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Question answered:26/10/07 Warning! this question is over two years old.
Unfortunately, we have been unable to locate much information to answer your question. This is often the case with symptom based questions. This is because much of the medical literature is written from a condition-based perspective.
We found no documents relating to the management of patients with a sore tongue and lingual papillitis.
Wrong Diagnosis has a section on the causes of sore tongue [1], this is too long to reproduce here but can be viewed via the URL below. In addition to that the site has a section “Tongue pain (Algorithmic Diagnosis of Symptoms and Signs)” [2], which reports:
“TONGUE PAIN
Pain in the tongue is rarely an isolated symptom. There is usually a focal or diffuse inflammation of the tongue or an ulcerating lesion. Diffuse inflammation is found in antibiotic glossitis, glossitis of avitaminosis (pernicious anemia), aphthous stomatitis, thrush, streptococcal glossitis, and acute diffuse glossitis. Focal lesions include cuts and ulcerations from trauma, such as the bitten tongue or burned tongue (hot pizza, etc.), or injury from a sharp tooth or jagged dental plate. Other painful focal lesions are carcinoma, tuberculosis, syphilis (often painless), and herpes simplex ulcers. When the tongue is completely normal, trigeminal neuralgia, polymyositis, trichinosis, and calculus of the submaxillary gland should be considered.
DIAGNOSTIC WORKUP
Most lesions will respond to conservative treatment and time. In patients with signs of systemic disease and vitamin deficiency, the workup includes serum B12 and folate level, upper GI series, ANA, and Trichinella antibody titer. Focal lesions that persist should command a referral to a dentist or oral surgeon.”
GP Notebook has a section on sore tongue [3], unfortunately, at the time of answering this question the site is down and so we are unable to report on that. This may make suggestions regarding investigations.
References
1) http://www.wrongdiagnosis.com/sym/sore_tongue.htm
2) http://www.wrongdiagnosis.com/symptoms/sore_tongue/book-causes-1a.htm
3) http://www.gpnotebook.co.uk/simplepage.cfm?ID=13631511
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