Tongue diagnoses
Tongue Laceration
- Secondary to tongue biting
- Serious injuries can cause hemorrhage and potential airway compromise
- Do not need primary repair unless >1 cm in length, widely gaping, involving tip, or large hemorrhage
- Use absorbable sutures
- Anesthesia of the anterior 2/3 of the tongue is obtained through an inf alveolar block
- Chlorhexidinemouth wash to prevent infection
Strawberry Tongue
- Hypertrophied lingual papillae,initially with white exudate
- Ass'd with scarlet fever and Kawasaki's disease
Black Hairy Tongue
- Benign reactive process
- Hyperplasia and increased pigmentation of filiform papille
- Smoking, GERD, Abx, poor hygiene predispose
- Treat with improved oral hygiene, gentle brushing, and a reducing pigment intake
Oral Thrush
- Candidal infection
- White curd-like plaques, easily removable with erythematous base
- Usually painless
- Risk Factors:
- Extremes of age
- Abx
- Immunocompromise (AIDS, immunosuppressants)
- Treatment
- Nystatin oral suspension 500,000 units (swish and swallow) QID OR
- Clotrimazole 10mg troches 5x per day OR
- Fluconazole, 100mg PO
Tongue Swelling
- Differential includes trauma, angioedema, other conditions listed
- Angioedema is true emergency, suggested by face,lip, and tongue swelling
- Hereditary,allergic (ACE), or idiopathic