Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

PAIN: Tongue

It's 3:00 P.M. on a sunny Friday and you're beginning to think about your plans for the week-end as your dental assistant seats the new patient. She is there because her tongue is in constant pain and tells you that, unlike the three previous dentists she had seen, who could not help her, she knows you will be able to because of your exceptional reputation.

WHAT DO YOU DO? If your examination does not demonstrate any likely explanation for her pain, you may suggest the patient wait a few more weeks, or you may choose to refer her to a specialist. This suggestion serves several practical purposes. 1.) The absence of any obvious source of the pain typically reduces the patient's anxiety. 2.) It provides the patient with a plan of action to be followed should the pain continue, and 3.) Should the symptoms not improve, the specialist may have more insight as to the cause of the symptoms.

Many conditions, both local and systemic can cause tongue pain. Usually patients with macroscopic symptoms are quite easy to manage, but treatment becomes more complex when symptoms don't improve. There is now evidence to support a relationship between the incidence of tongue pain and serum concentrations of systemic disease, Vitamin B12, zinc, folic acid, and copper deficiencies.

In a study I recently reviewed involving more than 300 patients with a chief complaint of tongue pain the following results were categorized:

 Hyperlipidemia 17%  Hypertension 6%  Zinc deficiency 10%
 Gastric Ulcer 16%  Cerebral Infarction 6%  Vit. B12 deficiency 2%
 Angina Pectoris 13%  Leimyoma 5%  Folic Acid deficiency 2%
 Diabetes Mellitus 10%  Anemia 5%  Copper deficiency 0.3%
 Thyroid Disease 10%    
 Mental Disorder 10%    

If your patient's oral examination does not reveal an obvious source of pain, you may consider calling the patient's primary care physician and discussing the possibility of one of the medical conditions listed as a possible cause of her tongue pain. Placing this call may help your patient as well as confirmed her belief that your exceptional reputation is deserved.

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍