way with tongue indications and characters. For example – thick, milky coated tongue calls for Antim crudum medicine, Mapped (geographic) tongue calls for Nat mur, smooth flabby tongue with imprints of teeth in edges will call for Merc sol, smooth red cracked tongue calls for kali Bich, no thirst in spite of dry tongue calls for Pulsatilla, etc.

In total, Homeopathy aims at normalcy (cure) in every way and in every aspect.

(To be continued)