Factors in the development of glossodynia and stages of treatment

General information

Glossalgia refers to diseases of the tongue, as the sympathocomplex has a number of causes: neurogenic, symptomatic, ischemic, caused by local factors. Usually the process is polyethylogical and does not cause morphological changes; it is expressed in the form of paresthesia and hyperesthesia , which are felt as a burning sensation and perversion of taste.
The course is long-term, from several months to several years, and is associated with systemic diseases, psychological disorders or depression .

Very often, the burned oral mucosa is considered exclusively as one of the symptoms of systemic diseases, especially those affecting the nervous system, and through local irritants, glossodynia manifests itself and increases discomfort, leading to relapse.

Glossodynia: what is it?

Pain and other unpleasant sensations in the tongue area occur with glossalgia, or glossodynia. These are two names for the same disease: “gloss” means “tongue” in Greek, and the roots “algos” and “one” mean “pain.” Glossalgia is a functional disorder, without organic changes in the organ; in other words, the functions of the tongue are disrupted, but its structure remains healthy.

It is noteworthy that glossodynia does not occur on its own, but is always caused by a provoking disease or another cause. The main provocateurs are diseases of the digestive and endocrine systems.

The disease can also be caused by:

• diabetes mellitus;
• heart problems;
• cerebrovascular accidents, stroke;
• liver dysfunction;
• drug overdose;
• mechanical damage to the mucous membrane of the tongue due to deformation of the tooth crown, surgery, incorrect filling or prosthetics procedure.

Pathogenesis

Pain localized in the tongue area is not a manifestation of a visible inflammatory process or the result of morphological changes.

The symptom complex of glossalgia is usually caused by damage to the autonomic nervous system, which are formed against the background of chronic somatic diseases of the digestive system, as a result of vascular and endocrine disorders. The development mechanism may be based on:

• allergic reactions;
• action of galvanic currents;
• disruption of salivation (salivation);
• decrease in the threshold for the perception of irritation.

Clinical manifestations

The symptoms of glossodynia are not so pronounced at the initial stage, and therefore it is ignored at first. Patient complaints mainly describe sensations in the tongue area that are close to pain, but they cannot yet be called a full-fledged pain syndrome. These include:

• Tingling;
• Burning;
• Numbness;
• Squeezing.

They may be present constantly or, on the contrary, be periodic. As a rule, these uncomfortable sensations weaken during eating, and intensify during stress or after talking for a long time. Some areas of the tongue may become numb. The greatest manifestation of symptoms develops on the lateral areas and the tip of the tongue.

The symptoms of glossalgia are also characteristic of other pathologies of the oral cavity or psycho-emotional nature. Only a doctor can determine the cause.

If we talk about the general condition of the patient, he is often aggressive, intrusive, or, on the contrary, depressed, immersed in personal problems. At the same time, he clarifies even minor symptoms that appeared from the very beginning of the development of the pathology.

Classification

With neurogenic development factors, burning pain syndrome is called glossodynia . It is an organic pathology of the nervous system and is usually caused by neuralgia , neuropathies of the lingual or glossopharyngeal nerve , ganglionitis of the submandibular or sublingual autonomic node , irritation of pain from the cervical part of the autonomic trunk or functional pathology with sympathalgia , a paresthetic sensory phenomenon against the background of bulbar disorders.

Glossodynia is more common in women over 30. Depending on the form and location of paresthesia, they are distinguished:

• mucosal glossopharyngeal form of glossodynia - concentrated on the root of the tongue, pharynx and cervical region of the esophagus;
• dermatomucosal form - when not only the oral mucosa is burned, but also the skin of the face.

Glossalgia is a particular manifestation of stomalgia , a disease manifested by constant pain and paresthesia of the mucous membranes and organs of the oral cavity. The burning sensation spreads not only to the tongue, but also to the palate, gums, mucous membranes of the cheeks, and throat.

Causes

The development of burnt tongue syndrome can be triggered by local factors:

• dental diseases, such as caries ;
• procedures in dental offices - filling, tooth extraction, etc.;
• chronic microtrauma and impaired capillary circulation;
• eating foods that irritate the oral mucosa;
• the presence of metal orthopedic structures and acrylic plastics in the oral cavity;
• pathology of the bite or temporomandibular joints - up to 17% of cases.

The mucous membrane in the mouth seems to be burned, it can be for no apparent reason (idiopathic) or due to systemic factors:

• taking medications that are ACE inhibitors (angiotensin converting enzyme);
• emotional stress and burnout;
• diseases of the digestive system (in 70% of cases), including decreased secretion of gastric juice, chronic colitis, gastritis, peptic ulcer ;
• diseases of the cardiovascular system such as ischemic and hypertension , atherosclerosis , etc.;
• endocrinology problems - disruption of the hypothalamus, decreased levels of thyroid hormones;
• hypovitaminosis;
• liver diseases, for example, hepatitis and cholecystitis, cause glossalgia in approximately 10%;
• infectious ( neurosyphilis ) and traumatic lesions of the nervous system.

Contact Information

Glossodynia is understood as a symptom complex characterized by the manifestation of unpleasant sensations in the oral cavity. Middle-aged and elderly women are more often affected, but recently younger women are also affected.

Causes of glossodynia. There are general and local factors. General: diseases of the digestive system; regular stress, irritability, fatigue; endocrine diseases/diabetes mellitus, thyroid dysfunction/; cardiovascular diseases; insufficient intake of iron into the body. Local: poor-quality dentures and fillings; periodontal tissue disease; difficult eruption, pathological abrasion of teeth; surgical operations in the teeth; pathology of the temporomandibular joint; bad habit of biting the tongue.

Symptoms. Patients complain of a feeling of burning, pressure, tingling - tingling, itching, heat, cold, numbness, crawling in the tongue. The tongue swells, but upon examination no signs of inflammation can be detected. There may be hyperemia or pallor of the mucous membrane of the mouth and tongue, decreased salivation and dry mouth, sometimes replaced by copious amounts of saliva, and impaired taste perception. The development of glossodynia is also manifested by a feeling of awkwardness and heaviness in the tongue. The occurrence of sensations is associated with fatigue, eating meat, talking for a long time, having teeth removed, and eating incorrectly. Typically, these sensations disappear while eating. Patients often examine their tongue in the mirror, so when asked to open their mouth, they immediately show their tongue, sticking it out on the side that bothers them. Patients are very irritable and concerned about their health, suffer from cancerophobia, and are tearful. In the mucosal form, paresthesia is localized at the root of the tongue, pharynx, and cervical esophagus.

The prognosis is favorable, but patients have to be convinced for a long time that they do not have a serious illness, since they are very suspicious.

Treatment of glossodynia. After examination by a therapist, the underlying disease is treated. The patient is examined by a dentist and a neurologist. Treatment for women begins after consultation with a gynecologist. Locally eliminate all irritating factors, dissimilar metals, poorly made dentures and fillings, sharpen the sharp edges of the teeth, and perform sanitation of the oral cavity. Psychotherapy is necessary and sometimes the main thing in the treatment of glossadynia.

No lubrication, especially with cauterizing substances, should be done.

Head of the otolaryngology department A.P. Ivchenko

Symptoms

Unpleasant and painful sensations with glossalgia are hyperesthesia - increased sensitivity and paresthesia - a sensitivity disorder, expressed in the form of burning and tingling sensations. Most often, patients describe the condition as follows:

• mouth feels like it's burned;
• the tongue seems to be sprinkled with pepper;
• it looks like he was scalded by boiling water.

In addition, glossalgic syndrome can cause:

• increased anxiety, sleep disturbances and panic attacks;
• dryness and discomfort in the mouth;
• numbness of the tongue;
• deterioration of diction;
• dulling and distortion of taste sensations;
• feeling of swelling of lips and tongue;
• distortion of smell perception ( dysosmia );
• the presence of a metallic, bitter or sour taste ( dysgeusia ).

Features of pain syndrome

The pain syndrome may differ from patient to patient - for some it is mild, for others it is painful and intolerable.

Important! With glossalgia, symptoms appear closer to the afternoon and may disappear at night and during meals. Pain and burning are usually localized - at the tip, at the root of the tongue, or, on the one hand, sometimes changes its location over time.

Glossalgia: symptoms

Pain and discomfort in the tongue area are the main signs by which glossodynia is diagnosed. Patients complain of burning, numbness, tingling and tingling in the tongue, and these unpleasant sensations go away while eating. As a rule, it burns and tingles on the side and at the tip of the tongue, much less often at the root and on the back of the tongue. Some patients, instead of seeing a doctor and starting treatment for glossalgia, try to drown out the pain by “eating,” which leads to excess weight and even bulimia.

What other signs are used to determine glossodynia?

• dry mouth, desire to wet the throat;
• slight swelling of the tongue;
• dilated veins in the tongue (common in elderly patients);
• increased size of taste buds;
• the appearance of a white or yellow coating on the tongue;
• decreased salivation;
• increased fatigue when speaking.

In addition to language-related problems, patients often experience:

• depressed mood;
• excited or, conversely, apathetic state;
• sleep disorders;
• heartbeat disturbances;
• violent aggression in response to a request to calm down;
• signs of nosophobia, when a person is afraid of getting a serious illness.

A fact that has not yet found a scientific explanation: stomalgia, or glossodynia, occurs 6 times more often in women than in men. Moreover, patients over 40 years of age suffer; in young women, the disease is diagnosed extremely rarely.

Tests and diagnostics

To make a diagnosis of burning tongue syndrome, it is necessary to exclude candidiasis , lichen planus , stomatitis and other infectious and allergic diseases.

After collecting anamnesis data, examination and examination of the patient, it is necessary to conduct allergy tests .

For targeted treatment of gastroenterological and other somatic diseases, it is important to conduct a clinical assessment of the condition of the oral cavity:

• pallor of the integument may indicate suspicion of diabetes mellitus , erythremia and anemia ;
• the presence of areas of desquamation - about intestinal dysbiosis and peptic ulcer;
• hyperkeratosis indicates hepatitis and kidney dysfunction;
• aphthae and ulcers - can be manifestations of Crohn's disease , ulcerative colitis , pathologies of the cardiovascular system.

Prevention

Preventive measures for diseases of the oral cavity and, in particular, the tongue are:

• giving up tobacco, hookah, electronic cigarettes and alcohol;
• daily high-quality hygiene and the use of mouth rinses that do not contain alcohol and toothpastes - without sodium lauryl sulfate;
• visit the dentist at least once a year;
• avoiding microtrauma of the tongue, for example, when using low-quality artificial onlays on teeth (veneers), when shelling seeds, eating food with sharp edges - candies, crackers, chips, nuts, apples with a hard crust;
• following a gentle healthy hypoallergenic diet.

Diet for glossalgia

Diet Table No. 1

• Efficacy: therapeutic effect after 3 weeks
• Terms: 2 months or more
• Cost of products: 1500 - 1600 rubles. in Week

At the first manifestations of systemic diseases, such as dry mouth, burning, tingling or pain, it is best to switch to a healthy diet. To make the diet also therapeutic:

• give up pickles, smoked meats, spicy and too sour foods;
• say no to “junk food” - crackers, chips, cookies, candies and street products - shawarma, hot dogs, junk food - semi-finished products, sausages, bakery products;
• do not eat too cold or too hot foods;
• Enrich your diet with fruit drinks, compotes, vegetable purees and pureed cream soups.