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