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Mouth Diseases

Tongue/Taste Bud Problems

08/18/2010

Question:

I have had this problem several times before. I don`t notice anything that links them together such as burning or biting my tongue. However, my tongue will get severely sore to the point where it hurts to touch my teeth or to talk. Underneath the tongue along the veins, it looks like there is a capillary or something that is very swollen with bumps along it that are very sore. Then I will get a random pattern of red, swollen taste buds on the surface of my tongue which are also very sore. Sometimes they will fall off. What could this be? Is it serious? Is there anything I can do to prevent it or treat it?

Answer:

What you describe on the upper (dorsal) surface of the tongue sounds very much like the condition known as transient lingual papillitis. This is a harmless, but annoying, problem. Although a very big name, it essentially refers to the temporary inflammation and soreness that affects the fungiform papillae scattered across this area of the tongue. Fungiform papillae are the normal little bumps on the top of the tongue that people call "taste buds."

These bumps can become notably red or white and are quite tender for one to several days. In the southern United States, these have sometimes been referred to as "lie bumps" - supposedly the person who gets one of these has recently told a lie, and this is their punishment!

While the cause of TLP is not known with certainty, most experts feel that local accidental trauma (rubbing, scraping or biting) is a major factor; however, contact reactions to things like certain foods have also been suggested.

Most people, when their tongue is irritated, cannot seem to keep from rubbing it against the teeth to make it feel better (sort of like scratching an itch); however, this usually makes things worse. Over-the-counter medications such as OraBase or Zilactin can be applied. These materials act like a bandage and help to protect the ulcerated surface of the fungiform papilla.

Lie bumps are not contagious and the discomfort is relatively minor. Typically, these lesions heal within a few days with no treatment. If they do not, then you should be seen by an oral pathologist.

Regarding the area under the tongue, this sounds like you may be describing the sublingual gland or glands, which have a number of small ducts that carry the spit (saliva) they produce into the mouth. An association between transient lingual papillitis and soreness or swelling of the sublingual gland(s) under the tongue has not been described in the scientific literature. Although it does not sound serious, it may be worth having your dentist take a look the next time this area bothers you.

Good luck! 

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Response by:

John R Kalmar, DMD, PhD John R Kalmar, DMD, PhD
Clinical Professor of Pathology
College of Dentistry
The Ohio State University