Tongue Problems - Please help

[andy75]

I have a quick question for members on the forum and would appreciate your response.

A few weeks back, I seem to get a feeling that my tongue was "cut", it looked bumpy from couple of places. I dont take any medicine, but was going through a period of high annxiety/stress. Dint get anything else in my mouth, lips or cheeks. At the same time I was having tongue troubles I was having some burning/pain like sensation that extended from my thoart and went all the way down till where my throat ends. It was worse sometime and OK at other times. This too went away on its own after some time and the tongue also felt better in a couple of days. I am wondering if someone can tell me what could be going on?    

What is worrying me now is that the tongue seems badly "cut" again (near the tip of the tongue) from 2 places (close to each other). I got some burning like pain for sometime but felt OK other times. I looked at my tongue and there is a very mild white coating that is not coming off. It seems worse towards the end of the tongue. I can also see some bumps, but they dont pain. Despite all this I dont have any canker sores in my mouth or any other symptoms anwhere in my body. Its been more than 2 weeks and the cuts dont seem to be getting better. I was wondering if someone can help and let me know what is going on. I cant seem to find a good source to solve this.

Is this Thrush? Or is it Stomatatis? What is it?
Are there any tongue issues related to stress?
Finally, please tell me when someone says "oral ulcers" as a means for clasifying symptoms, do they include tongue issue or not?

Thanks for your help

[scottma]

Oral surgeon is capable of making the diagnosis of fiiured tongue. I do'nt think there is a correlation between fissured tongue and hiv infection.

[andy75]

hi, i went to the oral surgeon today and his observation was that i have developed a fissured tongue even though i had no history or past observations of it. he examined my mouth and tongue and found nothing else. i also asked him about association of fissured tongue with HIV especially in early stage of the disesae. he said that in absence of other symptoms especially pain in fissures it is hard to see that association. i asked him if there was anything that i could do to heal the fissures and he said that its possible that they may never heal and there is nothing he would advice me to do.

i am a little surpised with his conclusion and wondering if you agree. do you think its possible that i never had any signs of fissure tongue and all of a sudden (with a coincidence that when i am going through the HIV scare) for the fissure tongue to appear? Is that possible?

[scottma]

Herpetic glossit is generally presents multiple discrete vesicles. Without the presence of vesicles, herprtic glossitis is generally not included in the differential diagnosis.Since you have made the appointment with an oral pathologist,I am sure the final diagnosis will be established. I am also specialized in oral pathology, I believe my colleague will take good care of you.

[andy75]

hi, can you please repond to my query. my fissures are not paining but i am getting scared since they resemble the description of herpectic geometric glossitis

[andy75]

Went to the dentist today and he could not detect anything particular ( no thrush or anything else). he referred me to an oral pathologist and will see him sometime next week.

came back home and started surfing the net. came across something called the herpetic geometric glossitis which is found in HIV patients. wondering if this disease shows up as an ealry sign in HIV or in advanced stage of disease. Also what are the symptoms of it? Some of the symptoms seem very familiar to my problem except that I dont have any pain.

[scottma]

vesicles mean small eruptions containing fluid. Please look up medical dictionary to get the formal definition. Some vesiculo-bullous lesions present vesicles first, 24-48 hours later, the vesicles rupture, fluid comes out, and mucosal surface is ulcerated, and an ulcer is formed.not to my know of that there is anything can enhance mucosal healing.

[andy75]

great... can you exapnd on "no vesciles present before ulceration". I am less worried about my ulcers and more worried about the cuts, is there something that I can do for it?

[scottma]

assuming your past medical history is non-contributory other than possible exposure to hiv, No constitutional symptoms present, My working diagnosis would be aphthous ulcer, if there is no vesicle present before ulceration.Topial application of topical corticosteroid preparation on affected area4-6 times /day, for a week,

[andy75]

thanks scottma.

i really apprecaite your interest in my case and helping me out. i am going to wait for a couple more days to see if these cuts become better and then try to take an appointment with an oral specalist.

i dont have any other issues with my overall health except this HIV scare (which is not yet confirmed). as per what i have read and consulted with other HIV specalists i am past the time that most new HIV patients fall sick or develop any health problems. Also this tongue issue is not accompanied with other symptoms. Is there other symptoms that i should be looking for? Also, does the presence of oral ulcer along with my tongue cut any sing of things getting worse?

[scottma]

Opportunistic infection refers to an infection is caught by immune compromised subject, such as diabetes, tuberculosis, hiv,etc.Sorry I can't explain in common verbal language. You are probably aware that English is not my mother tongue.Common things occur commonly. It appears that you have a more complicated past medical history, Comprehensive medical evaluation is advised.

[andy75]

since my troubles are limited to my tongue and i am only within 3 months of my exposure, i dont think i could be getting the opportunistic infections. correct?

also, in the primary hiv stage or ARS, that is 2-4 weeks after exposure, does the broad category of "oral" ulcers include tongue ulcers and tongue cuts also or are they seperate?

finally, just today it seems like i developed my first oral ulcer near the gum in lower lip. its still not full blown, but seems like it can burst open any moment. the cuts dont seem any better, just that they are not paining or burning. do you have any hypothesis of what could this be. is this something serious?    

[scottma]

common oral manifestations of hiv infections are oral ulcers resembling aphthous ulcer,hairy leukoplakia on lateral border of tongue, opportunistic infections such as candida albicans, herpes simplex. If you have an open wound, viruses have an easier access to circulation. Ulcer is certainly an open wound. However, if the ulcer is not contacted by pathogen, systemic infection is not likely to happen. I generally do'nt recommend my patient to use mouserinse, unless mechanical cleaning of tooth is not available. It appears that the ulcer is related to the sharp edge of lower front teeth. However, the healing time is unusual. Comprehensive medical work up is recommended. Seeing an oral pathologist is advised.

[andy75]

the cuts are towards the tip of the tongue. they are 2 cuts running in paralled about 1 inch long eash. i never got blood or anything from the cuts and again as i said they dont pain, an on-off  just a burning like sensation. they are decently deep, so that when i show it someone there reaction is like "ohhh". The only thing that i rememer eating was very hot and spicy chips a day before. Could that be the cause. Can stress cause this. Is this something to worry?

[MedGirl27]

Explain to me what the cuts look like. Is there blood? How big are the cuts? I have had some reaction like that to eating sunflower seeds all night and in the morning got cuts on my tongue. Or eating the ol' skool jolly ranchers that you can shape in to a shiv just by licking them, or sucking on a candy cane so long I actually cut my own tongue with the sharp edge of the candy. That's all I can come up with as far as tongue cuts go. Tell me more. And if you want to talk to me about HIV I am ok with that too, life is crazy some times but theres no reason to make yourself that way in order to cope.

[andy75]

thanks medgirl for the encoragement and kind words. i am indeed planning to get tested and get an answer. need to wait before the window period is over to get a reliable results.

in the menatime, i was wondering if you can address my tongue problems. is stress causing some chemical imbalance that is resulting in cut on my tongue or is this a sign of something serious? my worry is that its not healing up as quickly as i would have wanted/imagined. today, i bought some mouthwash and rinsed my mouth. strangely, even the cuts dint hurt. i dont have any pain in the cut but just a strange sensation which sometimes is OK and sometimes its worse.  please let me know is there is something else that i should be doing

[MedGirl27]

I know some persons with HIV and was there when they were diagnosed. In fact they had no such issues but each person is different. I would definitely go and get that ruled out even though it's scary and seems terminal. It's not. In fact there are people who live their whole lives with the virus and it never turns in to AIDS. Call it similar to diabetes or some other long term treatable illness. I just wanted to address your stress in that area since it seems like you are stressing about it. I would rinse with something like antiseptic as normal and keep my moth extremely clean esp. before bed time so as not to have your mouth stewing in bacterias. My heart goes out to you. Remember it's not the HIV that is bad it's the stigma around it. You won't dies from the virus alone. Stay healthy and eat right.

[andy75]

its been about 2 weeks since i started seeing the cut on my tongue. there are basically 2 cuts near the tip of the tongue right under my front teeth. i have a broken front tooth, but i dont remeber biting my tongue or causing any harm to it. its also the first time that the cuts are that deep in that specific location when my tooth has been broken fro a few years. anyways, the cuts doesnt pain, just an irritating feeling. is this something serious and should consult a doctor or give it some more time and see if it gets better? a couple of days back, started to feel that my front lower lip is becoming heavy. dont see any ulcer so far or anything just a feeling of wetting it with my tongue.

finally, i would really apprecaite if you can tell me if "oral ulcers" assocaited with primary HIV infection be localized to my tongue or are they widespread. also, does trauma of tongue fit the defination of oral ulcers as seen in patients which recently acquire HIV? I had a HIV and need to test to check if I am positive or not (doctors mentioned that my risk was absolutely low).

[scottma]

If oral mucosa is traumatized mechanically or chemically, the wound generally heals up in 10-14days. Allergic reaction may be triggered by foods, not necessarily restricted to spicy food. Once the "cut" heals up, you can test the suspicious food again to verify if it is the culprit.Anxiety/stress may be associated with immune system dysfunction and development of oral lesions. I do'nt know if there is hard evidence to establish the correlations.Candidiasis may cause pain, however, some patients are asymptomatic.

[scottma]

If oral mucosa is traumatized mechanically or chemically, the wound generally heals up in 10-14days. Allergic reaction may be triggered by foods, not necessarily restricted to spicy food. Once the "cut" heals up, you can test the suspicious food again to verify if it is the culprit.Anxiety/stress may be associated with immune system dysfunction and development of oral lesions. I do'nt know if there is hard evidence to establish the correlations.Candidiasis may cause pain, however, some patients are asymptomatic.

[scottma]

If oral mucosa is traumatized mechanically or chemically, the wound generally heals up in 10-14days. Allergic reaction may be triggered by foods, not necessarily restricted to spicy food. Once the "cut" heals up, you can test the suspicious food again to verify if it is the culprit.Anxiety/stress may be associated with immune system dysfunction and development of oral lesions. I do'nt know if there is hard evidence to establish the correlations.Candidiasis may cause pain, however, some patients are asymptomatic.

[andy75]

hi scottma,

thanks again. can this trauma be casued by eating spicy food? i remember eating something spicy a couple of days before i started getting developing the "cuts" on the tongue. Can these cuts be casued by annxiety/stress also? my cuts on the tongue are not causing me any pain right now. Is this normal, but its been about 2 weeks and it doesnt seem to be getting better?

finally, does oral thrush casue any pain?

[scottma]

Tongue cut is genarally caused by rough surface of teeth or by incidental bite. Without the presence of teeth or intraoral device, it's highly unlikely to get soft tissue trauma.oral thrush is an entity caused by candida albicans infection. Stomatitis refers to imflammation of mouth, which is non-specific .

[andy75]

hi scottma, thanks for replying to my posting. i am wondering if you can also tell me the reason why my tongue was cut in the first incident. i am also going through an HIV scare (low risk exposure) and read somwhere that "oral ulcers" are associated with primary hiv infection. since my first incident involved my tongue, i was not sure if what i had with my tongue can be bucketed into oral ulcers?

Also, i have had some tongue cuts in the past, but not as severly as this time. I also dont seem to have cut my tongue from my teeth, so not sure if this is keratosis.

Fianlly, can you give me some leading indicators for oral thrush or stomatis so that i can check for myself...

Thanks

[scottma]

non-wipable-off oral white lesions are commonly frictional keratosis.The source of irritaion is generally sharp edge of tooth.