Injuries and wounds of the tongue (cuts, biting, burns): how to treat and how to avoid

Tongue traumatism: theory

Before you begin treatment of the tongue, you should carefully study the nature of the injury and its causes.

Mechanical impact

The first type of damage - mechanical - is the most common cause of tongue injuries. Due to mechanical damage, ulcers and superficial erosions form on the tongue.

Conditions under which mechanical injuries occur are of a domestic nature:

damage to the integument by dental instruments - probe, bur, disc;
the occurrence of a wound under the influence of a sharp object - a bone, a knife, a fork;
biting the tongue while eating, epileptic seizure;
the appearance of tongue injuries from blows to the face.

Healing of a wound caused by mechanical impact occurs depending on the depth and area of damage to the mucous membrane.

Chemical burn

Chemical injury to the tongue, as the second type of injury, occurs due to contact with the mucous membrane of a chemical substance of an acidic or alkaline nature.

Under the influence of an irritant, chemical burns occur on the tongue. The latter are characterized by the appearance of dark-colored areas, scars, blisters and blisters on the tongue (in severe cases).

Instant rinsing of the mouth with solutions with neutralizing properties is the key to rapid restoration of the integument.

For chemical burns, it is preferable to seek help from medical institutions.

Painful influence from the outside

Damage to the mucous membrane by steam, hot water, fire, electric current or ionizing radiation is called physical trauma to the tongue.

Characteristic of this type of injury is pain that gradually subsides from the moment of injury.

The main danger of physical injury is the development of acute catarrhal glossitis (inflammation). Consultation with a doctor in complex stages of injury is mandatory.

Deep damage to the tongue caused by various kinds of external irritants can be accompanied by complications: abscess or phlegmon of the tongue.

Painful swelling and accompanying difficulties with swallowing and speaking are symptoms of an abscess. In later stages, with increasing inflammation of the tongue, the abscess turns into phlegmon. The victim requires emergency hospitalization and surgical intervention.

Glossitis - symptoms and treatment

Folded or scrotal tongue. The term “scrotal tongue” comes from the external similarity of the affected tongue to the skin of the scrotum (from the Latin scrotum - scrotum). With this form of glossitis, a deep central groove runs along the back of the tongue with adjacent cracks and folds, which can be located longitudinally or randomly. The tongue is slightly enlarged [5]. Due to atrophy of the filiform papillae, it may look “smoothed out”, but this does not affect the taste sensation [16].

Diamond-shaped or median glossitis. This is a chronic disease of the mucous membrane of the tongue with partial or complete absence of filiform papillae closer to the posterior third of the tongue. The lesion has a diamond shape, a dense texture and a red varnished color. Usually it has clear contours and does not protrude above the mucous membrane. The lesion does not cause pain, but some patients perceive it as an aesthetic defect.

Other forms of rhomboid glossitis are less common - with tuberous outgrowths and papillomatous growths. The patient then feels the presence of a foreign body on the tongue [5][16].

Desquamative or “geographical” language. With this form of glossitis, the keratinization of the tongue is partially disrupted with signs of desquamation of the epithelium - desquamation (Latin desquamo - remove scales). The papillae of a significant part of the surface of the back of the tongue are changed. The lesions take on the appearance of red spots with a diameter of 0.5 cm and desquamated whitish epithelium along the edges. The spots can merge with each other and create a pattern similar to a geographical map.

Patients often complain of pain and burning when eating food or drinks that irritate the oral mucosa, and some of them note a short-term loss of taste.

There are two forms of desquamative glossitis: migrating and fixed [16].

The fixed form is more common with moderate damage to the stomach by the bacterium Helicobacter pylori. The disease is usually accompanied by persistent atrophy and smoothness of the filiform papillae of the tongue. The size and location of the lesions does not change.

The migratory form occurs when the stomach is heavily colonized with H. pylori. Foci of desquamation are up to 2 cm in diameter, their location is constantly changing.

Also, with desquamative glossitis, the tongue may increase in volume due to inflammation of the fungiform papillae, which are located at its root. They reach 0.8 cm in diameter and are covered with a white or light gray dense coating [14].

Black "hairy" tongue. This is a rare lesion in which the keratinized epithelium of the filiform papillae located in the posterior and middle third of the dorsum of the tongue does not slough off. Because of this, the papillae acquire a brown or black color, become stiffer, grow up to 2-3 cm, and are covered with a coating ranging from green and light brown to black [16].

The tongue takes on an unaesthetic appearance, patients complain of the sensation of a foreign body in the mouth and the appearance of a gag reflex [4].

Diseases of the gastrointestinal tract. A sign of damage to the gastrointestinal tract is a grayish-white coating on the back surface of the back of the tongue. There are no pain or any other subjective sensations.

Another manifestation of gastrointestinal tract damage is swelling of the tongue with tooth marks on its lateral surfaces without visible relief disturbances. At the same time, patients may be bothered by constant biting and burning when eating hot and spicy foods. The fungiform papillae located at the root of the tongue may also enlarge. They become bright red and rise above the surrounding tissue. The listed symptoms may accompany gastritis, gastric and duodenal ulcers[5].

With hepatitis A, areas of desquamation appear on the back of the tongue. Due to atrophy of the filiform papillae, the tongue becomes smooth and red. Patients often complain that the taste of sweet and bitter foods has become less pronounced [5].

Liver cirrhosis is manifested by swelling of the sublingual veins, atrophy of the oral mucosa and deepening of the natural folds of the tongue.

Lesions of the pancreas. In acute pancreatitis, the tongue becomes covered with a yellow-white coating, and the filiform papillae increase in size. Patients are often concerned about its dryness and disturbances in taste sensitivity.

In chronic pancreatitis, a secondary deficiency of B vitamins occurs, which is manifested by pain in the tongue and protruding bright red fungiform papillae. The tongue increases in size, becomes smooth and shiny.

Cardiovascular pathology. With hypertension, blisters with bloody contents are often present on the tongue, the so-called “vesical” symptom. They can suddenly appear and burst on their own, damaging the epithelium.

Diseases of the endocrine system. With diabetes, the body is dehydrated, so dryness appears, and the vessels of the tongue become overfilled with blood. A burning sensation occurs and long-healing ulcers form. Very often, symptomatic candidiasis is found on the tongue, especially if the patient does not regulate blood glucose levels.

Insufficient function of the thyroid gland, or hypothyroidism, leads to enlargement of the entire tongue or part of it and swelling, which does not form a dimple when pressed. Due to high cholesterol levels, the tongue is slightly yellowish in color.

Diseases of the blood and hematopoietic organs. With iron deficiency anemia, there is a need to eat unusual substances, such as chalk, clay, as well as a burning sensation and pain in the tongue. It is often pale in color and slightly increased in size.

With Addison-Beermer anemia, which occurs due to impaired absorption of vitamin B12, the filiform muscles weaken. The tongue becomes smooth and as if “polished”. This condition was called “Gunter's glossitis.” Painful red inflammatory streaks and spots appear. The tongue or just its tip turns bright red, and a tingling and burning sensation occurs [5].

Acute leukemia is manifested by ulcers of irregular shapes without clear boundaries with a necrotic coating on the tongue, without rims of hyperemia (overflow of blood vessels) along the edges. Pinpoint and small blood spots and hematomas may also appear on the mucous membrane of the tongue. One of the main symptoms of this condition is heavy bleeding.

Chronic leukemia occurs much less frequently than acute leukemia and lasts longer. Characteristic ulcers and leukemic infiltrates (fluid accumulation) appear on the tongue. At the acute and chronic stages of leukemia, they lead to the formation of ulcerative-necrotic lesions, which are difficult to treat.

Agranulocytosis is characterized by a significant decrease in the blood of granulocytes - a type of leukocyte, “protective” blood cells. The disease manifests itself as non-demarcated ulcers on the tongue and, unlike acute leukemia, an inflammatory reaction around them. Due to decreased immunity and the resulting increased susceptibility of the body to fungal diseases, candidiasis may develop.

Changes in the tongue due to hypo- and avitaminosis:

hypovitaminosis A - dryness of the mucous membrane of the tongue and a tendency to increased keratinization of the skin (hyperkeratosis);
hypovitaminosis C - swelling of the tongue with teeth marks on it; ulcerative necrotic lesions, usually covering a significant surface area of the tongue mucosa;
hypovitaminosis PP causes a disease called “pellagra”, in which peeling of the surface layers of the epithelium occurs and a burning sensation of the tongue, it becomes smooth, shiny and crimson - the so-called “cardinal tongue”;
hypovitaminosis B1 is characterized by pain in the tongue and the appearance of blisters;
hypovitaminosis B2 is manifested by burning of the tongue, atrophy of the papillae and angular cheilitis - cracks in the corners of the mouth [4].

When infected with herpes simplex virus type 1 (HSV-1), patients complain of burning pain in the tongue. Upon examination, a deep crack is visible along its midline with several branches. In their depths there are painful blistering rashes, which over time burst with the formation of erosions.

Burning mouth syndrome. In the area of the tongue there is a feeling of a burn, paroxysmal burning pain, which intensifies with overwork and stress.

Galvanism. Patients experience a metallic taste in the mouth and rawness. Upon external examination, the tongue is swollen, its vessels are filled with blood, “bald spots” of the papillae and bright red erosions appear on its sides [5].

Treatment Basics

As mentioned earlier, treatment for tongue injuries depends on the nature of the injury. While a home first aid kit is sufficient to heal superficial injuries, eliminating the consequences of traumatic factors in case of serious injuries requires, first of all, consultation with a doctor who will select the necessary medications and prescribe recommended procedures.

What to do depending on the type of injury:

The standard method of treatment or initial treatment of mechanical injuries is the use of antiseptics (alcohol, iodine, brilliant green). Rinsing with disinfectants helps in restoring the mucous membrane: furatsilin, hydrogen peroxide, potassium permanganate dissolved in water in a ratio of 1 to 3000 or baking soda at the rate of 1 teaspoon per 250 ml. Do not neglect plant decoctions with calming properties.
Knowledge of chemical neutralizing reactions will be useful in case of chemical burns , because the “golden rule” of first aid for this is as follows: rinse with a neutralizing solution. Timely implementation of the necessary procedures will avoid further treatment. Blisters appearing on the tongue indicate severe damage. Opening of formations with subsequent processing should only be carried out by specialists. After neutralizing the blisters, doctors most often prescribe rinsing the mouth with disinfectants.
Profusely bleeding wounds require immediate tamponade. It is unacceptable to independently remove foreign bodies from ulcers.

Biting your tongue - everyone knows this

Biting the tongue, cheek or lip is accompanied by painful sensations, as damage to the mucous membrane occurs.

Obviously, the initial goal after a bite is to reduce pain. So, what should you do if you bite your tongue, what and how to relieve pain and inflammation?

The main rule is to remain calm. Calm down and try to come to terms with the pain, because tantrums and tears will not help heal the damage.

And then you should do the following:

Be sure to stop bleeding , if any. An elementary solution would be to repeatedly rinse with cold water: it will help narrow the blood vessels and reduce bleeding activity. A worthy alternative would be a piece of ice.
Cotton swabs soaked in 2% Lidocaine help in the fight against painful sensations . Another variation to reduce pain is eye drops with an anesthetic - Tetracaine, Alcaine.
It is important to disinfect the entire oral cavity : brush your teeth thoroughly and rinse your mouth.
Maintain regular rinsing : it is advisable to wash away the remains of eaten food after each meal.
Use antiseptics such as Antiangin, Trachisan, Furacilin in the form that is optimal for you: spray, lozenge or solution.
Avoid eating rough, cold or hot foods . During the restoration of the oral mucosa, it is advisable to create a daily menu of liquid soft foods at medium temperature: purees, soups.
Avoid cold foods - ice cream, frozen juice and other foods with temperatures below zero - they slow down the healing process.
Take a course of vitamins to help restore damaged areas. The optimal solution would be to include vitamin C and group B in the diet.

Do not forget to adhere to sanitary and hygienic measures: do not reach into the oral cavity with dirty hands, do not put pressure on the resulting injury.

Never pour iodine or brilliant green or peroxide into a wound: give preference to treating the environment around the injury. Antibiotics can only be used as prescribed by a doctor.

In practice, there are cases of tongue biting. In such a situation, it is important to remain cool, act quickly and in an organized manner: place the “particle” in a bag filled with ice and go to the hospital. To relieve painful sensations, it is permissible to ingest cold food: suck ice cream, frozen juice, ice, drink water.

Causes of injury

The lining of the oral cavity is very delicate. Even a slight impact violates its integrity. Any damage leads to infection. The severity of the damage, as well as the clinical picture, depend on the strength of the impact and on the characteristics of the body. The most common type of damage diagnosed is mechanical. Constant injury to the cheek by teeth is dangerous. Based on the depth of the lesion, the following types of pathologies are distinguished:

Hemorrhage inside tissues, that is, hematoma, when their integrity is not broken;
Erosion after injury;
Decubital ulcer;

Most often, erosions occur in irregular shapes. They are covered with a thin whitish-yellow coating. Ulcers, as a rule, are single, there is no swelling around them, they become moderately painful. Their bottom and edges are covered with a fibrinous film. The usual localization of ulcers is the inner side of the cheeks, tongue. With prolonged absence of therapy, their bases and edges become denser. Common causes of damage:

In babies in the first months of life, the mucous membrane is affected due to premature eruption of the masticatory organs. Since their dentin, the enamel layer, is underdeveloped, the frenulum, the lower part of the tongue, is injured when sucking. Disruption of the epithelial layer causes inflammation.
Biting lips and cheeks after anesthesia form abnormalities. In addition, children are often injured by stuck plates of apple cores.
People with increased nervousness may bite their cheeks, tongue, or lips. They often bite pencils and pens.
The provoking factor for injury may be the sharp edge of the crowns.
Damage occurs from overhanging edges of fillings, from wire splints, from ligatures, from wearing orthodontic systems.
Mechanical damage occurs in people who wear improperly installed veneers.
Accidental biting occurs when eating in a hurry.
Patients often consult a doctor with occlusion problems, carious cavities, and dilapidated crowns.
The causes of injury include chips, fractures of masticatory organs, and remnants of roots.

The oral cavity in children can be damaged by sharp toys, household items, and exposure to various bad habits. Defects occur during coughing, when the tongue is pressed tightly against the sharp parts of the lower units.

Traditional medicine at the service of the people

Here is a selection of recipes for solutions, the use of which will help disinfect, heal wounds and reduce pain:

A decoction of bedstraw helps to cope with tongue pain . Brew 1 tablespoon of dried herb with boiling water, leave for half an hour, strain the resulting mixture. The decoction is suitable for both rinsing and internal use.
Sage tincture is an assistant in the fight against pain during the treatment of oral injuries. By brewing 2 tablespoons of the substance with half a liter of boiling water and letting the infusion “rest” for 30 minutes, you will get an excellent antimicrobial and anti-inflammatory medicinal drug. Rinse frequency: 5-11 times a day.
Pour 1 tablespoon of chamomile 250 ml of boiling water and let it brew. Use the strained solution after meals and before bed to heal wounds and relieve inflammation.
St. John's wort tincture is a panacea for pain caused by a tongue injury. Use 40% alcohol and dried herb in a ratio of 5 to 1, respectively. Add 30-40 drops to 250 ml of water and rinse your mouth.
Finding potatoes in a cellar or drawer is not difficult, but peeling them is a matter of two minutes. Feel free to use sliced raw vegetables to relieve pain from burns.

Oral diseases (glossitis)

Glossitis is an inflammatory disease of the oral cavity that causes changes in the surface of the tongue. The tongue turns red and swells; A white coating, a burning sensation, and growths appear. There are more than 10 types of glossitis and only three of them are characterized by the appearance of cracks on the surface of the tongue.

Folded glossitis.

A congenital anomaly that is determined immediately after birth. Characterized by the presence of cracks of varying depths. Normally, they do not cause discomfort.

Diamond-shaped glossitis.

The affected area is diamond-shaped and has cracks in the middle of the tongue. Most often appears with gastritis with low acidity.

Desquamative glossitis.

It is sometimes called “geographical” because the lesions resemble the outlines of continents. Damaged areas can “move” on the surface of the tongue, almost always causing pain, burning, and shallow cracks. The reason for the appearance of such glossitis is still not clear. Some argue that this is an allergic reaction, others that it is a hormonal imbalance and gastrointestinal diseases.

The best way out is to avoid injury

Statistics show that most tongue injuries are mechanical in nature, which, in turn, is evidence of negligence. To avoid damage to the oral cavity, follow these simple rules:

do not get lost in thoughts while eating;
When eating, do not be distracted;
do not talk with your mouth full of food;
Chew your food thoroughly and slowly.

Often the cause of wounds is a malocclusion or unsuitable dentures. An improperly growing or filed tooth also poses a risk to the integrity of the oral cavity.

Be extremely careful and remember that it is better to prevent a traumatic situation from occurring than to suffer trying to cope with its consequences. If you observe suspicious symptoms, be sure to seek help from a dentist or ENT doctor.