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Burning Tongue Syndrome

Reviewed meds and side effects, started @ 2 years ago, tip of tongue bald-may be rubbing it on rough lower incisors which he prefers not to crown like the rest of his mouth. Cannot wear night guards he has. Referred to specialist at university nearby-this DDS did 2 rounds of laser on tongue and prescribed anxiety drugs!? I feel this is from chipped lower incisors but wanted to ask this experienced group of hygienists if there is something else to consider? I have been in practice 28 years (general and perio practices), and would love to help this long time patient.



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1 Answer

The balding and pain of the patient’s tip of their tongue could be due to rubbing it on rough lower incisors, but there could be some other reasons. Pernicious anemia, geographic tongue, nutritional deficiency, or even an allergy to oral care products could be causes. Like you mentioned, it could also be burning mouth syndrome which can be caused by underlying medical issues. You mentioned this patient was referred to a specialist- was it an oral surgeon? An ear/nose/throat specialist may be a good referral too. I think figuring out the underlying issue instead of just treating the symptoms is really important here. I would recommend this patient undergo some testing like blood tests to check for certain medical problems, oral swab tests, allergy tests, salivary flow test, biopsy of tissue, or even some imaging tests. I applaud you for caring so much about your patient and I sure hope a definitive diagnosis is made soon!

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